208340 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
r ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $75.52
+a CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 208340
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 00803279 28.30 BOTTLED GAS
601 5023990 08182329 10.51 OTHER EXPENSES
651 5023990 801449 26.20 OTHER EXPENSES
1094 4239012 8181566 10.51 SAFETY SUPPLIES
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY �cusTOMER: 0785 PAGE: 1
BIE P.O. BOX 78588 INVOICE 00803 _ORDER: 01. 608420 00
INDIANAPOLIS, IN 46278 -0588 I INV DATE: 04/1.3/1 ORD DATE: 04/13/12
317 290 -0003
SAL 000 T ERR: 007
r BRANCH: 009 INT: TRM
P /O:
I N ^;`P 3 C
SHIP VIA: W:i.] 1 Call
RELEASE u:
B S
I CARMEL STREET DEPT 11 CARM :L• STREET DEPT
3400 W 131ST ST F 3400 W 131ST ST
CARMEL IN 46074 CAilMi;1T, TN 46074
T T
O O
INVOICE AMOUNT: 28.30
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
-ITEM PRICE-
Location: sQT?a._.L- T DESCRIPTION UOM UNIT AMOUNT
P RICE Location: D
CD 50 j 1 Oj 11 0 CARBON DIOXIDE, 2.2 CYL J 19.845 19.85
UN1013
50CF 39.6900/100CF
!FSCFUEL SRCHGWC 1 OI TEMP DIESEL SURCILARG W/C EA 4.50 4.50
j HMCHAZ MAT CHG 11 01 HAZARDOUS MATERIAL C!1ARG!? E A 3.95 3.95
°•,.,t.ota]. i 28.30
I
TOTAL CYLINDERS SHIPPED:
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visit us at facebook or on the
web, at www.indianaoxygen. om
,Taxa amo :0.00
CARMEL STREET DEPT CUSTOMER: 0785. 20.30
3400 W 131ST ST INVOICE: 00803279
CARMEL IN 46074 INVOICE DATE: 0
ORDER: 01608420 -00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/13/12 00803279 $28.30
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
C
VOUCHER N WA RRAN T NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$28.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 I 00803279 I 42- 311.00j $28.30 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thurs8ay,/Apr"il 19, 2012
Street Commissioner/
Street ritre
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Ih! .BECINNINC- ENDING LEASED Rpi �f1AYS CYLINDER EXTENDED
yP ITEM iiJbviCE CATS 'INVOICE BALANCE it ?PE.^. RETURNED BALA NCE CYLINDERS RATE AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .339 10.51
Purchase
rn(
D;�acripfior I
P.O. �;7— F) or F
G. L. I bfi y
Bucket
Line 'Jescr i AP 0 i3
Purchaser_ Dale
Approval Date Y.
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1 TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 10.51
TOTAL
1411 E. 116TH ST. INVOICE: 08181566
CARMEL IN 46032 INVOICEDATE: 03/31/1 -2
TOTAL CYL VALUE: 100. 00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
154252 Indiana Oxygen Company Terms
P.O. Box 78588
Indianapolis, IN 46278 -0588
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/31/12 8181566 Rental of oxygen tanks Mar'12 30205 10.51
Total 10.51
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278 -0588
In Sum of
10.51
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1094 8181566 4239012 10.51 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
19 -Apr 2012
Signature
10.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
r,Ll oC JCIVU IVI'f VoI vvi In Iuom r A i mt::iJI
INV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED .RETURNED ENDING LEASED ggUDAYS CYLINDER EXTENDED
.P. BALANCE BALANC C YLINDERS RATE. AMOUNT
ALY ACETYLENE 1 0 0 1 1 0 .379 .00
MIX MIX GASES 1 0 0 1 1 0 .339 .00
NIT NITROGE 1 0 0 1 0 31 .339 10.51
OXY OXYGEN 1 0 0 1. 1 0 .339 .00
SHP SMALL HIGH PRESSURE 1— 0 0 1— 0 0 .339 00
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I TAX: .00
CARMEL WATER CUSTOMER: 12598 TOTAL lo, 10.51
3450 W 131ST ST INVOICE: 08182329
CARMEL IN 46074 -8267 INVOICEDATE: 03/31/12
TOTAL CYL VALUE: 12 0 0. 0 0 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 4/16/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/2012 08182329 $10.51
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date O fj& r
VOUCHER 114299 WARRANT ALLOWED
154252 IN SUM OF
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
08182329 01- 6360 -03 $10.51 i
Voucher Total $10.51
Cost distribution ledger classification if
claim paid under vehicle highway fund
PLEASE SEND TOPPORTIGNWiTHYOURPAYMEN I----
ITEM I ATY Q T Y DESCRIPTION UOM UNIT AMOUNT
iIP'D TO PRICE t
Location: D
CR030018X1 1 0 300 1/8 X 1# PKG F.C. AI,UM:I.NUM L13 26.20 26.20
I
RE300 -EOPP 3001/8X1
i
Subtotal 26.20
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Visit us at facebook or oa the
web at www.indianaoxygen. om
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Taxable am ount:, !0.00
CARMEL WASTEWATER CUSTOMER: 160')2 AMOU O ICE N T 26.20
THIS INV
760 3RD AVE. SW INVOICE: 00801449
INCLUDING TAX
CARMEL IN 46032 INVOICEDATE: 04/06/12
ORDER: 01605 -00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 4/16/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/2012 801449 $26.20
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date fficer
VOUCHER 117151 WARRANT ALLOWED
154252 IN SUM OF
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
801449 01- 7202 -06 $26.20
Voucher Total $26.20
Cost distribution ledger classification if
claim paid under vehicle highway fund