211618 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 355856 Page 1 of 1
ONE CIVIC SQUARE AIRGAS MID AMERICA CHECK AMOUNT: $67.27
CARMEL, INDIANA 46032 PO BOX 802615
ow�o CHICAGO IL 60680 CHECK NUMBER: 211618
CHECK DATE: 811 412 01 2
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9007538421 67 . 27 MATERIALS & SUPPLIES
TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL 800-727.0693
ORDER NO :>. INVOICE.No. IINVOICEDATE1 SOLD TON . $OLD.TO NAME
1006687327 9007538421 08/01/2012 1813998 {CITY OF CARMEL SEWER
PO/RELEASE BRANCH SHIP VIA PAYMENT.TERMS ORDER DATE
DEPOT CARMEL WELDING S112 OTHER NET 30 08/01/2012
DELIVERY NO./ QTY CYLINDER
DESCRIPTION MATERIAL NUMBER UOM pTY-8!0_ UNIT PRICE UOM AMOUNT
:... ....
0054010120 OX 20 1 CL 1 1 22.05 CL 22.05 N
OXYGEN INDUSTRIAL 20 CGA 540 (Vol: 1.9.000 FT3)
0054010120 AC MC 1. CL 1 1 38. 97 CL 38. 97 N
ACETYLENE IND MC CGA 200 (Vol: 8.000 FT3)
Product Surcharge 0.50
Sale subtotal: 61.52
Hazmat Flat Rate 5.75
.AMOUNT :: 67.27
SHIP TO:1778561
irgs. CITY OF CARMEL SEWER
www.airgas.com 130 1ST AVE SW AIRGAS USA, LLC
Airgas USA,LLC CARMEL IN 46032-2009 ACT. NO. 8606074182
PO Box 9249 PNC BANK,ABA NO.031000053
Marietta, GA 30065-2249
$EL-001000 Page 1 of 1
Disclosure
'{Sale: euch siik,of Goods mowvi,;�suyonmrga = is ar,,d sh,,il/,°governed uvtr,�mms and omm^oa"n"his mm rcms o.- lc
:~ ,'^^:^wn//muwn(if^,°has beet)'mxvlo!eu),and fx,Ttn`*o/aalemunum /,/�°�ov the�e,n^'x�./�)-
ca�co�m�m^me�'���ou�m���*��oe ae�r^,mau�/��m:o�+lsvanaoma ��*Tecrsasz*./ i;ivaialoe, *.:me
ovu.�",yam/ms being cvm.their price delivery terms,and ail other special 'Goods"refesto any items of romnra/.--'axvuoscri:eu'np omvau
,)rouarwisevmvdod/vewleimauye.
m,j Responsibility This document m.o\w:mr'ota|numoar^/nvonunm o /a,* ux'uxa�/u ^ *nteuo'
uus�we��a�wx:hs��x�omem����m��s��u����mmam�h���date shown.Tx~ �pnm*a',
m*, 11US chargec ue
'mpuuoreu correct for ao contractual n^poseouetwe :sunzanuu,xo,onless reports m Seller m writing opyenz3 Buyer claims /au days orz,,hcn^mhereof,
aw;aVmesmnunt!nv,,'r pay rent v./all m:/nrlurs charged/oovvo,until av�c,has either(/}mmmm such cylmuo,o`"aun*.n good^r-k/',,�uri",o,(u aeov,/xe
coumelo":,
�u��:R«�mp�woo�, yo�muio remuomr qwrvi�m shall remain th�.pron rwmmmos",nsm/rc-pmr* Such nxxc*o,,ao not be C-lxmmr
*'prp"scnomermu"o.osuranoofnuon,yuucy purchased nrmAimaou'/'-(-,%/cv'w and mmamam.,ucertaw Cases/v�, efrWemrt�z), .-;cn^finebm L*
smj*.tw as esubfi,,J�od by Airgas front lime mmno xiTgu °m 'efuu the uu/xvm fee when m,o'u" m/mums*v.�:, oyl;pdel'(,'°a'`o
n*�*��nmx�an�,yum»amAt:aa.s*,asuo�mv�^�ywma�wmu dcer �o�n'hox»p� esx�wx�y���°uo me9^�m�. �a`e�n�n�
�ia"znbi: A;/ omu"C�,, ntficr items ms,�o c*wvsm and om,�rcontainers furrmmo by no Airq,, om`»,rr shall .umm` mm, clu,,c`vm/' theroof wmmxng by t�,,e
mmrat the omeu'n/a and will meet Seller's purity upecif/on,/nn for all qwi vmuumv. SELLER Spso/p/uALc/ DISCLAIMS ANY OTHER EXPRESS oeIMPLIED
xrxuoxnns. GUARANTEES, onWARRANTIES, INCLUDING ANY WARRANTIES or Msxo*AwrAourv. FITNESS FOR APARTICULAR puuposE on wow'
mpmwaeMswTmxoAmvw^anAwneoTxxrmxvns*LLsoEoruxnmsAmxnEnucropuuSromonumxss.
|Jaca»goluof Liubj/Ky� SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS ANO PRODUCTS, :mCLumws
rHsn(�pLACemewroF GASES THAT oo NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT oO Mssraunxnpsn/pmxrmmy. BUYER KNOWINGLY
AND puuv Aomumsn THE moxo OF rnAwopoenwo AND un/wa oompnsosED mxoea. usuEn SHALL NOT BE LIABLE FOR ANY DIRECT eEx:srrxa
EXPRESSLY PROVIDED HEREIN).INDIRECT,SPECIAL,INCIDENTAL,CONSEQUENTIAL AND/OR PUNITIVE DAMAGES,Awa/womR ALLEGED TO Amss OUT or
OR IN CONNECTION WITH ITS PERFORMANCE op ANY OBLIGATIONS uxAmv puoounT. oroEn Ircmn OF mAce, OR EQUIPMENT SOLD op �-cASEo BY
SELLER.WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR ONUSSION Or,IS RELATED TO STRICT LIABILITY,OR OTHERWISE _
U-Pvujj�f:nt: un/e,�m/`en°meop*u'/�u/na�on�mc���"v�,000xma�ev:�:'e.xmmnmmmz�:avnaoo,m^�^',o/s000mmvo.^ A ate pav^`ew.u`n'z^v/�aa
:o ynpm,oast u"eov/aooe,will oou^,seoomoom/v(,-r/n'mvmmm dollars lSzw).n,the,rxx;'rum/anfu/nmn�,'/,^Fimo*/^L,Sl, -he o^on� --C�e/'mrec,
/ea.�
upm and receipt mvno-1yinn documentation oovm Seiler ueurohagem the event o* inv-xtrovmmur incrri�,, x.:the cost
z�'/6^^*o/and.arravnulenv/n used/o�opmvvct/onof Products*nv/o'(b)fuel,
Iu������o�� rc/°`vaoren�a/eno�/..nn"�uxan�mx/o".s°/�or�anama u^vrm`on"mo`vvr.mo.//�.,emove.y "o`o�/�ou/�a�`."x .�on�nu,,/vro',*+. wmu/ao/
a�/w-ownership n"arty enm/env/pmont.
Any taxosv",czmLvfederal; or other mms*a/aumuxtyon tie uaw.use o,po�ommmnorumu� ^'xm sale o.»un�wan,emaumco`mo"A.�nu
�:r.pmvshall^°nxy'�y Buyer/`/aumm.,'ome purchase
v'.uv
8er-J--a�uGhaooes:The toalaomont due nn*the Buyer may inClUdevarious uan/om charges,m*uu',o:charges for,e,handling ofoazard!^s materials and for compliance
v/m/./*s and mou/auv,.^'vrcem/nnhoza=",u materials:u`nmox'or xanmmn.ua/`��anuampv/nn�m��,cnumu�m'u��yo �u/�m000��oevoan�:�xe«un/a�x
or vaamorm/nu,^vuv any ao^ymnv"t authority,arid all vfmemameoammwxmuuymvuux",,The aa/w,owoo/sv,�oc°:v�uu,/�'"cmee/�/u.`^/".»v�°onme
and the aolumcaisassociated wi,.;.nie charges,wn/a/:ax vary uyvrou":1.oe,w,e.brie p/.ux/voe.amoou,»",mmox.
Go,nmrricnt-Contrzlcts:Gertain Airgas*mipmum are u.a, nmcmmon mnramro zinc! nubnono°ci:,�.`and are uob'ma and adhere * /m u�oerll laws
,^�.`'/,^mo°s.arcu&anlontm/eva"u=uv/aoonu.spe^'o.*ov Executive om^/ \Io. 11246.mf, and the vm.u,. Ere votm,xu`z/oom`vr/
Ac,mm74,./annmonded
Airgas oav*ness
N�.r/:'nc uu,.'essvvi//.^/rjos.00aso,,1"n over with m.r.`Ru.�"~ss ovaltu/-,,:t irritp:11w=v m/nps ws;'uso' / 'be,.'' `��vvW,a/ma&rwn.^:sovCYOU
/r—"~/n�oe�
VOUCHER # 125480 WARRANT # ALLOWED
355856 IN SUM OF $
AIRGAS USA, LLC
PO BOX 532609
ATLANTA, GA 30353-2609
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
nA
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
9007538421 01-7202-06 $67.27
Voucher Total $67.27
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
355856
AIRGAS USA, LLC Purchase Order No.
PO BOX 532609 Terms
ATLANTA, GA 30353-2609 Due Date 8/8/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/8/2012 9007538421 $67.27
hereby certify that the attached invoice(s), or bill(s) is (are)true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer