211803 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
j ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $108.82
CARMEL, INDIANA 46032 PO BOX 78588
o� INDIANAPOLIS IN 46278 CHECK NUMBER: 211803
CHECK DATE: 8114/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 08198607 87 . 80 BOTTLED GAS
601 5023990 08199011 10 . 51 OTHER EXPENSES
1094 4239012 8198270 10 . 51 SAFETY SUPPLIES
CYLINDER RENTAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER:07851 PAGE: 1
�.` P.O. BOX 78588 INVOICE: 08198607
INDIANAPOLIS, IN 46278-0588 INV DATE: 07/31/12
317-290-0003 SALESPERSON:0 0 0 TERR: 007
BRANCH: 004
P/O:
TERMS: NET 3 0
B CARMEL STREET DEPT H CARMEL, S'1'RI::E`P DEPT
� 3400 W 131ST ST P 3400 W 131-ST ST
CARMEL IN 46074 CARMEI:� TN 46074
T T
O O
INVOICE AMOUNT: 87.80
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------=-----------------------
--
INV ITEM -INVOICE DATE - INVOICE BEGINNING SHIPPED RF_TURNE-D_ ENDING LEASED BAUDAYS- CYLINDER EXTENDED
_ -� _ BALANCE .,LANCE CYLINDERS -RATE- -AMOUNT-
R ALY ACETYLENE 3 0 0 3 0 93 .379 35 .25
R ARG ARGON 2 0 0 2 1 31 .339 10.51
R CO2 CARBON DIOXIDE 1 0 0 1 0 31 .339 10. 51
R MIX MIX GASES 1 0 0 1 0 31 .339 10. 51
R OXY OXYGEN 2 0 0 2 0 62 .339 21.02
_ TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL - 87 . 80
3400 W 131ST ST INVOICE: 08198607
CARMEL IN 46074 INVOICEDATE: 07/31/1-2
TOTAL CYL VALUE: 2700. 00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
UCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
iana Oxygen
IN SUM OF $ CITY OF CARMEL
O. Box 78588 An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
F ianapolis, IN 46278-0588
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
o
$87.80 Payee
Purchase Order No.
N ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Street Department
Date Due
Invoice Invoice Description Amount
Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s))
{
1 08198607 42-311.00 $87.80 I hereby certify that the attached invoice(s), or 07/31/12 08198607 $87.80
bill(s) is (are)true and correct and that the
�l
materials or services itemized thereon for
which charge is made were ordered and
received except
Thu,rsday�A�jigust 09, 2012
UW4/ /Y P4
} Street Commissioner
trees Comnj,+ss;oner le
Tit
Cost distribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
claim paid motor vehicle highway fund with IC 5-11-10-1.6
20
c
f, t• r:, Clerk-Treasurer
t,.
�.
INV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED CYLINDER CYLINDER EXTENDED
p BALANCE BALANCE CYLINDERS -RATE - AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .339 10. 51
t
i
Purchase or
Descrlption Pff —�
P.O.#
G.L.# U- U22)L
Budget
Line Desc
Purchaser Date
Approval Date
—1-- - — -- TAX: . 00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL / 10.51
1411 E. 116TH ST. . INVOICE: 081982•/0
CARMEL IN 46032 INVOICEDATE: 07/31/1.2
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
7/31/12 8198270 Rental of oxygen tanks 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. 4,CCT#/TITLE AMOUNT Board Members
Dept#
1094 8198270 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
9-Aug 2012
Signature
$ 10.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
INV ..ITEM __INVOICE SATE INVOI(:E_.. BEGINNING SHIPPED-IRETURNEDI _ENDING LEASED BAUDAYS CYLINDER EXTENDED
iYF' - 6;"N WCE- - 3AIJdJC E-- C'i LING j PATE ...OUNT• ALY ACETYLENE 1 0 0 1 1 0 .379 . 00
• MIX MIX GASES 1 0 0 1 1 0 .339 .00
• NIT NITROGEN 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
'v
a�
V�
i
i
i
I
_ TAX: . 00
CARMEL WATER CUSTOMER: 12598 TOTAL ® 10. 51
3450 W 131ST ST INVOICE: 0819901.1.
CARMEL IN 46074-8267 INVOICEDATE: 07/31/1.2
TOTAL CYL VALUE: 1200. 00 P/O:
INDIANA OXYGEN COQ ILPAN a' P.O:_PDX 78588-_,INDJ;ANAPOLIS, IN_s. 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 8/9/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/9/2012 08199011 $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 Officer
VOUCHER # 121824 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
08199011 01-6360-03 $10.51
Voucher Total $10.51
Cost distribution ledger classification if
claim paid under vehicle highway fund