213062 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $306.47
INDIANAPOLIS IN 46278 CHECK NUMBER: 213062
CHECK DATE: 9/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 07010908 208 . 16 OTHER EXPENSES
2201 4231100 08202772 87 . 80 BOTTLED GAS
1094 4239012 8202433 10 . 51 SAFETY SUPPLIES
IMF iTEM INVOICE DATE INVOICE BECINNINC SHIPPED RETURNED F.NDINC LEASED 'A'(DAYS CYLINDER EXTENDED
P BALANCE BALANCE CYLINDERS RATE AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .339 10.51
Purchase Quo r
Df,scription a:
P.O.# �O P r F SEP 0 Q 2012
:a.�.# 1094 a2 ao i
3udcet
Durchaser I late-
approval_ ate TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 10. 51
1411 E. 116TH ST. INVOICE: 08202433
CARMEL IN 46032 INVOICEDATE: 08/31/12
TOTAL CYL VALUE: 1-00.00 P/O:
INDIANA OXYGEN COMPANY - P.O. BOX 78588- INDIANAPOLIS, IN 9 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
8131112 8202433 Rental of oxygen tanks
30205 $ 10.51
Total $ 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
, 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
I -
109 -Monon Center
PO#or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept#
1094 8202433 4239012 $ 10.51 i 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
20-Sep 2012
Signature
$ 10.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
INV RNT EXPIRATION - CYL
PPE SUP r_AOOP PERIOD DATE_ DESCRIPTION _ =A-- RATE AMOUNT
L AL1 ALY 12 09/2012 07010908 1 108.46 108.46
L 0X1 OXY 12 09/2012 07010908 1 99 .70 99 .70
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E 0 FER 1 YEAR D 5 YEAR LEASES
YR $1 2 . 19 PE CYL (ACETYLENE=$209 .16) PLUS '.1'
CARMEL WATER CUSTOMER: 12598 TOTAL ® 208. 16
3450 W 131ST ST INVOICE: 07010908
CARMEL IN 46074-8267 INVOICEDATE: 09/08/1.2
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 9/17/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/17/2012 07010908 $208.16
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 # 122126 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
07010908 01-6360-03 $208.16
Voucher Total $208.16
Cost distribution ledger classification if
claim paid under vehicle highway fund
CYLINDER RENTAL INVOICE
INDIAN-z1 INDIANA OXYGEN COMPANY CUSTOMER:O_7_851 PAGE: 1
DIMEP.O. BOX 78588 INVOICE: 08202772
INDIANAPOLIS,IN 46278-0588 INV DATE08/31/12
317-290-0003 SALESPERSON:0 0 0 TERR: 007
BRANCH: OO4
TERMS: -- .NET 30
B CARMEL STREET DEPT H CARML,l:, S'PRE.ET DEPT
� 3400 W 131ST ST P 3400 W 131-S'l' S'l:'
CARMEL IN 46074 CARMEL, IN 96074
T T
O O
INVOICE AMOUNT: 87. 80
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
II'P' - I'fEM� INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAL/DAYS CYLINDER EXTENDED
- - - .__BALANCE _ BALANCE CYLINDERS RATE AMOUNT
.. .. - -
R ALY ACETYLENE 3 0 0 3 0 93 .379 35.25
R ARG ARGON 2 1 1 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
I
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_ TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851. TOTAL ® 87.80
3400 W 131ST ST INVOICE: 08202772
CARMEL IN 46074 INVOICEDATE: 08/31/12
TOTAL CYL VALUE: 2700. 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))
08/31/12 08202772 $87.80
hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
✓ith IC 5-11-10-1.6
20
Clerk-Treasurer
baft-
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF $
P. O. Box 78588
Indianapolis, IN 46278-0588
$87.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 08202772 I 42-311.001 $87.80 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
�i Frida j September 21, 2012
Street Commissioner
VLIGGL VVIIIIIIIJJI VII .1
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund