213512 10/09/2012 u,*f CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CHECK AMOUNT: $95.13
CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 213512
CHECK DATE: 1019/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 08206944 84 . 96 BOTTLED GAS
601 5023990 08207348 10 . 17 OTHER EXPENSES
CYLINDER RENTAL INVOICE
INIJI-ANik INDIANA OXYGEN COMPANY CUSTOMER:07851 E: 1
ontoP.O. BOX 78588 INVOICE:---082 06944
INDIANAPOLIS,IN 46278-0588 INVDATE: 09/30/12
317-290-0003 SALESPERSON:0 0 0 1 TERR: 007
BRANCH: 004
P/O.
TERMS:_ NET 3 0
El S
I CARMEL STREET DEPT H CARMEL STRE�'ET DEPT
L 3400 W 131ST ST 3400 W 131ST ST
L CARMEL IN 46074 CARMI-,11-, IN 46074
T T
0 0
INVOICE AMOUNT:
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
F NV BEGINNING _.SHIPPED- RETURNED ENDING LEASED RAtJDAYS- C'ICINDEIR EXTENDED
YPE ITEM !NV0!(--E-DATE INVOICE BALANCE- BALANCE RATE'-- -AWIGUNT-
R ALY ACETYLENE 3 0 0 3 0 90 .379 34.11
R ARG ARGON 2 0 0 2 1 30 .339 10.17
R CO2 CARBON DIOXIDE 1 0 0 1 0 30 .339 10.17
R MIX MIX GASES 1 0 0 1 0 30 .339 10.17
R OXY OXYGEN 2 0 0 2 0 60 .339 20.34
TAX:
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL 84.96
3400 W 131ST ST INVOICE: 08206944
CARMEL IN 46074 INVOICEDATE: 09/30/12
TOTAL CYL VALUE: 2700. 00 P/c:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF $
P. O. Box 78588
Indianapolis, IN 46278-0588
$84.96
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 08206944 1 42-311.001 $84.96 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
Friday, October 05, 2012
bl
v V v vStreet Comisspy/er
Street CorTitieissioner
Cost distribution ledger classification if
claim paid motor 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 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))
09/30/12 08206944 $84.96
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
.. _ ._ INV ITDA - - - WVOIBE-DATE INVOICE---BEGI-NNING_ CHIPPED- RETURNFD ENDING "^LEASED gAUDAYS. CYLINDER EXTENDED
yp - BALANCE - BALANCE CYLINDERS- - -RATE-- --AMCUNT
R ALY ACETYLENE 1 0 0 1 1 0 .379 .00
R MIX MIX GASES 1 0 0 1 1 0 .339 .00
R NIT NITROGEN 1 0 0 1. 0 30 .339 10.17
R OXY OXYGEN 1 0 0 1 1 0 .339 .00
R SHP SMALL HIGH PRESSURE 1- 0 0 1-I 0 0 .339 00
I
I
1
_ TAX: .00
CARMEL WATER CUSTOMER: 12598 TOTAL ® 10.17
3450 W 131ST ST INVOICE: 08207348
CARMEL IN 46074-8267 INVOICEDATE: 09/30/12
TOTAL CYL VALUE: 1200 . 00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
VOUCHER # 122304 WARRANT # ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588 r
INDIANAPOLIS, IN 46278
'i
Carmel Water Utility ,
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
08207348 01-6360-03 $10.17
i
i
Voucher Total $10.17
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
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 10/3/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/2012 08207348 $10.17
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
/.151 Z' 6�0--,+mot /k--r
Date Officer