215239 12/05/2012 a CITY OF CARMEL, INDIANA VENDOR: 355856 Page 1 of 1
ONE CIVIC SQUARE AIRGAS USA LLC
CHECK AMOUNT: $77.95
CARMEL, INDIANA 46032 Po aox 532609
ATLANTA GA 30353-2609 CHECK NUMBER: 215239
CHECK DATE: 12/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9010281944 77 . 95 OTHER EXPENSES
TO ENSURE PROPER CREDIT SE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693
ORDERtNOM
PLEA
.,.s ,. .'iNV I NO.',i...._ !INVOI DATE . O Q T N ..., i;i 3 L`Q;T,O NAME z .,}
1009287820 9010281944 11/15/2012 1813998 (CITY OF CARMEL SEWER
e ...:i.PO!<REIEASE.. ,BRANCHr H< 5, SHiP':VIA nH PAYMENTTERMS:.== r�.,.s ORDER DATE=
CARMEL WELDING DEPOT S112 OTHER NET 30 11/15/2012
DELIVERY NO /' MATERIAL NUMBER �Qn UOMr QTY Q10 CYLINDER f f UNIT PRICES UOMk AfviOLJNT
0054010163 OX 20 2 CL 2 1 16.00 CL 32.00 N
OXYGEN INDUSTRIAL 20 CGA 540 (Vol: 38.000 FT3)
0054010163 AC MC 2 CL 2 1 20.00 CL 40.00 N
ACETYLENE IND MC CGA 200 (Vol: 16.000 FT3)
Sale subtotal: 72.00
Hazmat Flat Rate 5.95
SHIP To:1778561 At+AOUNT `° 77.95
A CITY OF CARMEL SEWER
lrgas. '
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
Page 1 of 1
r---i�uir iris F���� ��c• T
Disclosure Terms of Sate").
as x(collectively the the
e
governed by the terms and conditiervi oil this nt Disclosure,the Terns Of Sate affixed.
romPany is and shall b 9 air a .comlcustomor ether with any other material describing
by an Airgas ' - these Terms of Sale,tO9 ersonal property described in any Contract
and the Terms of Sale found at h t arwww' items of tangible P
sale of Goods or s er lrcompleted). Buyer Contract"1 sh. o d.gofers to any
Terms Each"lion(if one has be ecral provisions. or
to the Account App terms.and all other sp cylinders which Seller Buyer shall be
being sold,their price.delivery cylinders charged to umber O(i.e.,
cylinders thus charge
Each Contract far the safe of Goods or sell ices between Seller and BuY tat number°f°y' The number of cylinders s after the date hereof.
Goods or services date shown Seller the
or Otherwise provided by Setter to Buyer. O -,ibifity: This document shows the to Priors Buyer clams within 600 der or(ii,Pays any
Buyer reports to Seller in writing to Seller in 9°°d
working
C finder Rentals;Lease°and Re to Seller's records as of the month morn
Notice Re aide[ and which Buyer has not returned)according
unless Buy returned such cylinders
d to Buy ell to Buyer until E uyer has either(i
Purposes between Buyer and Seller,
°'. all cylinders charg' Each refillable
considered correct for all contra°rent as or its third-Pally vendors. Such c refrigerants).not be used Y
a•ices to continue to p Y ro erty of Airg ayes(e.9
gayer 9 ' linder was
replacement cost thereof. finders shall remain the p P days after the cy
rDe osit. Refillable refrigerant cylinders sh l from Airgas Or the return and reclamation of certain 9"
s redacts Purchased determination shalt be irrefutable sixty Y
n s n time to time. Airgas wilt refund the deposit fee when the Customer returns the re n9
R r iner.nt Cvlinder Re ur e of gas p Air as from Air as,which the
ur uses other than the story 9 Pe as established by 9 as determined by 9` published by
Customer for Purposes subject to a cylinder dep OR IMPLIED
cylinder will be subj tinder's condition is deemed to be unfit for reuse, shall conform to the es OTtHER EXPRESS ON-
an Airgas company A PARTICULAR PURPOSE OR N ANY
Cylinder unless the cylinder FITNESS FOR
returned, cylinder-, and other containers farms p oducts. SELLER SPECIFICALLY DISCLAIMS
writ specif cations for all gas P MERCHANTABILITY,USAGE• INCLUDING
Warrant All products. ocher Items of sale: cY Y WARRANTIESRESULT OF CUSTOM OR PRODUCTS
INCLUDING ANY ARISE AS A S CYLINDERS AND PR KNOWINGLY
TEES, OR WARRANTIES,Y BE ALLEGED BUYER
manufacturer atGUARAN f sate and 'A meet THAT MAY T OF DEFECTIVE GA SPECIFICATi ANY DIRECT(EXCEPT AS
STANDARDS,
INFRINGEMENT AND ANY WARRANTIES SELLER SHALL NOT BE LIABLE FOR
_ USING COMPRESSED GASES. F SALE,OR EQUIPMENTHERWtSOE LEASED BY
AND/OR PUNITIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT
"tv: SELLER SHALL BE LIABLE ONLY FOR PURITY REPAIR OR REPLACEMENT
O O
Ili O NOT MEET ITS PURIU SPECIFiCATiONS WITH GASES THAT DC MEET
Limit icon Rf.._Lt�b ENT OF GASES THAT D TING AND CC OTHER ITEMS
LIMES THE RISKS OF TRANSPCR INCIDENTAL, Y PRODUCT, TO STRICT LIABILITY,O
THE REPLACEM INDIRECT,SPECIAL, OR IS RELATED en account credit
AND FULLY ASS VIDED HEREIN), MANCE OF ANY OBLIGATIONS OORR OMISSION
EXPRESSLY PRO TION WITH ITS PERFOR FROM ANY NEGLIGENT A
IN CONNECT DAMAGE RESULTS past due balance,will be as
monthly
s after the date o{Seller s invoice. Continue °
OF OR aid.p
WHETHER SUCH DAM a rnent in full within 30 e of 1.5°l0 on the unpaid,
SELLER, Buyer shalt y takes A fate payment charg whichever is less.
ec-fled in a Contract.Buy or emergency increases in the cost
Term of Pavrn
n!'..Unless otherwise sP er's financial condition and in the to P Y' extraordinary
ay to Seiler a surcharge in the event of ally
is subject to Sellers assessment. r o{Buy n or other indicia of
2 or the maximum lawful rate allowable in the state Where the Goods are delivered
(minimum two dollars l� documentation,Buyer shall b fuel. identificatio
Upon notice and receipt of underlying Odl remove or otherwise disturb any
Sure_ ham= Up reduction of Products and/or O Buyer shall not cover,m fY•
e or performance o{services by an Airgas
O{(a)power and/or raw materials used in tile
equipment shall remain in Seller's name. Buy possession of Goods,or the s<
Title to E ui ment. Title 1O�ntaeequ pmennt.
Seller's ownership on any
federal.state.or other governmental authority on the sale.use°r es for the handling of hazardous materials and for
imposed by purchase price. including' charges or fuel.None of the charges
Taxes: Any taxes imp es for energy specifically quantified the
shalt be paid by Buyer in addition to the p delivery and shipping',and/or charges s (b)No such
company, from the Buyer may include various itemized charges, Other thing
es for handling, the Seller.The S!atC,,among other sp
es are retained by
a The total amount due hazardous materials:chi all°{the charg redact,service,time and P
1temiz arm O ulations concerning overnment authority, es which can vary by P
compliance with laws and or imposed by any 9 lrements of{ederai fawn
represent a tax Or fee p Ifmut mutual consent. ustmen
between the charges and the actual costs associated with the c ar subject to and adhere to the requ
relationship he charges
for in a Rider will be imposed w
charges not already provided es are U.S.government contractors and subcantracfors and are
n ive Order No. 11246,the Rehabilitation Act of 1973 and the Vietnam Era i?eterans ea
r�ontrscts_: Certain Airgas comps ecificatl Execut
�r o regulations.sp Y
executive orders,and attendant rules and reg as eBusiness Visit us online today to see how www.airgas.con can sav'v
Assistance Act of 1974,all as amended. Airg ��www.airgaS.com.
No%ti doing business with Airgas is easier ti-tan ever with our eBusiness websi{e,http:
E',me and rnoney.
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 11/27/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/27/201: 9010281944 $77.95
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
ii`3 11,� (�-�I✓�
Date Officer
VOUCHER # 126197 WARRANT # ALLOWED
355856 IN SUM OF $
AIRGAS USA, LLC
PO BOX a3 .9
AT AP4fia' GA a035 2ann
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
9010281944 01-7202-06 $77.95
Voucher Total $77.95
Cost distribution ledger classification if
claim paid under vehicle highway fund