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Home My WebLink About215672 12/18/2012 a CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1 0 ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $82.61 '4 CARMEL, INDIANA 46032 PO BOX 78588 INDIANAPOLIS IN 46278 CHECK NUMBER: 215672 CHECK DATE: 12/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231100 00868559 72 .44 BOTTLED GAS 1094 4239012 8214941 10 . 17 SAFETY SUPPLIES ORIGINAL INVOICE INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 0'/,£`i] PAGE: 1 P.O.BOX 78588 INVOICE: 00368559 ORDER: 01719243-00 INDIANAPOLIS,IN 46278-0588 I INV DATE i /,10/12 ORD DATE: 12/10/12 317-290-0003 SALESPERSON_000} ITERR: 007 BRANCH: 004 INT: MMG P/O: 12 :0.12 ;TERMS: _ Ni;'i' ------ I SHIP VIA: W; i"• Ca1.1-------- ----- ------ RELEASE#: B S I CARMEL STREET DEPT H CA;1MEi. STREET DEPT L 3400 W 131ST ST F 34 CC W 131S'.^ ST L CARMEL IN 46074 "A:ZM:!• IN 46074 T T 0 0 INVOICE AMOUNT: 72.44 ------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENI ------------------------------------------- M-- OTY-.-_I_ QTY � DESCRIPTION UOM UNIT AMOUNT T� ---- i imow' SHIP'D BiO - - - PRICE 4 I ** Location: D ** ------- ----- - ------- --- -- ---- NASKCP20696 1 0 3705 REPLACEMENT III3 UG;'./a :,:A 15.50 15.50 3014866 I I OX 220 2 ! 0 2 2 OXYGEN, COMPRESSED, 2.2 CYL 24.255 48.51 I I i UN1072 440CF @ 1.1 .0250/1"0";' FSCFUEL SRCHGWCI 1 0 TEMP DIESEL SURCHARGi; W/C ?A 4.48 4.48 HMCHAZ MAT CHG 1 OI HAZARDOUS MATERIAL, C :A:�zG:: !?A 3.95 3 .95 72.44 TOTAL CYLINDERS SHIPPED: 2 L 1E'TU!�Vis:): 2 I i I i I I I I I i i I Visit us at facebook or oa the web at www.indianaoxygen. om I I I I i I I L Taxable amount:; _ i0.00 CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT 72.44 INVOICE THIS 3400 W 131ST ST INVOICE: 00868559 CARMEL IN 46074 INVOICEDATE: 1.2/10/12 ORDER: 01.719243-00 P/O: 12.10.12 INDIANA OXYGEN COMPANY - P.O. BOX 78588- INDIANAPOLIS, IN 9 46278-0588 VOUCHER NO. WARRANT NO. ALLOWED 20 Indiana Oxygen IN SUM OF $ P. O. Box 78588 Indianapolis, IN 46278-0588 $72.44 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 00868559 I 42-311.001 $72.44 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 s 1 Friday,rDecember 14, 2012 Street Commissioner -,r - Title 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)) 12/10/12 00868559 $72.44 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, ITEA4 INVOICE DATE INVOICE_. _ BEGINNING SHIPPED RETURNED__ ENDING LEASED BAIJDAYS CYLINDER EXTENDED ryp -- BACANCE 9AIANCE- - CY'!NDERS _RATE AMOUNT R SHP SMALL HIGH PRESSURE 1 5 5 1. 0 30 .339 10.17 I lgRC WTIM DEC 5 201 i Puchase Cescript On L OF WE-JE)TAi1 S NOV I�„ P.O.# G.-.# C3U:tr @t Lit auescr Pu chaser ate A; roval )at-3__ i i I TAX: .00 CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 10.17 1411 E. 116TH ST. INVOICE: 0821494-1. CARMEL IN 46032 INVOICEDATE: 11/30/12 TOTAL CYL VALUE: 1-0 0 . 0 0 P/O: INDIANA OXYGEN COMPANY a 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 11/30/12 8214941 Rental of oxygen tanks Nov'12 $ 10.17 Total $ 10.17 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$ $ 10.17 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1094 8214941 4239012 $ 10.17 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 13-Dec 2012 Signature $ 10.17 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i I I I