HomeMy WebLinkAbout215951 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 366748 Page 1 of 1
ONE CIVIC SQUARE AIRGAS USA, LLC CHECK AMOUNT: $24.19
CARMEL, INDIANA 46032 PO BOX 532609
ATLANTA GA 30353-2609 CHECK NUMBER: 215951
CHECK DATE: 119/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9906032955 24 . 19 OTHER EXPENSES
TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693
INVOICE NO.= SOLD TO NUMBER SHIP TO I INVOICE DATE I RENTAL PURCHASE ORDER.Np: TERMS
99060329551 1813998 1778561 11/30/2012 RENT NET 30
MATERIAL/DESCRIPTION SUBJECT NET
BEG BAL.: SHIP, RETURN .ADJ END BAL LEASES RATE PRICE
DOCUMENT/DATE TO RENT DAYS
RRCYLISM—AC — Rent Cyl Ind Small Acetylene
1 2 1 0 2 1 1 16 $0.58/DAY $9.28 N
RRCYLISM—OX — Rent Cyl Ind Small Oxygen
0 2 1 0 1 0 1 16 $0.56/DAY $8.96 N
------- ---------
1 4 2 0 3 $18.24
to
Hazmat: 5.95
Important.See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the AMOUNT DUE . $ 24.19
Reverse side of this form.You will be deemed to have accepted the provisions in the said
Notice as part of the contractual arrangements between you and us,unless you reject such I gelm
provisions by written advice to us within(15)days after the date of this document.
SHIP To:1778561
Airgas. CITY OF CARMEL SEWER AIRGAS USA, LLC
www.airgas.com 130 1 ST AVE SW ACT. A ,ABA NO.
Airgas USA,LLC
CARMEL IN 46032-2009 PNC BANK,ABA NO. 031000053
PO Box 9249
Marietta, GA 30065-2249
sEL-001000 Page 1 of 1
Disclosure
Each m,/e;.o`�uyu,so,mro'`;)vanA/mao"s'r/aov.ua rid s/*oL'.governed uy the terms uouco"ux m'this Jismom* `�o forms msa'evmmm
mo`,//'".�xo�o,mn�:u/+�s»=nru�/�a ��mmme �o�om^Tem oleale'
e�,i for the ovmdsmsm.i�,,som*oo so,�e'a.�ma,yo,[cvntract`shall include those /ennomSom togi,thcr with mo /umscn�,il/mc
ana sv�,ces:*ny �eit prico.ue^~teonn anal m',rsPecimomvumm, "Goods"iefers If)any/mmomta.m"*~personal nrf.*erly described'in~/y' O*rou
o' sr.nmvuaxvrs,'v'mBuyer.
-1w,ocic,.frent snovvs tl��total number mcy.riders umnodm vvnich Seller ha-,,raitcdm
/y°ooe evvecx~nwu,, ouvr,has not,e^v.~J)oucmanmSt� e/.records aym the month e..n.'.c.o^teshown.—fie c"x`ber ofq'//ooe.,u.us charged max,y shall u*
ml��,oaamrectxra o trauua/purposes and Seller,unless avp"reports w Seller mmmng any errors a uyer claims wr'^ 3000ys after tnouo.110'e0f,
B^,, +*yt000*u".aw/�v rent on all c,r.do,ocharged[o Buyer vno/Buyer has either @mL^.f,(/m/e,cylinders m�.eor;nooconmffn«v,cimmVVpnw So.'o/the
mumoreo
oylinmrRe!un`�ao^osK_ n^'mou~m/,wnramq,: shall remain the/xc^ertymmrg*yu,its m',`/a'wvn"xn.x. Such vylmuv!!�shall not ua used
/`v
:,ls^)no-+r.�.�vam./c� �m,,!he mong����pmuuuv+,��awo"na�a'n./e,ommaoux«ummmmmm°m:o.���e�`�*a�°�)� c�h'ema.,�
or/me'� oo,o����,/nx�n�,u�wm :r aystemm"v brxgas from time o time. Airgas will refiina m*n*pow f** meG"Somo the
.,ma/m.�,x�''�.^'~o'nn�ee�°a'`�munoxvu,rn�ouemm.r=o.v��a�=mo o^�,nxn��"m`x/�/�.~oo�o»�*wrm;""m,mrr/om`m �a
�arz)�i-y All prodmz terl', of 'ad", 'ylimers and other containers'UrniSfHA by an oha:: coniorm to the ms, !dr��r thereof publk ,�d by the
w'he/n�./ ,'o'"dvv- na^colm,'s purity sp°:ificnfions for all gas luoducls, SELLER SPECIFICALLY DISCLAIMSANY OTHER EXPRESS 013 IMPLIED
snAnnAsoa, ooAnAwrcE7,o. OR WARRANTIES. INCLUDING ANY WARRANTIES oF MsnC*Awrxo/LnY, FnwssS FOR APARTICULAR ponposs OR NOW
INFRING ENIENT AND AN`'WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
of . SELI-EIR SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS A11D PRODUCTS,INCLUDING
THE REPLACEMENT Ot'�ASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FuLLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES.SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT xo
exenc^'ic/PROVIDED neRsIN),INDIRECT.SPECIAL, INCIDENTAL,CONSEQUENTIAL*wcxon PUNITIVE DAMAGES.ARISING op ALLEGED roARISE-OUT
OF OP iN CONNECTION VVITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT.OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR LEASED BY
ssuco,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT nx OMISSION oem RELATED Toan«cruAaunxnxorHEmw._1s
Te,r` iP umo,,,"aonmaosr*�Jme'`x`a Cori a"x*'shall make payment mfuow/mmuozqF#te,medim,/Sellers m"m'�, Continued open ac^^.xtcredit
^,,r�mao�,o (myc x',uw�"mmomx.mvum;mpy xu'c p�mv" o�qcy /�a*u"the x^�o�.p�'uu"1a m�w.�w�,�s� 'nnm�
u*oollars!xzJ.��_r the naxim.m m*od rate npaz��n the�;tmowhere ihe Goods mrexoiiveico,wh�cmeve u��
un1n�(11,° .-.'re:e/nt of.,m /.nuucume"mo�nvyer,oaonavmse/le'xsuvha.y*,rmeovvw olan,1. *xt/vmuoa/'^,r, �,rqeop'/nc*ame� '^,he cost
of mw" used mm",',�,Jluumoursx'.ctsvoomr(u)me;
TiUc i, T� ii:'".,a/u«uipnm/,'v' rcmmn tit a"ilcrvnmnC. u^n,shall not cnvcr,,vmnkmnmmorm*.m,isu disturb vnuc,wicntiono, .'d1cmof
sa*` xoeruhin or,p. ov.nri-erlL
T'ax�j "w'; i,y'edera/ state. r,,!h,,r L� authority�*hk- sj,ause or po��nonuaooc* n :t,sa-e or perflim.)nco of se�xce,� afl Airsas,
001x.*.~ uu/m:d :^vz if)addition zurp/r"asv��u
/wr/7,. c, w1', tow.amount o.^`,:o,the a.vo' n�',.:c/vue various /tc'ruor charge's .n`,mxro: :xo,gos'^, roraou'wou'"vzumuuun*�/y�m`d/m
mu.'hm�,mm" /.^^oxro�me/vr—��nm/vi�,un.�^u�'�u�,r'° / m�o��',.�mo*
-o,r,,mu tax o,4es/wi�`w:'irrposodn;any nvverrmont authority,and all y�';:�charges arc';51a,cuuvtle Set�,r, /lie aalle,he.�� ,�)ecirnu:,! mc
u°.we, m"',..�"vrm/,�.x:u^'rmo°awvm/e.v*�moxou/u'��r'�u�'�nv"�u/v/'�^xv�o,m'��o.'cxnu/»�* m.",.a.xre'omm^� �`�wnpx�
ua ov-;�'1 ~,mn�uo ^x he imposed mu�m�n�o
cv�t,act�, ''./m/'`A/xax are u.s, xommcw,�,,*`/^,,o'ooancm�and are aubj^c*t(� m'eesm, w�'`..a�/a*^.
, mxna'c /'.`.`.uw^S ,pp/=�rm.ww'ocu/ *. `1e*133./rm :m�`xu ^.m,,��u,."`r..��,.y^n .�'�^mn�
.,^nomden,
Airgas eau /"es,
:'` vi'. `1' /:'`.^*ai( 1-:, *,00u"up=ms^°ba/e, *ttf.«ww°a/m" .com. Visit.so'/`^� �v^w °sc,;/°vw°wniro s.om''^ ',^enu
VOUCHER # 126412 WARRANT # ALLOWED
355856 IN SUM OF $
AIRGAS USA, LLC
PO BOX 532609
ATLANTA, GA 30353-2609
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
9906032955 01-7362-06 $24.19
i
I
Voucher Total $24.19
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
355856
AIRGAS USA, LLC Purchase Order No.
PO BOX 532609 Terms
ATLANTA, GA 30353-2609 Due Date 12/28/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/28/201: 9906032955 $24.19
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with ICp 5-11-10-1.6
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Date Officer