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217202 02/13/2013 f CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1 ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $332.91 �< CARMEL, INDIANA 46032 PO BOX 78588 INDIANAPOLIS IN 46278 CHECK NUMBER: 217202 CHECK DATE: 2/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231100 7011933 99. 70 BOTTLED GAS 1094 4239012 8223128 10 . 82 SAFETY SUPPLIES 2201 4231100 8223459 90 .28 BOTTLED GAS 601 5023990 8223845 10 . 82 OTHER EXPENSES 601 5023990 879882 47 . 90 OTHER EXPENSES 2201 4231100 880293 73 .39 BOTTLED GAS ORIGINAL INVOICE INDIANA INDIANA OXYGEN COMPANY CUSTOMER_: 07_851 PAGE: 1 P.O.BOX 78588 INVOICE: _0 0880293 !ORDER: 01736151-00 INDIANAPOLIS,IN 46278-0588 INV DATE: 01/23/13 I ORD DATE: 01/23/13 j 317-290-0003 SALESPERSON: 000 I TERR: 007 BRANCH: 004 INT: DAB ' P/O: SIiOP TERMS: NIT 30 SHIP VIA: Will Call RELEASE#: B I CARMEL STREET DEPT H CARMEL STREET DEPT L 3400 W 131ST ST P 3400 W 131ST ST L CARMEL IN 46074 CARMEL IN 46074 T T O O INVOICE AMOUNT: 73.39 1 ------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT-------------------------------------------- ITE^A I CITY _ I_ QTY UOM I UNIT AMOUNT I BHIP'D 8/0 PRICE ** Location: D ** AL S 1 0 1 1 ACETYLENE, DISSOLVED, 2 .1 ! CYL 65.178 65.18 UN1001 i 147CF @ 44.3388/100CF RECORD "ACTUAL" CUBIC FOOTAGE CF CF i (60-175CF/CYL) FSCFUEL SRCHGWC 1i 0j TEMP DIESEL SURCHARGE W/C EA 4.26 4.26 HMCHAZ MAT CHG lI 0� HAZARDOUS MATERIAL CHARGE, EA 3.95 3.95 Subtoial j 73.39 I j TOTAL CYLINDERS SHIPPED: 1 RETURNED: li j I I I I ' �- j i i i i Visit us at facebook or oi the web at i.indinaoxygen. om j i ' I ( Taxable amount: 10.00 I CARMEL STREET DEPT CUSTOMER: 0785.1 • 73.39 THIS 3400 W 131ST ST INVOICE: 00880293 INCLUDING TAX CARMEL IN 46074 INVOICEDATE: 01/23/13 ORDER: 01736151-00 P/O: SHOP INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588 CYLINDER RENTAL INVOICE INDIAN11 INDIANA OXYGEN COMPANY CUSTOMER:O7851. PAGE: 1 P.O. BOX 78588 INVOICE: 08223459 INDIANAPOLIS, IN 46278-0588 INV DATE: 01/31/13 317-290-0003 SALESPERSON:0 0 0 TERR: 007 BRANCH: 004 P/O: TERMS: NET 30 B CARMEL STREET DEPT H CAIZMEL S`PREEP DEPT 3400 W 131ST ST P 3400 W 1.31 ST ST CARMEL IN 46074 CARMEL IN 46074 T T 0 O [INVOICE AMOUNT: 90.28 ---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT------------------------------------ -- _.INV'-- ITE!":--- -R.'VCICE CATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED R,gUDp.YS CYLINDER EXTENDED TYPO 8ALANCE BACANCE C'r LINDERS FATE AMOUNT - R ALY ACETYLENE 3 1 1 3 0 93 .389 36.18 R ARG ARGON 2 0 0 2 1 31 .349 10.82 R CO2 CARBON DIOXIDE 1 0 0 1 0 31 .349 10.82 R MIX MIX GASES 1 0 0 1- 0 31 .349 10.82 R OXY OXYGEN 2 0 0 2 0 62 .349 21.64 I i I I _ TAX: .00 CARMEL STREET DEPT CUSTOMER: 07851 TOTAL ® 90'28 3400 W 131ST ST INVOICE: 08223459 CARMEL IN 46074 INVOICEDATE: 01/31/13 TOTAL CYL VALUE: 2700. 00 P/O: INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588 CYLINDER LEASE' INVOICE INDIANA INDIANA OXYGEN COMPANY C-IUSTOMER:-o'185q- - IPAGE: 1 P.O. BOX 78588 INVOICE: 0'/01-1933 INDIANAPOLIS,IN 46278-0588 INVDATE: 02/04/13 317-290-0003 SALESPERSON:0 0 0 ITERR: 007 BRANCH: 004 P/O: 1.567 30 S CARME1, S'.1'RLET DEPT CARMEL STREET DEPT H 1 1 3400 W 31 ST ST L 3400 W 131ST ST P L CARMEL IN 46074 CARME!� !:N 46074 T T 0 0 INVOICE AMOUNT: 99.70 ------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT---------------------------------------- INV SUP RNT CYL RATE AMOUNT EXPIRATION DESCRIPTION I.FASED__ TYPE GROUP PERIOD DATE - L AC1 MIX 12 02/2013 07011933 1. 99.70 99 .70 WE OFFER 1 YEAR AND 5 YEAR LEASES YR $1 2.19 PER CYL (ACETYLENE=$209.16) PLUS CUSTOMER: 07851 TOTAL 99.70 CARMEL STREET DEPT 3400 W 131ST ST INVOICE: 07011.933 CARMEL IN 46074 INVOICEDATE: 02/04/1.3 P/O: 1567 INDIANA OXYGEN COMPANY o 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)) 01/23/13 00880293 $73.39 01/31/13 08223459 $90.28 02/04/13 07011933 $99.70 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. ALLOWED 20 Indiana Oxygen IN SUM OF $ P. O. Box 78588 Indianapolis, IN 46278-0588 $263.37 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 00880293 42-311.00 $73.39 1 hereby certify that the attached invoice(s), or 2201 08223459 42-311.00 $9028 bill(s) is (are) true and correct and that the 2201 07011933 42-311.00 $99.70 materials or services itemized thereon for which charge is made were ordered and received except 6 Frid y Fe 8 . z0 3 V LW "-7�T§ - - " SS"bCCIN 4;iOOMr Title Cost distribution ledger classification if claim paid motor vehicle highway fund ------------------------------------------- FLEASE SEND TOP PORTION WITH YOUR PAYMENT---- --------------------- ------------- -ITEM aTY I-aTY DESCRIPTION - UOM UNIT AMOUNT SHIP'D I/O�- —---I — PRICE ** Location: A ** i AC 144 li 0 1 1 COMPRESSED GASES, N.O.S. , 2.2 CYL 39.69 39.69 UN1956 144CF @ 27.5625/1.00CF (75% ARGON 25% CARBON DIOXIDE) ! FSCFUEL SRCHGWC 11 0 TEMP DIESEL SURCHARGE W/C EA 4.26 4.26 i HMCHAZ MAT CHG li 0 HAZARDOUS MATERIAL CHARGE EA 3.95 3.95 i Subtotal 47.90 I TOTAL CYLINDERS SHIPPED: 1 RETURNED: 1. i I I I I � ) I i I i I i I Visit us on facebook or oa the web at www.indianaoxygen. om Taxable amount:] 10.00 _ CARMEL WATER CUSTOMER: 12598 AMOUNT 47.90 3450 W 131ST ST INVOICE: 00879882 THIS INVOICE INCLUDING TAX CARMEL IN 46074-8267 INVOICE DATE: 01/22/13 ORDER: 01735449-00 P/O: INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588 wv ITEM ----INVOICE DATE INVOICE BEGINNING SHIPPED- RETURNED ENDING LEASED . BPIJDAYS __CYLINDER EXTENDED IYp- BALANCE BACANCF- CYLINDERS RAiE AMOUNT R ALY ACETYLENE 1 0 0 1 1 0 .389 .00 R MIX MIX GASES 1 1 1 1- 1 0 .349 .00 R NIT NITROGEN 0 0 1 0 31 .349 10.82 R OXY OXYGEN 1 1 1 1. 1 0 .349 .00 R SHP SMALL HIGH PRESSURE 1- 0 0 1 - 0 0 .349 .00 I �Q I ------�--- - TAX: .00 CARMEL WATER CUSTOMER: 12598 TOTAL ® 10. 82 3450 W 131ST ST INVOICE: 08223845 CARMEL IN 46074-8267 INVOICEDATE: 01/31/13 TOTAL CYL VALUE: 1200. 00 P/O: INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, fN • 46278-0589 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 2/5/2013 Invoice Invoice Description Date - Number (or note attached invoice(s) or bill(s)) Amount 2/5/2013 879882 $47.90 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 # 123474 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 879882 01-6200-06 $47.90 ��38y 5 ct.c��o•u� 10 �2 Voucher Total 5 'Fs-,7L Cost distribution ledger classification if claim paid under vehicle highway fund INV ITFM _ _.. INVOICE DATE-1. INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED IYY' ---BALANCE BALANCE CYI INDERS _ __ RATE AMOUNT R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .349 10.82 i I �7 3r D:a m;f tion iLa p.o.# YY1000353 or G.L # 1094- 4sSA �2- t�uc ge 1 Lin;Ulscr Pur 3hz se, Date Ap ro al Date - 1 TAX: .00 CARMEL CLAY PARKS CUSTOMER: 03390 FiOTAL 10.82 1411 E. 116TH ST. INVOICE: 08223128 CAMEL IN 46032 INVOICEDATE: 01/31/1.3 TOTAL CYL VALUE: 1 0 0 . 0 0 P/O: INDIANA OXYGEN COMPANY • 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 ;8223128 voice Description Date umber (or note attached invoice(s) or bill(s)) PO# Amount 1/31113 Rental of oxygen tanks Jan'13 $ 10.82 Total $ 10.82 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$ $ 10.82 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1094 8223128 4239012 $ 10.82 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 7-Feb 2013 Signature $ 10.82 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund