217686 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
`�. ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $701.31
CARMEL, INDIANA 46032 PO BOX 78588
o� INDIANAPOLIS IN 46278 CHECK NUMBER: 217686
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 00884845 191 . 76 GARAGE & MOTOR SUPPIE
2201 4237000 00886526 64 . 90 REPAIR PARTS
2201 4237000 00886527 246 . 30 REPAIR PARTS
2201 4237000 00887005 198 .35 REPAIR PARTS
ORIGINAL INVOICE
INDIANIk INDIANA OXYGEN COMPANY CUSTOMER: 07_851 PAGE: 1
P.O.BOX 78588 INVOICE: 00884845 ORDER: 01742303-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 02/07/13 ORD DATE: 02/06/13
317-290-0003 SALESPERSON_000 I TERR: 007
BRANCH: 004 TINT: DAB
P/O: SHOP - MIKE HENRICKS
TERMS: NET 30
SHIP VIA: Will 1 Call
RELEASE#:
B S
I CARMEL STREET DEPT H CARME1, STREET DEPT
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3400 W 131ST ST F 3400 W 1.31-ST ST
CARMEL IN 46074 CARMEL IN 46074
T T
O O
1 INVOICE AMOUNT: 191.76
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM OTY oTV DESCRIPTION UOM_ UNIT AMOUNT
S"P•D Dro _ PRICE
** Location: D **
THD7-3580 2 0 EXTRA COOL TORCH COOLANT EA 37.63 75.26
ALY1382FO5 44 0 86 .035 X 44# SP SPOOLARC86 LS 2.371 104.32
86035X44 70S6035X44 SPOOL
T 1 0 CONTACT TIP .035"-0,9MM PKG 12.18 12.18
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Subtotal 191.76
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Taxable amount: 0.00
CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT-, 191.76
THIS INVOICE
3400 W 131ST ST INVOICE: 00884845
1 INCLUDING TAX
CARMEL IN 46074 INVOICE DATE: 02/07/1.3
ORDER: 01742303-00 P/O: SHOP - MIKE HENRICKS
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
ORIGINAL INVOICE
-1NQ1ANj1 INDIANA OXYGEN COMPANY CUSTOMER-:---0'7 851 PAGE: I
P.O.BOX 78588 INVOICE_ 00887005 ORDER: 01746041-00
INDIANAPOLIS,IN 46278-0588 INVDATE: 02/14/13 ORD DATE: 02/14/13
317-290-0003 SALESPERSON: 000 TERR: 007
I
BRANCH: I INT: MMG
P/O: SHOP
TERMS: NET 30
SHIP VIA: Will Call
RELEASE#:
B S
I CARMEL STREET DEPT H CARMEi, S'FfRU,.= DEPT
L 3400 W 131ST ST 1 P 3400 W 131ST ST
L
CARMEL IN 46074 CARMEL IN 46074
T T
0 0
INVOICE AMOUNT: 198.35
-------------------------- ------ --------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
UNIT
1TEM OTY °n DESCRIPTION----- u0m. AMOUNT
SHIP'D B/O PHICE
Location: D
IVIC0387-0005 ii 0 7H 7 CA13 50-CS CUTTING ATTAC1;. 1N C EA 198.35 198.35
Subtotal. 198.35
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I Taxable amount:' '0.00
CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT-'-"'O 198.35
THIS1NVIC
Ev
3400 W 131ST ST INVOICE: 00887005
CARMEL IN 46074 INVOICE DATE: 02/14/1.3
ORDER: 01746041-00 P/O: SHOP
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
ORIGINAL INVOICE
INDIAN)k INDIANA OXYGEN COMPANY (CUSTOMER_ 07 8 51 PAGE: 1
P.O.BOX 78588 INVOICE: 00886527 ;ORDER: 01744951-01
INDIANAPOLIS,IN 46278-0588 -INVDATE: 02/13/13 1 ORD DATE: 02/12/13
317-290-0003 SALESPERSON: 000 !TERR: 007
-BRANCH. _004 INT: DAB
P/O. MIKE HENRICKS
TERMS: NET 30
SHIP VIA:--Will Call
RELEASE#:
B S
CARMEL STREET DEPT H CARM;'h STREET DEPT
L 3400 w 131ST ST P 3400 W 131ST ST
L
CARMEL IN 46074 CARMEL, IN 46074
T T
0 0
INVOICE AMOUNT: 246.30
----------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM QTY Q-ry DESCRIPTION UOM UNIT AMOUNT
SHIP-'D a/0 PRICE-
Location: D
THD9-8407 30 0 ELECTRODE EA 8.21 246.30
Subtotal 246.30
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Taxable amount:! ;0.00 1
CARMEL STREET DEPT CUSTOMER: 07851 246.30•
3400 W 131ST ST INVOICE: 00886527
CARMEL IN 46074 INVOICE DATE: 02/13/1.3
ORDER: 01744951-01 P/O: MIKE HENRICKS
INDIANA OXYGEN COMPANY • P.O. BOX 78588® INDIANAPOLIS, IN o 46278-0588
ORIGINAL INVOICE
IN 1)U*VN k INDIANA OXYGEN COMPANY CUSTOMER: 0'7851 PAGE: I I
P.O.BOX 78588 -INVOICE: 00886526 ORDER: 01744951-00
DUMB
INDIANAPOLIS,IN 46278-0588 INV DATE:__02./13/13 1 ORD DATE: 02/12/13
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH. 004 INT: DAB
PIO: —MIKE HENRICKS
ITERMS: NET 30
SHIP
-VIA.
- - —Will Call
(RELEASE#:-
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
L 3400 W 131ST ST 1 p 3400 W 131ST ST
L
CARMEL IN 46074 CARME1, IN 46074
T T
0 0
INVOICE AMOUNT: 64.90
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
Y
ITEM' QT DESCRIPTION lom UNIT
AMOUNT
PRICE
Location: D
' THD9-7726 101 20 TIP EA 6.49 64.90
Subtotal. 64.90
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Taxable amount:i 0.00
CARMEL STREET DEPT CUSTOMER: 07851 • 1' 64.90
3400 w 131ST ST INVOICE: 00886526
CARMEL IN 46074 INVOICE DATE: 02/1-3/1.3
ORDER: 01744951-00 P/O: MIKE HENRICKS
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
$701.31
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
T
2201 00884845 42-321.00 $191.76 1 hereby certify that the attached invoice(s), or
2201 00886527 42-370.00 $246.30 bill(s) is (are) true and correct and that the
2201 00886526 42-370.00 $64.90
materials or services itemized thereon for
2201 00887005 1 42-370.00 $198.35
which charge is made were ordered and
received except
Th Y ay,', ruary 21, 2013
Sta ommissione°r er
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))
02/07/13 00884845 $191.76
02/13/13 00886527 $246.30
02/13/13 00886526 $64.90
02/14/13 00887005 $198.35
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