HomeMy WebLinkAboutINDIANA OXYGEN COMPANY- 003370- 12/20/2012 CARMEL REDEVELOPMENT COMMISSION 003370
1
Indiana Oxygen Company Check: 3370
PO Box 78588 Date: 12/20/2012
Indianapolis, IN 46278-0588 Vendor: INDOXYG1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
00865600 156.70 156.70 0.00 0.00 156.70
helium, baloon grade
156.70 156.70 0.00 0.00 156.70
littiza-ATHE KE;YaT,Q DOCbMENTtSECURI'fY oAC3'IVATfDiT U 81F3RIi3TMDDITIONA S CllRIT'Y'FEATURESINCLUDED•SEE;mSA'CK FOR'.DET'AILS
At-AS 003370
ES,� Carmel Redevelopment Commission A REGIONS
rti 30 West Main Street 20-1421n40
Suite 220
`AR""E`, Carmel, IN 46032
3370
DATE AMOUNT
12/20/2012 **********156.70.
PAY
THE SUM OF ONE HUNDRED FIFTY SIX DOLLARS AND 70 CENTS ***********************************
TO THE
ORDER
OF Indiana Oxygen Company
PO Box 78588
Y SENS.
Indianapolis, IN 46278-0588 �
swn
n'003370" 1:0 740 L 4 2 L 31: 0 0 8 7 5 0 4
CARMEL REDEVELOPMENT COMMISSION 003370
Indiana Oxygen Company Check: 3370
PO Box 78588 Date: 12/20/2012
Indianapolis, IN 46278-0588 Vendor: INDOXYG1
Prior
invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
)0865600 156.70 156.70 0.00 0.00 156.70
helium, baloon grade
156.70 156.70 0.00 0.00 156.70
K-11.52 COMPUTEREASE FORMS DIVISION(877)577-5791 T-71771 �.�i1
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 21366 PAGE: 1 —_
M
INVOICE: 00865600 'ORDER: 01713839-00
P.O. BOX 78588
INDIANAPOLIS,IN 46278-0588 INV DATE: 11/29/12 j ORD DATE: 11/27/12
_ In „ 317-290-0003 SALESPERSON: 000 I TERR: 005 j
. . ; BRANCH: 001 TINT: TIM ;
. P/O:
TERMS: NET 30
SHIP VIA: Our Truck .
RELEASE N:
B S
1 CARMEL REDEVELOPEMENT COMMISION H CARMEL REDEVELOPEMENT COMMISION
L 30 WEST MAIN STREET P 111 WEST MAIN STREET
L
SUITE 220 CARMEL IN 46032
TO CARMEL IN 46032 T
O
INVOICE AMOUNT: 156.70 ,
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
ITEM Qn ()Ty .---CYUND DESCRIPTION UOM ! UNIT AMOUNT I
SHIP'D B/L) ;;SHP'D _,<REVD:, 1 PMCE _
** Location: A ** 1
HE 200 1 ! 0I 1 1 HELIUM BALLOON GRADE: 20CCir CYL 125.463 125.46
' � I
CGA580-NOT FOR INDUS'T'RIAL USE
200CF @ 62.7315/100CF •
CALL 496-9116 '
FSCFUEL SURCHRG 1 0 TEMP DIESEL SURCHARGE OUR TRUCK EA 5.31 5.31
HMCHAZ MAT CHG 1 0i HAZARDOUS MATERIAL CI{ARGE EA j 3 .95 3 .95
I !
Subtotal, 134.72
� i I
I � i
TOTAL CYLINDERS SHIPPED: 1 RETURNED: 1
6rI � I
1 I
.
Visit us on facebook or o the Del Charge ! 21.98
web! at www.indianaoxygen.r_om
Taxable amount: 10.00 i I
CARMEL REDEVELOPEMENT COMMISION CUSTOMER: 21366 AMOUNT C • 156.70
THIS INVOICE
30 WEST MAIN STREET INVOICE: 00865600 INCLUDING TAX. .
SUITE 220 INVOICE DATE: 11/29/12
CARMEL IN 46032 ORDER: 01713839-00 WO:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
Presdibed 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
/hl 4 N' kk ��� v"7 ;may Purchase Order No.
P6 (). ' 755i Terms
/7o/Ji 6 /42 1162,78- o Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/2?/a OO6 56O0 }ila/,v:v /SG_zo
Total /56.
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
/1.Zr. , 20 ( 2.-
4111. -Treasurer
VO.LICHER NO. WARRANT NO.
ALLOWED 20
/ IN SUM OF $
// /i.,/ o //l TZ.2 , USA;'
$ /57 -`7G
ON ACCOUNT OF APPROPRIATION FOR
UL,
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s),
9e;2 Co G s6 cry c?3 5 y 3 /5 -27d 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
20
z Signature
Executive Director
Title
Cost distribution ledger classification if Carmel Redevelopment Commission
claim paid motor vehicle highway fund