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Home My WebLink About222298 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 366748 Page 1 of 1 0 ONE CIVIC SQUARE AIRGAS USA, LLC CHECK AMOUNT: $52.89 ' CARMEL, INDIANA 46032 PO BOX 532609 ATLANTA GA 30353-2609 CHECK NUMBER: 222298 CHECK DATE: 7/30/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 9910971999 52 . 89 OTHER EXPENSES CYLIN DER RENTAL INVOICE •- o.- !98 • e •o .Aas USA,LLC INVOICE DATE PAINVOICE NO. DUE DATE PAY THIS AMOUNT Airgas. PO Box 9249 06/30/2013 181 9910971999 07/30/2013 $ 52.89 Marietta,GA 30065-2249 . • , e AMOUNT ENCLOSED SOLD BY AIRGAS USA, LLC Ja ❑ Check 5430 W MORRIS ST INDIANAPOLIS IN 46241-3429 F] Credit Card 317-243-6606 Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. IIII...I�JIII'1111....IIIIIIIIIIIILII��IIII�JIIII��I,�I�L„11 T481 **AUTO 3-DIGIT 460 PL8 S296 BILL TO {CITY OF CARMEL SEWER II I'I ' II III I I II I IIII IIIII IIIIIIIII"I 1 CIVIC SQ AIRGAS USA, LLC 111. CARMEL IN 46032-2584 PO BOX 532609 M6 ATLANTA GA 30353-2609 138315 18139981991097199900000052897 TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORT'l ON WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727 4693 INVOICE NO. SOLD'•TO NUMBER "$HIP TO.? INVOICE DATE RENTAL.PURCHASE ORDER NO. TERMS' 99109719991 1813998 1778561 06/30/2013 RENT NET 30 -MATERIAL I DESCRIPTION SUBJECT BEG BAt - _BRIE RETURN Apd END BAC LE_A_5ES - NET DAYS. RATE ,F - ' PRICE DOCUMENT/DATE: TO:RENT RRCYLISM-AC - Rent Cyl Ind Small Acetylene 2 0 0 0 2 1 1 30 $0.6148/DAY $18.44 N RRCYLISM-OX - Rent Cyl Ind Small Oxygen 1 0 0 0 1 0 1 30 $0.59/DAY $17.70 N ==============------------=-=3 0 0 0 3 $36.14 0� Hazmat: 16.75 Imaortant.See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the AMOUNT:7 $ 52.89 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 . provisions by written advice to us within(15)days after the date of this document. SHIP TO:1778561 CITY OF CARMEL SEWER AIRGAS USA, LLC Airgas. g 130 1 ST AVE SW Acct No. k,ABA4 o 0 www.air as.com PNC Bank,ABA No 031000053 Airgas USA,LLC CARMEL IN 46032-2009 PO Box 9249 Marietta,GA 30065-2249 Page 1 of 1 SEL-001000 VISA MASTERCARD DISCOVER AMEX Exp. mm/yy Card # Print Name Card Billing Address lCard Holder's Phone Number IV vou are faxing this form please provide your Airgas acct# and Invoice# tfi,om the reverse side. Disclosure ]eois of Sale- Ea:,,h sq.e of Goo,is or serv:ces by an Airg as 1"company is and shall be cover neo by tile terms and conditions on this Disclosure,the Ternis of Sale affixed w the Account Amyva"on/if one rpSve*^oump'etou),and the Terms m Sale found ot 11 ��gcuuuou�axn �m,n°ou,v/vmv^�nn,�onur> m"xcno;m.,/^.the sale o/oon,r".so-vices u*twoon Seller and Buyer rco^trau'>oha//."'a/ua these Terms o/Sale.together with any other u/eoa/describing the Goods rra,rv/p°a:)e/np sold,their v,i^o.ce:vex terms,and all other onoom'nm,/mms. "Goods"refers m any items m tangible v*000a�property described m any Contract vro?henwmern`m~o'u'Seller!c Buve., Notice Regarding Cylinder RentaisiLeases and Resnonstbility: This diCUomnt shows the lom�number of cylinders charged mu��ya,�m�swu��x��m�� .ev�uwows,un«which Buyer x"�^m�mneu>x�r�nomaoov,o'w*�xa,ofm*mrmhonu/ o � / n" be m / Buyer o ou u,o,meredmno-A'c,all contractual v"poses between oApr and Seiler,v"/*sn Buyer reports m Seller mwriting any errors Buyer claims within eo days after the date hereof. suve,agrees wm-o,upmpay or.all cylinders charged m Buyer until Buyer has a.merW returned Such,cylinders m Seller m good working order^,(m pays oonv,om ep/aceMem cos,me/^wf. Refrigerant Refillable cylinders o remain the property,xmrgasmxsu`/,a-v"rty vendors. nucxov:ndom shall riot be used uv Customer for purposes other mnr/�e storage of gas products purchased fioin Airgas or the retum and reclamation of certain gases(e.g.,refrigerants), Each refillable cylinder will uasubje�;tma cyiiridnr./,no,uue.ouecwma:ouuvmmaso"nnmemuals. xov;wioremnumeuenositmowhe,meoustome returns the refrigerant c�/nm�unless�o:/onuersm^lmuo/oueeme wuo^nm�/evm`.e,d�pon/^vuuvA/may'wmu`oe�^n.nat'm`shnooe/nommmon��days after m~uvxrmo/was nyvmau. Warrantv A!' ,nmuow, n'ne, ue=s of sale, udina,u and mh°rov.,mmo,�s fum/vxeo "v n"mmas company oxnn conform tom* description thereof published by the .nanvmomre,:�t t"atime m sale and will meet ue/e,'o purity opociooaon"u for all gas pmd..r!s SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS onIMPLIED uTxmoxnoo, ouAnAwrsEo, OR wwnnAwnsa, INCLUDING ANY WARRANTIES OF meno*Awn^amrY, pnwsas FOR APARTICULAR punpoos on NOW INFRINGEMENT AND ANY WARRANTIES Tx^TMxvBc ALLEGED/oARISE AoA RESULT op CUSTOM oRUSAGE. SELLER s4xLLosuAe4+ONLY FOR THE PEPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS. INCLUDING THE REPLAGEMENT OF GASES THAT DO NOT MFET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS, BUYER KNOWINGLY AND FULLY ASSUMES THE R13KS OF TRANSPORTING AND USING COMPRESSED GASES. SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS EXPRESSLY PROVIDED *sRew). INDIRECT, SPECIAL. INCIDENTAL, CONSEQUENTIAL AND/OR PUNITIVE DAMAGES,ARISING on ALLEGED ro ARISE OUT OF OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT,OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR LEASED BY SELLER,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT on OMISSION omm RELATED To STRICT LIABILITY.u*OTHERWISE. Iwoscf-PPm,)qz Unless^me.^/oesnmyoau:nvco^t'a*.Buyer^hx:make payment~.full within m days after the date of'a,v*/sinvoice. Continued open account credit /°xv,,jecto*/'°,`assess rent of Buyer's onawrz/condition nnuability m pay.A'atennvme"t charge Of 1s%uo the unpaid, »os/due balance,will oe assessed monmlv (mmx"ux.�«zunoo�{�uuu> o'/�omummvm/�*u/m'enno�amomma,w��xem��co�dsa�ueomwu,wh/u`eva,ix/,mo suoJarqv�� L000 notice and mco'mofunoenyi,n documentation Buyer o^o'/pay t:uooao surcharge m the event ofoovumwmu/noryo,ema��oxmoma�smmemu m(a)power^nmnr raw mate"^w,s,mm the production u/pmuucy and/or/b>fuel. Title m all rental env wro ',*m/,pinnlnuaelle,'snam* avyerm,it riot uove mo ify,remove m otherwise disturb any identification or other ."momof Seller's�r,mwnn^any rental equipment T8`eo A,v taxes imposed»%'federal State,mnuo'governmental authority on the Sale,use or possession o/Goods,u,the sale o,performance of services bvavA/rgao comp,.`v shall ue paid uva^ye. 'nnux./mr/o the nuuhaoeprice. Itemized Chaa�es: (a)The total amount due from the avvo,mav'Jn"/uuo various.te°.,eu ma,o*s, mc/"moo: oua,oeo for the^""u000 o//,aza'uoux mate/.a/suoa for compliance with laws and regulations mou,m/ro hazardous ma/e'/aa:charges for x�.nuo^n.delivery onvsh'pvmo�anu!c,charges'or energy m fuel.None m the charges represent tax or fee pv.d I"Or imposed by v..x government-aomn"tu ,nu all oro.v o»xmea are ,*mn,y/ by the Seller r'o no/leronu riot specifically quantified the ,elo'wnmi�,uetw^er,the'ha�ossnum^arun'my�er�u��x�me�xamm.vx�c`can v^�u`�nu�m newu "m~orunm" omvo ^merm`ogc, (»)mosuch ��no,/,^o'maov �Ur ri a Ridor wlii w)osed w/"."`w*v" :u`;co/ x" U.S *�mm^,a�^uundy'u�r�a�o�and rmw�"um and auoom ,xo �o,mm":r�uu�/ a y `^ec~''``'��r,,°""an°'mant~oo and s `vecm=/!�,ueo.mwmne/ No, 11 246�the Rehabilitation Act mmr,j and the Vietnam Era Veterans Readjustment Ass:m""^=^�c,of`o'4,all a^~",a"ueu. ' A`o°, zerv.°,m*.°.+. �m`, , n ��naeaysmeoo �m�a»�w�""x ' e"~ ~`�°e�u�m��v"va»naac*m �mu'»^w« m see xu="w=air9a^.pom Can m,veyou 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 7/24/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/24/2013 9910971999 $52.89 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 # 136045 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 9910971999 01-7362-06 $52.89 Voucher Total $52.89 Cost distribution ledger classification if claim paid under vehicle highway fund