222444 07/30/2013 F CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $359.81
CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 222444
QOM O
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 01032417 116 . 22 REPAIR PARTS
2201 4232100 01035647 233 . 12 GARAGE & MOTOR SUPPIE
1094 4239012 08243983 10 .47 SAFETY SUPPLIES
_________________________________ __________ _____ __
INV ITEM. INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED
ryp LANCE CA..A10E CYLINCERS RATE AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 30 .349 10.47
23 04
_ I
_ TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 10.47
1411 E. 116TH ST. INVOICE: 08243983
CARMEL IN 46032 INVOICEDATE: 06/30/13
TOTAL CYL VALUE: 100 . 00 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 Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
6/30/13 8243983 Rental of oxygen tanks Jun'13 $ 10.47
Total $ 10.47
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.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 10.47
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 8243983 4239012 $ 10.47 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
25-Jul 2013
$ 10.47 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ORIGINAL INVOICE
IN DI V\ INDIANA OXYGEN COMPANY CUSTOMER: 9_4698 _ PAGE: 1
P.O.BOX 78588 INVOICE: 01032417 ORDER: 01789310-01
INDIANAPOLIS,IN 46278-0588 -INV DATE: 07/11/13 ORD DATE: 05/21/13 j
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: DAB
P/O: JIM BUTTLER 966-3762
TERMS: NET 30
SHIP VIA: Will Call I
RELEASE#:
B S
I CARMEL CITY OF FIRE DEPT. H CARMEL, CITY OF FIRE DEPT.
L FIRE STATION #1 P FIRE STATION #1
L
2 CIVIC SQUARE 2 CIVIC SQUARE
TO CARMEL IN 46032 TO CARMEL, IN 46032
INVOICE AMOUNT: 116.22
------------ ------------------------------ PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM C" nTy DE UCCA UNIT
v A"f0UNT
SHIP�D a/0 PRICE
** Location: D **
MIP253521 1 0', CoNSUMABLES xIT FOR xr-40 roRCll EA 116.22 116.22
jSubtotal 116.22
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Visit us at facebook or o the I
web) at ww .indinaoxygen. om
II
Taxable amount:) 0.00
CARMEL CITY OF FIRE DEPT. CUSTOMER: 94698 AMOUNT 116.22
THIS INVOICE
FIRE STATION #1 INVOICE: 0103241.7
INCLUDING TAX
2 CIVIC SQUARE INVOICEDATE: 07111.11.3
CARMEL IN 46032 ORDER: 01789310-01. P/O: JIM BUTTLER 966-3762
INDIANA OXYGEN COMPANY o P.O. BOX 78588 o INDIANAPOLIS, IN o 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))
01032417 $116.22
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 $
PO Box 78588
Indianapolis, IN 46278
$116.22
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 01032417 I 42-370.00 I $116.22 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
JUL 2 9 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY -CUSTOMER:-07851 PAGE: I
P.O.BOX 78588 [INVOICE 01.035647 ORDER: 01842398-00
@mom
INDIANAPOLIS,IN 46278-0588 INVDATE: 07/19/13 ORD DATE: 07/19/13
317-290-0003 SALESPERSON: 000 !TERR: 007-
BRANCH: 004 INT: MMG
P/O:
TERMS: NET 30
SHIP VIA: Will Call
RELEASE#:
B s
I CARMEL STREET DEPT H "APME], STREET DEPT
L 3400 w 131ST ST 3400 W 131ST ST
L CARMEL IN 46074 CARMEL, IN 46074
T T
0 0
INVOICE AMOUNT: 233 .12
--------------------------------- --------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
I QTY UNIT
ITEM I DESCRIPI-10114 UOM PRICE AMOUNT ago SHIP'D
Location: ID
ALY1382FO5 44 0 86 .035 X 44# SP SPOOLARC86 LB 2.533 111.45
16015X44 70S6015X44 SPOO1,
OX 220 2 0 2 2 OXYGEN, COMPRESSED, 2.2 CYL i 24.983 49.97
UN1072
440CF @ ll.3559/1000P
AL S 1 0 1 ACETYLENE, DISSOLVED, 2.1 CYL 71.696 71.70
UN1001
147CF @ 48.'/'/28/`0.0C;;'
RECORD "ACTUAL" CUBIC ;'00TAC.;-'
CF
CF
(60-175CF/CYL)
Subtotal 233.12
TOTAL CYLINDERS SHIPPED: 3 RETURNED: 3
vis it us At facebook or oi the
webat www.indianaoxygen. --om
J--Taxable amount: 0.00 -1
CARMEL STREET DEPT CUSTOMER: 0785, AMOUNT 233.12
3400 W 131ST ST INVOICE: 0103564 / THIS INVOICE
-IkCL6D[-NG TAX
CARMEL IN 46074 INVOICE DATE: 07/19/13
ORDER: 01842398-00 P/O: SHOP
INDIANA OXYGEN COMPANY • 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))
07/19/13 01035647 $233.12
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
$233.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
2201 I 01035647 I 42-321.001 $233.12 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
id 13
-V . -7 -ff
N t 18MOr
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund