HomeMy WebLinkAbout223379 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 355856 Page 1 of 1
a ONE CIVIC SQUARE AIRGAS MID AMERICA CHECK AMOUNT: $54.09
* �a CARMEL, INDIANA 46032 PO BOX 532609
ATLANTA GA 30353-2609 CHECK NUMBER: 223379
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9911778145 54 . 09 OTHER EXPENSES
CYLINDER RENTAL INVOICE
Airgas USA, LLC INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT
AergaS. PO Box 9249 07/31/2013 1813998 9911778145 08/30/2013 $54.09
Marietta,GA 30065-2249
• • 1 • AMOUNT ENCLOSED
SOLD BY AIRGAS USA, LLC 5q `O�
5430 W MORRIS ST ❑ Check
INDIANAPOLIS IN 46241-3429 Credit Card
317-243-6606 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
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BILL TO {CITY OF CARMEL SEWER
1 CIVIC SQ AIRGAS USA, LLC
CARMEL IN 46032-2584 PO BOX 532609
ATLANTA GA 30353-2609
135357
18139981991177814500000054093
TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693
INVOICE NQ.- ,$ D TO NUMBER :s.. SH€PTO. €NVO€G
> E:DATE RENTA .PVRCHASE.ORDER:NO. :::TERMS
99117781451 1813998 1 1778561 1 07/31/2013 1 RENT NET 30
MATER€AL lOESCRIP.TION " SUBJECT.
BEG:BA l SMIP . RETURN ADJ1 END:BAL LASES .;,, - NET DAYS RATE PRIGS`
t€OGUMEI�T I DATE': : TO'RENT
RRCYLISM-AC - Rent Cyl Ind Small Acetylene
2 0 0 0 2 1 1 31 $0.6148/DAY $19.05 N
RRCYLISM-OX - Rent Cyl Ind Small Oxygen
1 0 0 0 1 0 1 31 $0.59/DAY $18.29 N
--------------------------------------------------------------------------
3 0 0 0 3 $37.34
Hazmat: 16.75
Important.See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the AMOUNT DUE_ $ 54.0 9
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.
SKIP To:1778561
CITY OF CARMEL SEWER AIRGAS USA, LLC
Airgas. www.airgas.com 130 1ST AVE SW Acct No. k,ABA4 o 0
Airgas USA,LLC
CARMEL IN 46032-2009 PNC Bank,ABA No 031000053
PO Box 9249
Marietta,GA 30065-2249
REV 1.1.13 SEL-001000 Page 1 of 1
CREDIT CARD BOLLING
VISA MASTERCARD DISCOVER AMEX Exp. mm/yy
Card #
Print Name
Card Billing Address
Card Holder's Phone Number
Signature
If you are faxing this form please provide your Airgas acct# and Invoice#
ftoL�� the reverse side.
Disclosure
Terms of$ale: Each sale mGoods or services by an m "'company is and shall be governed by the terins and conditions an this Disclosure,the Terms of Sale affixed
to 11ho Accounit Application(if one has been completed),andlt-.�Terms of Sale found at !cusjqfn1p,,� SLrN�Lgq rrns.,�sp�.(collectively In,,,`Terflf'S Of Sale",
Each Contract for the sale of Goods or servk;es between Se;,�r anci Buyer("Coniract')shall include these Terms of Sale,together with any other material descrb,rg the
Goods or sorv�ces being sold,their price.delivery terryis.and ail other special provisions "Goods'refers to any terns(if tangible personal property described in any Coritract
or otherwise provided by Sellet to Buyer.
This document f-,hmm the total number ofuv//ooerscharged too / � x » Sell Sellp,has u or
leased to Buyer,and which Buyer has not returned)according to Seller's records as of the month onding date shown.The number ofcylindors thus changed to Buyer shall be
mruvomu correct xv contractual purposes between Buyer And Seller,Unlesi,Buyei reports to Seller in writing any errors Buyer ciA.ms within 60 days after the date hereof.
uoe,agrees ocuofi,uom pay rent on.//cylinders m`org,dlmauvor until avvu,ties either<o returned such q//mvu/sm Seller mo:uo working order:r(mns/^Seller,hc
replacement cost thereof.
o'n,xenmnenv�^/,«ono'�sm/m'psxr"enuom. Such c�myn�smonot m,"e*uv
|
Customer for purposes other than the mum e of gas product purchased from Airgas or the return and rec!amation of cortain gases .refrigerants) Each mx/'ume
/
cylinder will uesubject to a cylinder deposit fee,as established by Airgas from tinie to time. Airgas will refund the deposit fee when the Custorner returns the ipfrigeant
� ¥xcu,unless the n///,`uu,'s condition mooemoutouvunntm,remm.a,ueunnmeuuvA/mas,°m/oourmnnmaovnaxpnueivemtameo'xtyoovxano �,ca/noerwas
� /el^',`*«,
Warrant)L. All products. other tems of saie, cylinderi, and other containers furnished by an mrgas company sha!l confoirn to the description isxeduy the
nn^�/"mvre,at the,*".w sale and w:/mmx Seller's purity yrrun*mm^x for ,it gas products, SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS onIMPLIED
un^woAnoo, ouAmxwresa. OR WARRANTIES, INCLUDING ANY WARRANTIES oF MERCHANTABILITY, rnmeau FOR APARTICULAR PURPOSE OR mow'
INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
a 1.CLLER SHALL BE LIABLE ONc -:OR THE REPAiy OR REPLACEMsNT OF DEFEG;'IVE GAS CYLINO,,RS AND PROoI)C-Is. INCLU[hx(.
THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES. SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS
EXPRESSLY PROVIDED xsnem). 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 OR OMISSION OR IS RELATED TO STRICT LIABILITY.OR OTHERWISE-..
To� otherwise opo'Jmclinnuow/ar/.nvveru`nn mike pp"°n./o full wit!,nmn"'s after 1m'/ale,xaeoe,'sinvoice. co //"v"o.pon,n`w`,n=,p
w subject m Seller's assessment u condition and ability m pay,A late^avmoo charge of 1.vunn the unpaid.past due balance,will oeassessed .nv::�iiy
ltn,ni*urn two dollars(S2.00),or the maximum lawf,.,i rate,allowable in the state where the Goods are delivered,whichever is less.
Upon mx and o"eimOf underlying uvcfj lation,Buyer sh�l pay to Seller as/,hmme.`the evon"ma,«extraordinary m°`iergeo/ no',.°ym/m,Cost
�
of power andlor�°mu�e nalsusox/n the of Products umumsan u x�(»)fuel,
�
���oE_quujp um�t. rmem all rental enu.»m"o,shall remain/n Seller's name. ffiiyer shall not c.,-,,or,ma.,dify�remove or otherwise distuft)anv identification rrr other indic�a of
;ownership vxmrnmtol/°9u/pneot,
T� m,v*x;" u,�,,uom/, u,other oomwmenta/authority"o the*a/e. "oov. possession m Goods;m the sale v,performance,a~e.,/caxxv^nmrgv,
eu>e. mwm/�nto the v",umor:,rc*
!tL,r"zd Cbarou« r,amta/ awo,m due from the Buyer may include various xo^`ueu000,oeo. mo/vumo*charges for the-a^u:/noof»azamvuoma,e./a/a and�'
'��^'�m.,.���m'/om. �'x onv:.:pvs r. �^en`mo»a/n,u"v�ma�e,/u/o�ox,n,.�m,�en0000�.*mvrvaru,mppmn�"nmnruxa�o�m'^o^rxvv//vo m"x..���*erxa'p`,
'cl ,on'^ta/ o' l,^ rau� z /.nro^�uuv any oo,ommentauwmv and soo/',exxu�°, ,m'e�uoub� moze,ec The so'/�'xz� no� ,no�.�.w�v,.^'m�ruo`o
rolalionshio hcl%veen tie charaes and/o,actual i�osu associated with the(.1!swou,which can vary uvnmuum,service,time and,00,,ammng Other,m^oo. 'n)Nu°mx
m^'*`oo,a/.*:.'vr'°Jed'x-/o~il�`^,pmue/^.o",ecwxwv'mummcows*n/.
Certain xvno companies are u�.government conractors and subcontractors and are z;kjt)je(.-.L to and aohwe to the requifsmpnts of federal 1:4vvs.
\ momwe orders,v^c^oonuo",rules a,d,00u/amno,srecn'mov Executive Order No. 11x+e.the nv»ubv/taoonAc/of 1um and meuomum Era Veterans neadjv,*rnmn
| x^nistanno Act mmm,rill osamena°o
/
mmasoaus/ness
w'�"o."nm.m"°no°mm�nn/veaoer*""e"�,°/mo,'oou,m*nyw�u°/wvuv�x°m�a.�us�mm Visit;,s online today w see how°°w.x/rgpv,00m can save you
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 8/15/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/15/2013 9911778145 $54.09
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
Date Officer
i
VOUCHER # 136189 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
9911778145 01-7362-06 $54.09
Voucher Total $54.09
Cost distribution ledger classification if
claim paid under vehicle highway fund