224265 09/23/2013 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $27.35
CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 224265
CHECK DATE: 9/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 1049573 16 . 53 SAFETY SUPPLIES
1094 4239012 8252433 10 . 82 SAFETY SUPPLIES
ITEM Q are DESCRIPTION UOM UNIT
� AMOUNT
SHIP'D 6/O ! PRICE
** Location: A **
OKIWESMCW-2BC 2 0 312-MCW-2BC CYL WRENCH ZINC EA 5.14 10.28
W/CHAIN j
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Subtotal 10.28
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Visit us on facebook or o the !,rei.ght 6.25
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web• at www.indi'I naoxygen. om
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( Taxable amount: 0.00 j
CARMEL CLAY PARKS CUSTOMER: 03390 • 16.53
s
1411 E. 116TH ST. INVOICE: 01049573
CARMEL IN 46032 INVOICE DATE: 08/29/13
ORDER: 0184471.4-00 P/O: MC04412
INDIANA OXYGEN COMPANY 0 P.O. BOX 78588 o INDIANAPOLIS, IN • 46278-0588
-v-1 Jiii-1-Y UL)li t'A Y M L'1Nf- -_- -------------------- -------------
'Nv iTEivi INVOICE-DATE INVOICE BEGINNING . SHIPPED RETURNED ENDING LEASED gAUDAYS CYLINDER EXTENDED
p BALANCE E3ALAr Cf L!NPFRS RATE AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .349 10. 82
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TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL 10.82
1411 E. 116TH ST. INVOICE: 08252433
CARMEL IN 46032 INVOICE DATE: 08/31/13
TOTAL CYL VALUE: 1-0 0 . 0 0 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
8/29/13 1049573 Oxygen tank keys $ 16.53
8/31/13 8252433 Rental of Oxygen tanks Aug'13 $ 10.82
Total $ 27.35
I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and 1 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$
$ 27.35
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1094 1049573 4239012 $ 16.53 1 hereby certify that the attached invoice(s), or
1094 8252433 4239012 $ 10.82 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
19-Sep 2013
$ 27.35 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund