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Home My WebLink About226588 12/03/2013 s CITY OF CARMEL, INDIANA VENDOR: 355856 Page 1 of 1 ONE CIVIC SQUARE AIRGAS MID AMERICA CHECK AMOUNT: $54.09 CARMEL, INDIANA 46032 PO BOX 532609 ATLANTA GA 30353-2609 CHECK NUMBER: 226588 CHECK DATE: 12/3/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 9913910277 54 . 09 OTHER EXPENSES CYLIN DER RENTAL INVOICE Alm s. AirgasUSA, LLC INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT Ma Box,GA /31/2013 1813998 9913910277 11/30/2013 $ 54.09 Marietta,GA 30065-2249 • • 1 • AMOUNT ENCLOSED SOLD BY AIRGAS USA, LLC 59 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. IIIIIIIIII�IIrII�IIIIIIil�lllnu.�ill.l.11.�..11lll��llll �lll 134842 1 AT 0.384 T471 3DG460 PL7 S296 �Ill�ll�ll.�II�II �InII ��III�Irll�llll��illirun�r�lln..11 BILL TO {CITY OF CARMEL SEWER 1 CIVIC SQ AIRGAS USA, LLC 0 CARMEL IN 46032-2584 PO BOX 532609 ATLANTA GA 30353-2609 134842 18139981991391027700000054098 - - - ----------- - ---.�— — — --TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693 iNVOIC8 NO.- 'SOLD TO NUMBER ShttP TO ffuOtGt DATE t2ENTA Pl?FtCMASE UR I t N0 T RNIS 99139102771 , 1813998 1 1778561 1 10/31/2013 1 RENT NET 30 IJiATERrAL TiESCRiP7I0N t.�A stje� cT `: . •• BEG'8AL SFitR RETURN ADil END BAt. SES ...: NET RAYS. RATE PRIDE OOs;UMENTi RATS TO RENT. , U. 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 AMOLINT:DUE $ 54.09 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 AIRGAS USA,LLC Airgas. CITY OF CARMEL SEWER www.airgas.com 130 1 ST 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. mmlyy Card # Print Name- Card Billing Address Card Holder's Phone Number If you are faxing this form please provide your Airgas acct# and Invoice # frorrIlhe reverse side. � Disclosure igvmm�� Each sale,of Goods or services by an Airgas' is and shell be governed by the tenns and coml.ho!is on this Disclosme,the. Terms of affixed to tho AccountApplication 6f ono has been completed).and the Terms of Sale found at ("'ollective'v the"ler't�s of Sale"). Each Conlract for the�iale oi Goods or between Sel!et and Buyer("ContracC) .,hall include,,these Terms ofSale,logiather with any ofhe�mate!!""l dosc—o�-,4 the Good&Or servCos being sold,their price,delivery terms.and all other special provisions, "Goods"refers to any items of tanr bre personal propr.,rtv described tri any Co,trict or othe:vvise crov.ded.by Seller to Buyer. me total number charged io Buyer leased to Buver,and which Buyer has not returned)according to Seher's records as of the month end.ng date shown. The nurnber o4cylinders thus charged to Boyer shall be conz�;oe reLl corre of for a"Wn[CaCtnal purposes betvveen Buyer tand Seller,unless Buyer reports to Seller in writing any errom Adyer cla:rns w1lbi-60(lays afte� fhi�dale le,e0f, buyer agrees to continue'to pay rent on @11 cylinders charged to Buyer until Buyer has either(i)returned Such cylinder-,to Seiier in good,vorcing order or iih pays Se.'erthe ep aceirerit cost thereof. nomiaule refrigerant rx/ride"s*g/remaumennnen ofAirgras or its m/nd-n xveamom, Such oyl/noeis shall not ueusemin, Custorner for purposes other t%han the storage of gas products,purchased on Airguoor the r�tum and reclamation moeur/n gases.�.g. mmowmnm) Eaoxnmomule vvx"uvrmmue subject u,a cylinder deposit me'as established uxmrga"onmomntomne. mm*a will refund o`o deposit fee when n`*Customer remms the,r,*rk;mran/ cyhride er unless the cylinder's cond4jon is deemied to be unfit for rouse,as detenninee bvAirgas,which determination shall be irrefutable sixty cmv,Ffire,the qx/nuo,,ms ,mumau All nmuvxts, mhm, of sale, cylinders and other cumamom mm/vxeu u'onmas comnan' shall conform to aeucx ,� meex��um�*m uv the mnnv��oe,a,the umaof sale and wm meet Seller's purity specifications for all ass products. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS onIMPLIED eTAwo*moa. GuxmAmreea. OR WARRANTIES, /woLoo/wG ANY wwnnAmnsn OF mseo*AwrAa/LITY, pnmEaS FOR n*or/CuLAn pumposs on NOW INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE. Lit�gt i,)n � SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS, 11vCLUDING 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 Op TRANSPORTING AND USING COMPRESSED GASES. SELLER SHALL NOT oe LIABLE FOR ANY DIRECT(sxCeprxs EXPRESSLY PROVIDED HEREIN), 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 mn/S RELATED noarn(cr LIABILITY,onor*E*w'me ]� un/aauomeow�xeuve:mvum°ovnuo�.euvoroxonm"�evu/memmmo�uunaooavvuoe,m*aa�o/seno,�sm,ome� omm/`vouapenm000un!x�gx ;s it.biect!,-)Seller's assessrlpnf of Bkjvpr s finanr/al condition and ability to pay.A late niym*n charge of 1smon the.unnam.pas,due uo/an,s, wuueasoe.,,oe�J1monm/, (m.nw,m*muo:mrs iszou}.ormemuxmumlawful rate anowomoin the state the Goods are uox,ereu.ww/uxevo,/uless, Su,ch�uue� Upon nvooeanu receipt munuenvmouucumonmoon Buyer shall pay m Seller axvv&urgum the event wauv extraordinary o,mn`v,o°",vmcneavaom the cost of(a)nnwe,enu/u,owmmm,/o/susaam the production ofpmuycto and/or(b)fuel, Titill to : Tue/o all rental enu/pmentcxaoremain m Seller's mme. Buyer shall not cover,modify,remove o,otherwise msm,u any identification o,ome,/ouaia of ae/le,'a ownership nn any rental equipment. Taaes� ^nv taxes mposeuuv federal.state, or other governments'authority on the saie,use or possession of Goods,or',no sale or perionnance of services i-,,y an Aigas /mmva^voxpobe paid�v Buyer m addition m the,purchase v'/ca. (a)The mta/arrovv/due oum the Buyer may include various itemized mamoo, mmuu/no:charges�orma xanunno -f hazardous mauxa/n and for compliance with laws and regulations conocrring hazardous materials:charges for handling,deliveryand shipping;and./orctiargesfoi energy or fuel.None orflnp changes mnmwnta tax o,fee nammo/i.nnuaoauv any oovummen[authority, anu all orme,charges are ,elameuuv the aenm The Seller has nol specifically vuammeuthe rell'tionship between the charges and the actual costs assoc/ated with the charges,which can vary by product,service.time and placce,among otherthings. NO such charges not already provide:u to-/nanma,vvo/uo imposed Wu^ouLmume/cunuent, � cu�am�nvsoon`puo/eoarc ua oo�nmemonnoaom�and xvmmnom�om and am�4oc�m and»u�ammmemnv/�m°nmu/�me�/mwm. oxecuo,r",ckeo,anu attendant nuon and reou/auons,s»oomnuuys,eci/xe Order No. 112ms.the[Rehab ntao nAmm1man^umemmnmm sav*teians��u�mw' Aoe/conceAct of 1o7w.ail asamended. A/maxue"s/"ess wm*umnnu"sinom,with msa,/,easier t^a"over with our eo"smos,weusxo.»mpaw°*a/mam,,^m, Visit Lis^non*today tonoexwwwwwu*ues.camcanamvyom oma and mono» VOUCHER # 136875 WARRANT # ALLOWED 355856 °.j IN SUM OF $ AIRGAS USA, LLC PO BOX 532609 ATLANTA, GA 30353-2609 3 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 9913910277 01-7362-06 $54.09 i 1 i 4 Voucher Total $54.09 Cost distribution ledger classification if claim paid under vehicle highway fund 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 11/25/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/25/201,' 9913910277 $54.09 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 p12-7/3 Date Officer