226707 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $10.82
moo'? INDIANAPOLIS IN 46278 CHECK NUMBER: 226707
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 8260853 10 . 82 SAFETY SUPPLIES
INV ITEM INVOICE DATE INVOICE BEGINNING $HIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED
TYPE SALANCE BALANCE CY:.INDERS RATE. AMOUNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .349 10.82
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104-- �3q la. I
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----- -! --- --I TAX: . 00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 10. 82
1411 E. 116TH ST. INVOICE: 08260853
CARMEL IN 46032 INVOICE DATE: 10/31/1 3
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
10/31/13 8260853 Rental of Oxygen tanks Oct'13 $ 10.82
Total $ 10.82
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
, 20_
Clerk-Treasurer
Voucher No. Warrant No.
154252 Indiana Oxygen Company A1Ilowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 10.82
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 8260853 4239012 $ 10.82 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
27-Nov 2013
$ 10.82 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund