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Home My WebLink About227650 1/8/2014 CITY OF CARMEL, INDIANA VENDOR: 366748 Page 1 of 1 ONE CIVIC SQUARE AIRGAS USA, LLC CHECK AMOUNT: $52.89 CARMEL, INDIANA 46032 PO BOX 532609 ATLANTA GA 30353-2609 CHECK NUMBER: 227650 CHECK DATE: 1/8/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 9914906731 52 . 89 OTHER EXPENSES CYLINDER RENTAL INVOICE •- sb- •-- • • • ,0-596-6112.' -. Airgas USA,LLC INVOICE DATE PAYER INVOICE NO DUE DATE PAY THIS AMOUNT PO Box Ma �UAMas. 11/30/2013 1813998 9914906731 12/30/2013 $52.89 Marietta,,GA GA 30065-2249 • • P • AMOUNT ENCLOSED SOLD BY AIRGAS USA, LLC 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. "Inllln.II,.III,IIIb.IIII,II„I.Iullllurllllllllllr111111 135673 1 AT 0.381 T471 3DG460 PI-7 S296 IIII�II'11”II'11"II111'I'111'Il'Il'Illl"IIIII'Illl'I"1111"11 BILL TO {CITY OF CARMEL SEWER 1 CIVIC SQ AIRGAS USA, LLC r� CARMEL IN 46032-2584 PO BOX 532609 ATLANTA GA 30353-2609 135673 18139981991490673100000052894 TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693 INVOICE:NO.:;i 1,SOLD-TO'NUMBER" SHIP TO.'.*'.ii; I INVOICE DATE I RENTAL PURCHASE ORDER NO: ;.:: T.ERMSS> 99149067311 1813998 1778561 11/30/2013 RENT NET 30 MATERIALIDESCRIPTION SUBJECT BEG BAL SHIP RETURN � ADJ EA END BAL LSES NET DAYS RATE- DOCUMENT:/DATE TO RENT RRCYLISM-AC - Rent Cyl Ind Small Acetylene 2 0 0 0 2 1 1 30 $0.61/DAY $18.44 N RRCYLISM-OX - Rent Cyl Ind Small Oxygen 1 0 0 0 1 0 1 30 $0.59/DAY $17.70 N --------------------------------- 3 0 0 0 3 $36.14 ------------------------------------------------------------------------------------------------------------- Hazmat: 16.75 Important.See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the '' AMOUNT°:';` $ 52.89 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. CITY OF CARMEL SEWER AIRGAS USA,LLC Acct No.8606074182, www.airgas.com 130 1 ST AVE SW PNC Bank,ABA No.031000053 Airgas USA,LLC CARMEL IN 46032-2009 PO Box 9249 Marietta,GA 30065-2249 REV 1.1.13 SEL-001000 Page 1 of 1 CRED97 CARD [MOLLOM6 VISA MASTERCARD DISCOVER AMEX Exp. mm/yy Card Print name CardBilling Address Card Holder's Phone Number Signature If you are faxing this form please provide your Airgas acct# and Invoice# �=ii the reverse side. Disclosure Lernilof Sale, Each sale oi Goods or services by an Airgas'"company is and shall be govern,40 by the terms and conditions on this Disclosure.the Terms of Sale affixed to the Account Application(If one has been comple-'ed),ano the Terms of Sale found at h1tUL.,Nymv. m;qustornor servicefterrr!55 ,a PX(collectively the"Terms of Sale"). _ Each Contract for the sa!e(if Goods or services between Selk)t and Buyur("Contraci')shall include thesc Terms of Sale,together with any other material describing the Goons or servtce,�,berg so d,their once delivery longs.and all other special proii:sions. "Goods"refers to any items of tangible personal property described in any Contract ,.I o!hFiwose provided by S(-ker to Buyer. ttiott ardiLiqCvIindeL erftals%Leas,,s and Btsjponsib.liik: This do,-urnent shov-,the to'al number of cylinders charged to Buyer;i.e,ry!inders which Seller has rented or leased to Buyer,and which Buyer has not returned)according to Seili records a,,,of the mo-ith ending date shown,The number of cylinders thus charged to Buyer shall be can�idered correct for ak contractual purposes between Buy(-r and Seller,unless Buyer reports to Seller in writing any errors Ru'ver claims within 60 days after the date hereof Buyer agrees io continue to pay rent on all cylinders chargeo,to Buyer Until Buyer has either 0)returned such cylinders to Seller in good working order or(.it)pays Seller the replacement onst thereof. R efriggL,,_int C yhniler Returr,siDej)osit, Refillable refrigerant cylinders shalt remain the property of Airgas of its third parly vendors, Such cylinders shall not be used by Customer for purposes other than the storage o!gas product-,purchased from Airgas or the *(-!urn and reclamation of certain gases(erg,refrigerants). Each refillable cvlipd,�r will be subject to a cylinder deposit fee,as established by Airgas from tiniti to time. Airgas will rorund the deposit fee when the Cummer returns the refrigerant the cy1ride,'s conditiori is deemed to be unlit for reuse,as determ ined by Airgas,which,determination shall be irrefutable sixty days after the cylinder was retu,-!d. nrOGLICIS Other items of sale. cylinders and other containers fuiu:;hecl by an Airgas company shall conform to the description thereof published by me I1.ianuf'.1CtL1rer at the time cf sale and viiiii meet Siefler's purity specifications for all gas products. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NOW INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE. ..q,I It <-J_-a-)i liy: SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDFRS AND PRODUCTS, INCLUDING THf!REPLACEMENT OF GASES I HAT DO NOT MEET 1'15 PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY AND FULLY ASSUMES 1 HE RISKS OF TRANSPORTING AND USING COMPRESSED GASES. SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS EXPRESSLY PROVIDED HEREIN).INDIRECT,SPECIAL, INCIDENTAL, CONSEQUENTIAL AND/OR PUNITIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT,OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR LEASED BY SEI-LER,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE Tqrtn ofpaymoqt UnlE,ss othemiise specified in a Contra(;:,Buyer snall make jpaynieni,In fuk within 30 days after the date of Seller's:nvoicc. Continued oven account credit IF" ut jet to Se!Ier's as.qt—,srnPnt of Buyer's financial condition ano aluiiity to pay.A late payment charge of 1.5%or.,the unpaid.past dup balance,will be assessed monthly i'm3iiii,ium to4c 00i,or the maximum lawful rate,allowable in the state where the Goods are delivered,whichever is less. Surcharge s- IJ,iot,not;ro and receipt of undonying documentation,Buyer shall pay to Seller a surcharge in the event of any extraordinary or emergency increases in the cost of iia!power-,,,cio,r;ii%-jn,,AAnals used in the production of Products and/or(b)fuel. Eq:,,,.,)ILLI; Tfl;7i if)Hit yenta,equipment shall remain in Seller's name. Buyer shall not cover,modify,remove or otherwise disturb any identification or other indicia of Se,lqrs owncrs!iip(,in u.)v rentai equipment. Ary t-ircs impcsc,-j by feii state.cr other governmental authority on the sale. use or possession of Goods,or the sale ur;,,crformanir-e of services by an Aimas ipiny, I-11 ne paid bly Buyer inadditionto ine purchase price. Tne tr;'a-.),nmint duc from.the B..yei may nciucie various iteri charces, inCkfflin.J: charge:.`,,r the hir:d1mg of h,,zn,cous 7interials=nit for 1<,,% --w rc-ry a'r,IS"Oncerninq charges tar handling.deliver,,.and shilpoing:and;-r ,nargi I,,enerc y nr f,el-flow of the cr,,—qf-s I! ;o o. "i", any govf-t;inent riWkorty. and at+of the-harges are relaincd :iy file Sfii,ui, The Scalier nas it,;! if-(,' -r-'am" c?he i;,.l costs with the charges.which can vary;)yproduct service.tims and p;at,e among other fl,,,rcis.. (b)N)such 1, 1 •0; ir,q RI'le, :'i'i be im:w,;i:d 4i9thout JTJ-.ItI-J,1j consent. )rtra:'t, coripan,es are IJ-S.government contractors and'Subcontractors and are subject to and adl w ttie Qjd rerMink(Jfederal out, e oi,1k;.s,z,rd atierruant ru es and regu ations,specifically Executive Orcer No. 11246,the Rehabilitation Act of 1973 and the Vietnam Era Veterans Readjustment Assistance Act of 1974, 'fl as amended. Airgas eBusiness -v dofn-1 At'gas is easier 111'911 ever i&Ah our eBusiness website,http://www.airgas.coni. Visi:us onin,(>tcoptv:0 bre- 1,cw wNw.airgas.corii can sr r 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 12/31/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/31/201' 9914906731 $52.89 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC5-11-10-1.6 Date Officer VOUCHER # 137113 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 9914906731 01-7362-06 $52.89_ Voucher Total $52.89 Cost distribution ledger classification if claim paid under vehicle highway fund ��1 3