Okaloosa County BOCC — March 18, 2014 — Airgas Invoice-Dec 2013 — reading text

Cara 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the infarmation on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: bad faPdecQ aM Daf ppdyelaP Tha fal fo] [PP seg ]focpygpepred f ppeagl eLLTO ATTN ACCOUNTS PAYABLE eae flos fgets ft let alte tiie OKALOOSA CO EMS AIRGAS USA, LLC 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609 000628 1294994195001 5604 700005L81948 CRESTVIEW EMS S048 1021385855 03 OX USPDA S048 2 CL 2 2 6.33 CL 12.66 N (Vol: 30 FT3) OXYGEN USP DA MED CGA 870 CRESTVIEW EMS So48 1021385855 03 OX USP125 S048 3 CL 3 3 14.04 Ch 42.12 N (Vol: 381 FT3) OXYGEN USP 125 Sale subtotal: 54.78 Delivery Flat Fee 13,50 68.28 SHIP TO: 1288928 — § Airyas OKALOOSA COUNTY EMS FOR WIRE TRANSFER PAYMENTS . www.airgas.com CHRISTOPHER D TANNER, MD 90 COLLEGE BLVD E AIRGAS SA ALG Airgas USA, LLC Acct No. 8606074182 PO Box 9249 NICEVILLE FL 32578-1343 PNC Bank, ABA No 031000053 Marietta, GA 30065-2249 REV 1.1.1 SEL -001000 Page 35 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 Airgas | USA Lc , INVOICE DATE PAYER INVOICE NO, DUE DATE PAY THIS AMOUNT Airgas. ; Moro 92%9 30065-2249 C1 01/06/2014 1291991 9500156047 J 01/31/2014 {| SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT sotpay AIRGAS USA, LLC 922 SKIPPER AVE H eee ard FORT WALTON BEACH FL 32547-7315 realt Gal 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: Walpapleafpstlee dppb aleflle ALD fea perce fppeat Bito ATTN ACCOUNTS PAYABLE [PEM pleedpe tog epee al tenner lie OKALOOSA CO EMS AIRGAS USA, LLC be 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609 000628 129195914950015604700003181748 oe ENSURE PROPER CREDIT, PLEAS! OLDe E RETURN THE UPPER PORTION WITH YOUR REMITTANCE, FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-727-0693 ee TO: = 5: STERM TREGIONINV.NG| 1291991 1288928 CRESTVIEW FD so48 1021386771 03 OX USPDA S048 3 CL 3 3 6.33 CL 18.99 N (Vol: 45 FT3) OXYGEN USP DA MED CGA 870 . Sale subtotal: 18.99 . Delivery Flat Fee . 13.50 SHIP TO: 1288928 Airgas OKALOOSA COUNTY EMS . www.airgas.com CHRISTOPHER D TANNER, MD Airgas USA, LLC 90 OT LEE BLN DE post Ne 3606074182 PO Box 9249 NICEVILLE FL 32578-1343 PNC Bank, ABA No 031000053 Marietta, GA 30065-2249 oe REV 1.1.13 SEL- 001000 Page 36 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT 01/08/2014 1291991 9500156047 § 01/31/2014 ff SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT (1 check [-] Credit Card Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. Airgas ey LLC Ai a PO Box 9249 C1 . Marietta, GA 30065-2249 so.pay AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 PLEASE MAKE CHECKS PAYABLE AND REMIT TO: TATA (Pe ee POPLAR | PRES eLTo ATTN ACCOUNTS PAYABLE et Be Mellel el eee tie arys, OKALOOSA CO EMS AIRGAS USA, LLC tet 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609 000628 4251991195001 56047000031L8L948 SRECRNCAW Nee: RR ITTANCE, CALL: 800. PELE 0693 1201004 1288028 523071143 | 00000000 NET 30 12/31/2018 a ESSEX ROAD $048 1021419107 03 OX USPDA S048 7 CL 7 7 6.33 CL 44.31 N (Vol: 105 FT3) OXYGEN USP DA MED CGA 870 Sale subtotal: 44,31 Delivery Flat Fee 13.50 57.81 SHIP TO: 1288928 $ 87-8 Airgas OKALOOSA COUNTY EMS www.airgas.com CHRISTOPHER D TANNER, MD Airgas USA, LLC 80. COLLEGE BLVD E font No, 8606074182 PO Box 9249 . PNC Bank, ABA No 031000053 Marietta, GA 30065-2249 FEV 1.1.19 5b 001000 Page 37 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 Airgas | USA, jic INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT Airgas. ‘ FiO Box 024 og5-2240 cilfo1/06/2014] 1201901 | 9600156047 | 01/31/2014 || SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT sotpBy AIRGAS USA, LLC 922 SKIPPER AVE HT nek 4 FORT WALTON BEACH FL 32547-7315 eat van 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: Weal Paftoafpeddeedpptyalef Mad olf IP feogd {trey pa eree|f prea puto ATTNACCOUNTS PAYABLE VLE a otro Ta ol a TT To OKALOOSA CO EMS AIRGAS USA, LLC 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 , ATLANTA GA 30353-2609 000628 1291991195001 5604700005L815948 TO ENSURE porn CREDIT, aac noe THE aa rae woe YOUR REMITTANCE, FOR QUESTIONS ON. ee ACCOUNT PLEASE CALL: SRD E Coa aera 0693 FD Niceville S048 1021424247 03 OX USPDA S048 2 CL 2 2 6.33 CL 12.66 N (Vol; 30 FET3) OXYGEN USP DA MED CGA 870 Sale subtotal: 12.66 Delivery Flat Fee 13.50 SHIP TO: 1288928 Airgas. OKALOOSA COUNTY EMS . www.airdas.com CHRISTOPHER D TANNER, MD Ages USAC SO.COLLEGE BLVD E fcet No. 8506074182 PO Box 9249 NICEVILLE FL 32578-1343 PNC Bank, ABA No 031000053 Marietta, GA 30065-2249 REV 1.1.13 SEE-90t000 Page 38 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 : Aitgas | USA, fhe INVOICE DATE PAYER INVOICE NO, BUE DATE PAY THIS AMOUNT Airgas. © Morea ode 30065-2249 C1fotos2014§ 1201901} 9500156047 J 01/31/2014 || SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT sotoByY AIRGAS USA, LLC (I check 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 L] Credit Card 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: TUR Led Reo PP ced Ld Peed 10 capped pet BLLTO ATTN ACCOUNTS PAYABLE ADEN fp Mot tye allen lie OKALOOSA CO EMS AIRGAS USA, LLC 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609 000628 4259155934950015604700003181948 NICEVILLE EMS so48 1021424246 03 OX USPDA 8048 4 CL 4 4 6.33 CL 25.32 N (Vol: 60 FT3) OXYGEN USP DA MED CGA 870 NICEVILLE EMS $048 1021424246 03 OX USP125 so48 2 CL 2 2 14.04 CL 28.08 N (Vol: 254 FT3) OXYGEN USP 125 Sale subtotal: 53.40 Delivery Flat Fee 13.50 66.90 SHIP TO: 1288928 : $ Airgas OKALOOSA COUNTY EMS www.airgas.com CHRISTOPHER D TANNER, MD nigga utc Sn ee tet No S610 PO Box 9249 ~ PNC Bank, ABA No 031000053 Marietta, GA 30065-2249 REV 1.1.13 S&+-001000 Page 39 of 42 REV 1.1.13 Airgas USN phe PO Box Marlette on 30065-2249 Airgas. soLosy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 BILLTO ATTN ACCOUNTS PAYABLE OKALOOSA CO EMS 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 000628 T0 ENSURE FROFE FROPER CREDI, PLEASE RET CREDIT, PLEASE RETU RESICNINVNG CONSOLIDATED RENTAL INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT 01/06/2014 1291991 [| 9500156047 ff 01/31/2014 |] SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT L] Check [[] Credit Card Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: Pls © bod Foe FTL EP AIRGAS USA, LLC PO BOX 532609 ATLANTA GA 30353-2609 225945941950015604700003181948 ERA S NVOICE DA Ee GEA Ko [9915684755 <—ce 1288028 “RENT Pytoaot4 ae ET 30 RRCYLMLG-OX ~- Rent Cyl Med Large Oxygen 37 34 34 0 37 25 12 372 $0.26/DAY $96.72 N IRRCYLMXS-OX - Rent Cyl Med Xs Oxygen 137 194 194 0 137 1) 137 4247 $0,.22/DAY $934.34 N 174 228 228 0 174 $1,031.06 Important. See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the Reverse sl - SHIP TO: 1288928 Airgas USA, LLC PO Box 9249 Marietta, GA 30065-2249 SEL - 001000 ide 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. OKALOOSA COUNTY EMS www.airgas.com CHRISTOPHER D TANNER, MD 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 FOR WIRE TRANSFER PAYMENTS AIRGAS USA, LLC Acct No. 8606074182 PNC Bank, ABA No 031000053 Page 40 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 Airgas USM gt INVOICE DATE PAYER INVOICE Ni DUE DATE PAY THIS AMOUNT Airgas. Moree ai? so0es-2249 ciffo1/06/20149 1291991 | 9500156047 J 01/31/2014 |] SEE SUMMARY PAGE PLEASE MARK YOUR METHOD OF PAYMENT solpBy AIRGAS USA, LLC oO Check 922 SKIPPER AVE . FORT WALTON BEACH FL 32547-7315 L] credit Card 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. PLEASE MAKE CHECKS PAYABLE AND REMIT TO: MaMpopbeaf ylang ab yotey iat olfe Mfoap [Pp eapapepead fp yee auto ATTN ACCOUNTS PAYABLE LRN opea fetta pele eye ener thet OKALOOSA CO EMS AIRGAS USA, LLC bee 90 COLLEGE BLVD E PO BOX 532609 NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609 000628 12919911950015604 7000031815948 SUMMARY PAGE Sales Sold Ship Ship To Name Region Inv Delivery Invoice Amount Org To To Num Number S000 1291991 1288928 OKALOOSA COUNTY EMS 9022262855 8022914464 109.83 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022262856 8023008436 12.66 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022319422 8023008410 92.22 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022337960 8023000533 38.82 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022337961 8023048712 26.16 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022337962 8023048713 84.51 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022384010 8023045517 60.57 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022384011 8023092354 19.83 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022384012 8023133554 132,96 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022384013 8023168634 6.33 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022448014 8023196449 12.66 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022482748 8023179148 131.58 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022482749 8023226967 71.85 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022540989 8023279179 112,59 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022558961 8023279177 32.49 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022558962 8023314323 32,49 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022558963 8023314324 19,83 So00 1291991 1288928 OKALOOSA COUNTY EMS 9022673261 8023361678 93.60 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022716385 8023428198 46.53 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022735313 8023467175 66.90 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022735314 8023518091 64.14 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022735585 8023546017 6.33 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022793301 8023551336 40.20 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022793302 8023551338 19.83 So00 1291991 1288928 OKALOOSA COUNTY EMS 9022854890 8023597479 32.49 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022912721 8023643118 103.50 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022912722 8023563786 6.33 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022912723 8023672789 79.56 S000 1291991 1288928 OKALOOSA COUNTY EMS 9022912724 8023677113 79.56 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022945417 8023706979 38.82 $000 1291991 1288928 OKALOOSA COUNTY EMS 9022945418 8023713230 32.49 CONTINUED SHIP TO: Airgas OKALOOSA COUNTY EMS . www.airgas.com CHRISTOPHER D TANNER, MD ss usnne cocouect ava ARCHOS PO Box 9249 ICEVILLE FL. 32578-1343 PNG Bank, ABA No 031000083 Marietta, GA 30065-2249 REV 1.1.1 SEL-001000 Page 41 of 42 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 Airgas ush Le INVGICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT Airgas. FO Box 8249 oo ng5-2240 Ci 01/06/2014] 1291991 | 9500156047 | 01/31/2014 $ 3,181.04 PLEASE MARK YOUR METHOD OF PAYMENT soLpBy AIRGAS USA, LLC 1 check 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 LJ Credit Card 850-862-5214 Please visit www.airgas.com/onlinebillpay or complete the information on the