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CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE 770-590-6112
- AIRGAS USA, LLC INVOICE DATE PAY INVOICE NO. DUE DATE PAY THIS AMOUNT
Alrga ROIS VAUGHN RD NW STE 400 cafo7/03/2014§ 1291991 f 9500200746 | 07/31/2014 $ 2,663.67
PLEASE MARK YOUR METHOD OF PAYMENT
sopBy AIRGAS USA, LLC
[] Check
922 SKIPPER AVE °
FORT WALTON BEACH FL 32547-7315 [] Credit Card
850-862-5214 Please visit www.airgas.com/onlinebiilpay or
complete the information on the reverse side of this form.
PLEASE MAKE CHECKS PAYABLE AND REMIT TO:
itis bic CT cba LLL a
PAYER ATTN ACCOUNTS PAYABLE
OKALOOSA CO EMS AIRGAS USA, LLC
90 COLLEGE BLVD E PO BOX 532609
NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609
000581
1259499115950020074L00002LL3b77
SUMMARY PAGE
Sales Sold Ship Ship To Name Region Inv Delivery Delivery Invoice Amount
org To To Num Number Date
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028075660 8028934207 06/02/2014 38.82
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028075661 8028956036 06/02/2014 6.33
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028135451 8028985012 06/03/2014 87.27
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028209978 8029040172 06/04/2014 52.86
s000 1291991 1288928 OKALOOSA COUNTY EMS 9028209979 8029040173 06/04/2014 26.16
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028244796 8029128284 06/06/2014 19.83
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028244797 8029128285 06/06/2014 80.94
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028244798 8029140513 06/05/2014 55.62
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028336952 8029175853 06/06/2014 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028336953 8029175882 06/09/2014 70.47
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028336954 8029229633 06/10/2014 51.48
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028430960 8029276156 06/11/2014 26,16
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028430961 8029276158 06/11/2014 74.61
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028430962 8029335320 06/13/2014 40,20
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028430963 8029335630 06/11/2014 45,15
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028430964 8029354691 06/12/2014 6.33
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028477174 8029367442 06/13/2014 45.15
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028477485 8029406919 06/13/2014 12.66
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028477486 8029420760 06/13/2014 12.66
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028548734 8029436629 06/16/2014 6.33.
SO00 1291991 1288928 OKALOOSA COUNTY EMS 9028581119 8029396986 06/16/2014 93.60
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028581120 8029442455 06/17/2014 51.48
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028626180 8029504008 06/18/2014 59.19
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028626181 8029504009 06/18/2014 26.16
so00 1291991 1288928 OKALOOSA COUNTY EMS 9028662324 8029580056 06/20/2014 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028662595 8029580057 06/20/2014 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028662596 8029580058 06/20/2014 19.83
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028778391 8029614227 06/20/2014 93.60
so00 1291991 1288928 OKALOOSA COUNTY EMS 9028811200 8029655656 06/23/2014 92.22
S000 1291991 1288928 OKALOOSA COUNTY EMS 9028811201 8029707439 06/24/2014 64.14
$000 1291991 1288928 OKALOOSA COUNTY EMS 9028857386 8029753172 06/25/2014 26.16
CONTINUED
FOR WIRE TRANSE MENTS
Airgas. www.airgas.com AIRGAS USA, LLG
AIRGAS USA, LLC Acct No. 8606074182
2015 VAUGHN RD NW STE 400 PNG Bank, ABA No 031000053
KENNESAW GA 30144-7802
REV 1.1.13 Ser 101000 Page 1 of 41
Airgas.
sotpBy AIRGAS USA, LLC
922 SKIPPER AVE
AIRGAS USA, LLG
2015 VAUGHN RD NW STE 400
KENNESAW GA 30144-7802
ci
FORT WALTON BEACH FL 32547-7315
850-862-5214
PayeR ATTN ACCOUNTS PAYABLE
90 COLLEGE BLVD E
Eg OKALOOSA CO EMS
NICEVILLE FL 32578-1343
000581
13
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE
770-590-6112
INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT
07/03/2014 1291991 ] 9500200746 ff 07/31/2014
PLEASE MARK YOUR METHOD OF PAYMENT
CG check
LJ Credit Card
Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
AMOUNT ENCLOSED
SUMMARY PAGE
Sales
Org
sooo
sooo
sooo
sooo
Sooo
sooo
sooo
sooo
1291991
1291991
1291991
1291991
1291991
1291991
1291991
1291991
Ship
To
1288928
1288928
1288928
1288928
1288928
1288928
1288928
1288928
Ship To Name
OKALOOSA
OKALOOSA
OKALOOSA
OKALOOSA
OKALOOSA
OKALOOSA
OKALOOSA
OKALOOSA
COUNTY
COUNTY
COUNTY
COUNTY
COUNTY
COUNTY
COUNTY
COUNTY
EMS
EMS
EMS
EMS
EMS
EMS
EMS
EMS
Region Inv
Num
9028857387
9028936492
9028936493
9028936494
9029022243
9029058403
9029058404
9920117868
Delivery
Number
8029801424
8029842691
8029842694
8029842695
8029931301
8029898701
8029898737
N/A-Rental
Delivery
Date
06/25/2014
06/27/2014
06/27/2014
06/27/2014
06/30/2014
06/27/2014
06/30/2014
N/A
Airgas. www.airgas.com
AIRGAS USA, LLC
2015 VAUGHN RD NW STE 400
KENNESAW GA 30144-7802
REV 4.1,19 SEE> 101000
Page 2 of 41
Invoice Amount
6.
45,
66.
19,
6.
19,
93,
1,060,
33
is
90
83
33
83
60
80
$ 2,663.67
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
: = AIRGAS USA, LLC INVOICE DATE PAYER: INVOICE NO. DUE DATE PAY THIS AMOUNT
| Airgas. 2015 VAUGHN RD Nw SIE 400 cifozi03/2014 1291991 | 9500200746 | 07/31/2014
| PLEASE MARK YOUR METHOD OF PAYMENT
soLoBy AIRGAS USA, LLC [7] check .
922 SKIPPER AVE El credit card
FORT WALTON BEACH FL 32547-7315 reall ar
850-862-5214 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BiLtTo }=ATTN ACCOUNTS PAYABLE
"ae OKALOOSA CO EMS
ee 90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000681
13
CRESTVIEW EMS
$048
1026068964 03
OX USPDA S048 4 CL 4 4 6.33 CL 25.32 N
(Vol: 60 FT3) OXYGEN USP DA MED CGA 870
Sale subtotal: 25.32
Delivery Flat Fee 13.50
SHIP TO: 1288928
Ai OKALOOSA COUNTY EMS
igas. www.airgas.com CHRISTOPHER D TANNER, MD
AIRGAS USA, LLC 90 COLLEGE BLVD E
2015 VAUGHN RD Nw ste 499 NICEVILLE FL 32676-1343
KENNESAW GA 30144-7802
REV 4.4.19 SEL- 101000 Page 3 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
- AIRGAS USA, LLG INVOICE DATE PAYER INVOICE NO. DUE DATE
2015 VAUGHN RD NW STE 400
Ai mas. KENNESAW GA 30144-7802 C19§ 07/03/2014 1291991 § 9500200746 Ff 07/31/2014 F SEE SUMMARY PAGE 1
PLEASE MARK YOUR METHOD OF PAYMENT
so.pBy AIRGAS USA, LLC
922 SKIPPER AVE H paar ‘d
FORT WALTON BEACH FL 32547-7315 a
850-862-5214
Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BILLTO =ATTN ACCOUNTS PAYABLE
OKALOOSA CO EMS
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000581
13
Ocean City FD S048
1026126204
02
OX USPDA $048 1 CL 1 1 6.33 CL 6.33 N
(Vol: 15 FT3) OXYGEN USP DA MED CGA 870
: Sale subtotal: 6.33
SHIP TO: 1288928
Air as OKALOOSA COUNTY EMS
g . www.airgas.com CHRISTOPHER D TANNER, MD
90 COLLEGE BLVD E
AIRGAS USA, LLC
2018 VAUGHN RD Nw STE 490 NICEVILLE FL 32578-1343
KENNESAW GA 30144-7802
REY 1.1.19 SEL- 191000 Page 4 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
- AIRGAS USA, LLC INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT
Airgas. 2015 VAUGHN RD NW STE 400 07/03/2014, 1291991 | 9500200746 | 07/31/2014
PLEASE MARK YOUR METHOD OF PAYMENT
solpey AIRGAS USA, LLC [1] check ;
922 SKIPPER AVE | Credit Card
FORT WALTON BEACH FL 32547-7315 Feat Gar
850-862-5214 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BiLTo ATTN ACCOUNTS PAYABLE
wre OKALOOSA CO EMS
“488 90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000581
43
URE eS aoe
ESSEX ROAD 5048
1026099438 03
OX USPDA so4g 5 CL 5 5 6.33 CL 31.65 N
(Vol: 75 FT3) OXYGEN USP DA MED CGA 870
ESSEX ROAD $048
1026099438 03
OX USP125 S048 3 CL 3 3 14.04 CL 42.12 N
(Vol: 381 FT3) OXYGEN USP 125
Sale subtotal: 713.77
Delivery Flat Fee 13.50
SHIP TO: 1288928
Airgas. chnisToPt COUNTY EMS
www.airgas.com PHER D TANNER, MD
AIRGAS USA, LLC 0 COLLEGE BLVD E
2015 VAUGHN RD NW STE 400 NICEVILLE FL 32578-1343
KENNESAW GA 30144-7802
REV 1.4.19 SEL- 101900 Page 5 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
. AIRGAS USA, LLC INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT
Alrga . PRIS VAUGHNRD NW STE400 Cc ilo7/03/20141 1291991} 9600200746 | 07/31/2014
PLEASE MARK YOUR METHOD OF PAYMENT
soLpBy AIRGAS USA, LLC U1 check
922 SKIPPER AVE ol Credit Card
FORT WALTON BEACH FL 32547-7315 reat Var
850-862-5214 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BiLTO }==ATTN ACCOUNTS PAYABLE
OKALOOSA CO EMS
Eee 90 COLLEGE BLVD E
" NICEVILLE FL 32578-1343
000581
1,3
re98 eee 9028200978 00000000 NET: 30
RELEASE ORB
NICEVILLE EMS S048
1026094827 03
OX USPDA So48 4 CL 4 4 6.33 CL 25.32 N
(Vol: 60 FT3) OXYGEN USP DA MED CGA 870
NICEVILLE EMS S048
1026094827 03
OX USP125 S048 1 cL 1 1 14.04 CL 14.04 N
(Vol: 127 FT3) OXYGEN USP 125
Sale subtotal: 39.36
Delivery Flat Fee 13.50
SHIP TO: 1288928
Ai OKALOOSA COUNTY EMS
irgas. www.airgas.com CHRISTOPHER D TANNER, MD
90 COLLEGE BLVD E
AIRGAS USA, LLC
2015 VAUGHN RD NW STE 400 NICEVILLE FL 32578-1343
KENNESAW GA 30144-7802
REV 1.1.1 Seb > 101000 Page 6 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
- AIRGAS USA, LLC INVOICE DATE PAYER INVOIGE NO, DUE DATE PAY THIS AMOUNT
Airgas. Nk aad C1 07/03/2014 1291991 9500200746 § 07/31/2014 | SEE SUMMARY PAGE 1
PLEASE MARK YOUR METHOD OF PAYMENT
sotpsy AIRGAS USA, LLC
922 SKIPPER AVE Here ,
FORT WALTON BEACH FL 32547-7315 reall Gar
850-862-5214
Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BLLTO ATTN ACCOUNTS PAYABLE
a. OKALOOSA CO EMS
i 90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000581
13
FD 8048
1026094828 03
OX USPDA 8048 2 CL 2 2 6.33 CL 12.66 N
(Vol: 30 FT3) OXYGEN USP DA MED CGA 870
Sale subtotal: 12.66
Delivery Flat Fee 13.50
26.16
SHIP TO: 1288928 i
Al OKALOOSA COUNTY EMS
IQS. swv.airgas.com CHRISTOPHER D TANNER, MD
AIRGAS USA, LLC 0 COLLEGE BLVD E
2018 VAUGHN RD NW STE 400 NICEVILLE FL 32578-1343
KENNESAW GA 30144-7802
REV 1.1.13 S6b 101000
Page 7 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
- AIRGAS USA, LLC INVOICE DATE PAYER INVOICE NO. UE DATE PAY THIS AMOUNT
IN RD NW STE 400
irgas. POR AUCH RD Ny Sie cif 07/03/20149 1291991 J 9500200746 | 07/31/2014 | SEE SUMMARY PAGE 1
PLEASE MARK YOUR METHOD OF PAYMENT
soLpay AIRGAS USA, LLC
922 SKIPPER AVE H cree 4
FORT WALTON BEACH FL 32547-7315 realt Gan
850-862-5214 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
eiLto ATTN ACCOUNTS PAYABLE
‘ OKALOOSA CO EMS
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000581
1,3
SUES TONS Cs me YOUR ACCOUNT PLEASE CALL: 800: 727-0693
125190 1208028 Ee 00000000 NET 30 06/06/2014
OKLOOSA ISLAND FD So48
1026100854
03
OX USPDA S048 1 CL 1 1 6.33 CL 6.33 N
(Vol: 15 FT3) OXYGEN USP DA MED CGA 870
Sale subtotal: 6.33
Delivery Flat Fee
13,50
SHIP TO: 1288928
Ai OKALOOSA COUNTY EMS
irgas. www.airgas.com CHRISTOPHER D TANNER, MD
90 COLLEGE BLVD E
AIRGAS USA, LLC
2015 VAUGHN RD Nw ste 400 NICEVILLE FL 32578-1343
KENNESAW GA 30144-7802
REV 1.1.13 SB 101000
Page 8 of 41
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
- AIRGAS USA, LLC INVOICE DATE PAYER INVOICE NO. BUE DATE PAY THIS AMOUNT
Alrga , 2018 VAUGHN RD NW STE 400 cio7/03/2014] 1291991 || 9500200746 Ff 07/31/2014
PLEASE MARK YOUR METHOD OF PAYMENT
so.pByY AIRGAS USA, LLC [1] check
922 SKIPPER AVE EF] credit card
FORT WALTON BEACH FL 32547-7315 reat Var
850-862-5214 Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
BiLLTO ATTN ACCOUNTS PAYABLE
wait OKALOOSA CO EMS
HM 90 COLLEGE BLVD E