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Okaloosa County BOCC — March 18, 2014 — Airgas Invoice-Jan 2014 — reading text
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Bie 30065-2249
sotpBy AIRGAS USA, LLC
922 SKIPPERAVE |
FORT WALTON BEACH FL 32547-7315
850-862-5214
PLEASE MAKE CHECKS PAYABLE AND REMIT TO:
Walpoflecdpetlecdp Upelad Hal AP [Hoag ty faenprpegeed apa
eto ATTN ACCOUNTS PAYABLE PYM Uo Pete ro) TE or |
_. OKALOOSA CO EMS AIRGAS USA, LLC
it ~=90 COLLEGE BLVD E PO BOX 532609
NICEVILLE FL 32578-1343 ATLANTA GA 30353-2609
000625
429199)1595001beb? 700003091681
he GCM AGES SREDIT, eae RE alee Sere YOUR ACG! of
GATE RENTAL RURGHAS OER NG:
reotenaeas|(2otee 1288928 RENT Poaosia0i4 NET 30
RRCYLMLG~OX - Rent Cyl Med Large Oxygen
37 31 50 0 18 18 0 168 $0.26/DAY $43.68 N
RRCYLMXS-OX ~ Rent Cyl Med Xs Oxygen
137 197 199 0 135 0) 4211 $0. 22/DAY
Important, See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the
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
$ 970,10
provisions by written advice to us within (15) days after the date of this document.
. SHIP TO: 1288928 AIRGAS USA, LLC
Airgas OKALOOSA COUNTY EMS Acct No. 8606074182
» www.airgas.com CHRISTOPHER D TANNER, MD PNC Bank, ABA No 031000053
90 COLLEGE BLVD E
Airgas USA, LLC
POBox 9249 NICEVILLE FL 32578-1343
Marietta, GA 30065-2249
REV 4.1.13 SEL-001000 Page 45 of 47
Alrgas USM fhe
PO Box 924!
Mariella, GA” 30085-2249 C1
Airgas.
CONSOLIDATED INVOICE
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
INVOICE DATE PAYER INVOICE NO, DUE DATE PAY THIS AMOUNT
02/05/2014 1291991 9500162677 § 03/03/2014 | SEE SUMMARY PAGE
PLEASE MARK YOUR METHOD OF PAYMENT
AMOUNT ENCLOSED
Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
PLEASE MAKE CHECKS PAYABLE AND REMIT TO:
afb afaflendpeMteeagtl fp tp fa hee lier
soLpsy AIRGAS USA, LLC | Check
922 SKIPPER AVE F | creait card
FORT WALTON BEACH FL 32547-7315 reait Gan
850-862-5214
BILLTO }=©ATTN ACCOUNTS PAYABLE
OKALOOSA CO EMS
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
000625
AIRGAS USA, LLC
PO BOX 532609
ATLANTA GA 30353-2609
1291994455001b2b7700003091b81
TQ ENSURE EROFER CREDIT, PLEASE RETURN THE UPreR PORTION WITH YOUR REMITTANCE. FOR QUESTIONS oN HOUR ACCOUNT PLEASE CALL: a Bel 0693
SUMMARY PAGE
Sales Sold Ship Ship To Name Region Inv Delivery Invoice Amount
Org To To Num Number
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023087885 8023867272 26.16
SO00 1291991 1288928 OKALOOSA COUNTY EMS 9023087886 8023867274 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023087887 8023882413 8.00
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023135809 8023888520 106.26
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023135810 8023932793 25.32
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023174631 8023943899 142.86
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023174632 8023970760 6.33
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023221300 8023988000 106.26
SO00 1291991 1288928 OKALOOSA COUNTY EMS 9023284568 8024041455 73.23
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023284569 8024083186 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023284570 8024083188 45.15
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023284571 8024105224 6.33
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023344341 8024137910 79.56
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023344342 8024178052 6.33
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023391570 8024169744 32.49
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023391571 8024170057 104.88
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023448551 8024198804 95.79
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023470034 8024230661 92.22
SO00 1291991 1288928 OKALOOSA COUNTY EMS 9023470305 8024250434 79.56
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023470306 8024250435 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023470307 8024330240 18.32
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023514644 8024312139 45.15
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023514935 80243123903 19.83
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023514936 8024353511 12.66
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023562039 8024372044 57.81
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023562040 8024413805 6.33
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023633473 8024427584 93.60
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023673842 8024473102 66.90
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023741150 8024513517 57.81
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023741151 8024513519 32.49
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023741152 8024525259 6.33
CONTINUED
SHIP TO:
OKALOOSA COUNTY EMS
CHRISTOPHER D TANNER, MD
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
Airgas. www.airgas.com
Airgas USA, LLC
PO Box 9249
Marietta, GA 30065-2249
‘SEL - 004000 Page 46 of 47
REV 1.1.13
FOR WIRE TRANSFER PAYMENTS
AIRGAS USA, LLC
Acct No. 8606074182
PNC Bank, ABA No 031000053
Airgas. {:
SOLD BY
BILL TO
eS
000625
AIRGAS USA, LLC
922 SKIPPER AVE
FORT WALTON BEACH FL 32547-7315
850-862-5214
Airgas L USA he
Maria, ae 30065-2249
ATTN ACCOUNTS PAYABLE
OKALOOSA CO EMS
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
C1
CONSOLIDATED INVOICE
oO Check
[] Credit Cara
Please visit www.airgas.com/onlinebillpay or
complete the information on the reverse side of this form.
PLEASE MAKE CHECKS PAYABLE AND REMIT TO:
FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112
INVOICE DATE PAYER INVOICE NO, DUE DATE PAY THIS AMOUNT
02/05/2014 1291991 9500162677 § 03/03/2014 $ 3,091.68
PLEASE MARK YOUR METHOD OF PAYMENT
AMOUNT ENCLOSED
Phos fy i Pood Teco Wo ECO oP
AIRGAS USA, LLC
PO BOX 532609
ATLANTA GA 30353-2609
L29L991L245001b2b7 700003091681
SUMMARY PAGE
Delivery Invoice Amount
Airgas.
Airgas USA, LLC
PO Box 9249
Marietta, GA 30065-2249
REV 1.4.13,
SEL - 001000
www.airgas.com CHRISTOPHER D TANNER, MD
90 COLLEGE BLVD E
NICEVILLE FL 32578-1343
Page 47 of 47
AIRGAS USA, LLC
Acct No. 8606074182
19,83
38.82
38.82
85.89
18.99
6.33
64,14
71.85
59.19
6.33
26.16
65.52
106.26
970.10
$ 3,091.68
Sales Sold Ship Ship To Name Region Inv
Org To To Num Number
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023741153 8024565285
so00 1291991 1288928 OKALOOSA COUNTY EMS 9023741154 8024565286
so00 1291991 1288928 OKALOOSA COUNTY EMS 9023741455 8024565287
S000 1291991 1288928 OKALOOSA COUNTY EMS 9023801194 8024603726
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023801435 8024636446
So00 1291991 1288928 OKALOOSA COUNTY EMS 9023861222 8024700984
$000 1291991 1288928 OKALOOSA COUNTY EMS 9023891956 8024661013
sod0 1291991 1288928 OKALOOSA COUNTY EMS 9023891957 8024707966
$000 1291991 1288928 OKALOOSA COUNTY EMS 9024035742 8024804018
$000 1291991 1288928 OKALOOSA COUNTY EMS 9024035743 8024877761
$000 1291991 1288928 OKALOOSA COUNTY EMS 9024076967 8024744639
S000 1291991 1288928 OKALOOSA COUNTY EMS 9024076968 8024751973
S000 1291991 1288928 OKALOOSA COUNTY EMS 9024076969 8024846602
S000 1291991 1288928 OKALOOSA COUNTY EMS 9916414685 N/A
SHIP TO:
OKALOOSA COUNTY EMS
PNC Bank, ABA No 031000053