Okaloosa County BOCC — November 18, 2014 — Airgas Invoice-September 2014 — reading text

CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. QUE DATE PAY THIS AMOUNT 10/03/2014 1291991 9500218670 § 10/31/2014 | SEE SUMMARY PAGE 1 PLEASE MARK YOUR METHOD OF PAYMENT (J Credit Card Please visit www.airgas.com/oniinebillpay or LL] Check complete the information on the reverse side of this form. (Vol: 180 FT3) OXYGEN USP DA MED CGA 870 Delivery Flat Fee - , Airgas. www.airgas.com AIRGAS USA, LLC 2015 VAUGHN RD NW STE 400 KENNESAW GA 30144-7802 REV 1.1.13 SEL-90t000 SHIP TO: 1288928 OKALOOSA COUNTY EMS CHRISTOPHER D TANNER, MD 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 Page 30 of 36 8048 03 12 CL 12 12 6.59 CL 79,08 N Sale subtotal: 79.08 14.25 $ 93.33 ri AIRGAS USA, LLC Airgas 2015 VAUGHN RD NW STE 400 . KENNESAW GA 30144-7802 so_psy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 BiLLTO ==ATTN ACCOUNTS PAYABLE ed OKALOOSA CO EMS be 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 000574 3 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT 10/03/20149 1291991 | 9500218670 | 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT O Check L] Credit Cara Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. BOER DATES 1291901 ‘708028 9031891660 | 00000000 NET 0 09/26/2014 Pt DESTIN EMS S048 1029504530 03 OX USPDA So48 4 CL 4 4 6.59 CL 26.36 N (Vol: 60 FPT3) OXYGEN USP DA MED CGA 870 DESTIN EMS $048 1029504530 03 OX USP125 S048 1 cL 1 1 14.46 CL 14.46 N (Vol: 127 FT3) OXYGEN USP 125 Sale subtotal: 40.82 Delivery Flat Fee 14.25 55.07 SHIP TO: 1288928 § Airgas OKALOOSA COUNTY EMS » 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 1,1,19 SEL-001000 Page 31 of 36 AIRGAS USA, LLG Airgas. 2018 VAUGHN RD NW STE 400 KENNESAW GA 30144-7802 so.ppy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 BiLTO ATTN ACCOUNTS PAYABLE raz ~OKALOOSA CO EMS we 690 COLLEGE BLVD E NICEVILLE FL 32578-1343 000874 3 Delivery Flat Fee TO ENSURE PROPER CREDIT, ae RETURN THE He PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT FEA ae eae 727-06! 2 ESSEX ROAD 8048 1029504532 03 OX USPDA 8048 3 CL 3 3 6.59 CL 19.77 N (Vol: 45 FT3) OXYGEN USP DA MED CGA 870 ESSEX ROAD 5048 1029504532 03 OX USP125 S048 2 CL 2 2 14.46 CL 28.92 N (Vol: 254 FT3) OXYGEN USP 125 Sale subtotal: 48.69 ___CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT 10/03/2014] 1291991 | 9500218670 | 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT Oo Check : LJ credit Cara Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. 14,25 SHIP TO: 1288928 Airgas. www.dirgas.com CHRISTOPHER 0 TANNER, MD AIRGAS USA, LLC 90 COLLEGE BLVD E 2015 VAUGHN RD NW STE 400 NICEVILLE FL 32578-1343 KENNESAW GA 30144-7802 REV 1.1.13 S&L- 004000 Page 32 of 36 - AIRGAS USA, LLC Airgas 2015 VAUGHN RD NW STE 400 . KENNESAW GA 30144-7802 soLpsy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL. 32547-7315 850-862-5214 C] check BILLTO. ==ATTN ACCOUNTS PAYABLE raze OKALOOSA CO EMS aie 690 COLLEGE BLVD E NICEVILLE FL 32578-1343 000574 3 (J credit Cara Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. ORDER DAT CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO, DUE DATE PAY THIS AMOUNT 10/03/2014, 1291991 § 9500218670 § 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT AMOUNT ENCLOSED. [ ‘200025 | sos20%2147 | 0000000 09/20/2014 CRESTVIEW EMS 1029679488 OX USPDA (Vol: 8048 10 CL 150 FT3) OXYGEN USP DA MED CGA 870 Delivery Flat Fee 10 03 10 8048 6.59 CL Sale subtotal: SHIP TO: 1288928 Airgas. www.dirgas.com CHRISTOPHER D TANNER: MD AIRGAS USA, LLG 90 COLLEGE BLVD E 2015 VAUGHN RD Nw ste 400 NICEVILLE FL 32578-1343 KENNESAW GA 30144-7602 REV 1.1.13 SEL-001000 Page 33 of 36 65.90 N 65.90 14.25 $ 80.15 z AIRGAS USA, LLC Airgas 2018 VAUGHN RD NW STE 400 . KENNESAW GA 30144-7802 sotpBy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 BILLTO =ATTN ACCOUNTS PAYABLE wait, OKALOOSA CO EMS [ee 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 000874 3 10 Seon ae CREDIT, PLEASE RETURN THE ci ronton ae YOUR REMITTANCE, FOR QUESTIONS ON YOUR ACCOUNT PLEASE ae notes aie ee CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER INVOICE NO. DUE DATE PAY THIS AMOUNT 10/03/2014 1291991 { 9500218670 | 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT [_] Check . (J Credit Card Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. S We 1291991 1288928 "9032012148. ‘00000000 Posreaa0ia ao ae CRESTVIEW FD 1029679487 OX USPDA S048 (Vol: 45 FT3) OXYGEN USP DA MED CGA 870 Delivery Flat Fee S048 03 3 °CL 3 3 6.59 Ch 19.77 N Sale subtotal: 19.77 14.25 Airgas. www.airgas.com AIRGAS USA, LLC 2015 VAUGHN RD NW STE 400 KENNESAW GA 30144-7802 REV 1.1.13 SEL- 001000 SHIP TO: 1288928 OKALOOSA COUNTY EMS CHRISTOPHER DB TANNER, MD 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 Page 34 of 36 CONSOLIDATED INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER: INVOICE NO. DUE BATE PAY THIS AMOUNT 10/03/2014f 1291991 | 9500218670 | 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT Cd check C1 credit Card Please visit www.airgas.com/onlinebillpay or complete the information on the reverse side of this form. . AIRGAS USA, LLC irgas 2015 VAUGHN RD NW STE. 400 . KENNESAW GA 30144-7802 so.pBy AIRGAS USA, LLC 922 SKIPPER AVE FORT WALTON BEACH FL 32547-7315 850-862-5214 piLto ATTN ACCOUNTS PAYABLE raze OKALOOSA CO EMS [sae 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 000574 3 FREE ¢ PORTION. a ESSEX ROAD S048 1029712898 03 OX USPDA S048 - 4 CL 4 4 6.59 CL 26.36 N (Vol: 60 FT3) OXYGEN USP DA MED CGA 870 Sale subtotal: 26.36 Delivery Flat Fee 14.25 SHIP TO: 1288928 $ 40.61 Airgas , OKALOOSA COUNTY EMS . 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 SEL- 001000 Page 35 of 36 AIRGAS USA, LLC 2015 VAUGHN RD NW STE 400 KENNESAW GA 30144-7802 Airgas. AIRGAS USA, LLC 922 SKIPPER AVE SOLD BY FORT WALTON BEACH FL 32547-7315 850-862-5214 ATTN ACCOUNTS PAYABLE OKALOOSA CO EMS 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 BILLTO 000574 3 Bee PORTION | CONSOLIDATED RENTAL INVOICE FOR ADDRESS CORRECTIONS, PLEASE FAX NOTICE TO: 770-590-6112 INVOICE DATE PAYER: INVOICE NO. DUE DATE PAY THIS AMOUNT 10/03/2014, 1291991 [| 9500218670 J 10/31/2014 PLEASE MARK YOUR METHOD OF PAYMENT (J Credit Cara Please visit www.airgas.com/oniinebillpay or O Check complete the information on the reverse side of this form. RRCYLMLG-OX - Rent Cyl Med Large Oxygen 17 19 19 0 17 17 0 0 $0.29/DAY RRCYLMXS-OX - Rent Cyl Med Xs Oxygen 139 144 144 0 139 9 139 4170 $0.26/DAY $1,084.20 N RRCYLVHPO6K - Rent Cyl Very High Pressure 6K i) 4 4 0 0 0 0 0 $1. 838/DAY 156 167 167 0 156 $1,084.20 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 inthe said $ 1 1084.20 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: 1288928 Airgas. www.airgas.com AIRGAS USA, LLC 2015 VAUGHN RD NW STE 400 KENNESAW GA 30144-7802 REV 44,13 S&L-001000 OKALOOSA COUNTY EMS CHRISTOPHER D TANNER, MD 90 COLLEGE BLVD E NICEVILLE FL 32578-1343 Page 36 of 36