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HomeMy WebLinkAbout254011 01/26/16 CITY OF CARMEL, INDIANA VENDOR: 343500 ONE CIVIC SQUARE ZEE MEDICAL, INC. CHECK AMOUNT: $*******355.86* CARMEL, INDIANA 46032 CINTAS CORPORATION CHECK NUMBER: 254011 PO BOX 631025 CHECK DATE: 01/26/16 CINCINNATI OH 45263-1025 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4239012 5004343262 355.86 SAFETY SUPPLIES i CiNrAs. Page 2 INVOICE # 5004343262 PAYER # 0010664222 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-264-5119 Indianapolis , IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 55556 DISINFECTANT RIPE 1 $5 . 95 $5 . 95 163020 BURN RELIEF 4X4 DRESSING 1 $8 . 83 $8 . 83 163050 BURN RELIEF PACKET/ 6 PK 1 $11 . 55 $11 .55 UNIT SUBTOTAL $36 . 78 REMIT TO CINTAS CORPORATION SUB-TOTAL $355 . 86 PO BOX 631025 TAX $0 .00 CINCINNATI , OH 45263-1025 TOTAL $355 . 86 SIGNATURE : ------------------------------ DATE : ------------------ NAME : ------------------------------ ** � � � STAN MM M Aid A afety Address f®r Payments: Newt Remittance s oration. z Cintasf Core x � - P®�BoX 631025 h ,� r•.�"� '`#f a � �, H��45263 1025 Csdcmnati, �` s ClNrAso Page 1 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-264-5119 Indianapolis , IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 INVOICE PLEASE PAY DIRECTLY FROM THIS INVOICE CARMEL STREET DEPT INVOICE # 5004343262 3400 W 131ST ST DATE 1/19/16 WESTFIELD , IN 46074-8267 PO # N/A 317-733-2001 CUSTOMER # 0010652787 PAYER # 0010664222 SVC ORDER # 8012003055 CREDIT TERMS NET 10 DAYS UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 6633596 MAIN BLD MENS R 01560255 110 CABINET CLEANED 1 $0 . 00 $0 . 00 120 CABINET ORGANIZED 1 $0 . 00 $0 . 00 130 EXPIRATION DATES CHECKED 1 $0 . 00 $0 . 00 400 SERVICE CHARGE 1 $9 . 95 $9 . 95 12221 LIQUID BANDAGE SMALL 1 $12 . 16 $12 .16 43059 FINGERTIP BANDAGE MED 1 $10 . 95 $10 . 95 50239 HYDROGEN PEROXIDE 2 OZ 1 $7 . 51 $7 . 51 55556 DISINFECTANT RIPE 1 $5 .95 $5 .95 62029 BURN CARE PUMP 2 OZ 1 $9 . 76 $9 .76 111389 ACETAMINOPHEN MED 1 $16 .34 $16 .34 111399 ACETAMINOPHEN LRG 1 $30 . 63 $30 .63 111599 PAIN AWAY X-STRENGTH LRG 1 $32 . 60 $32 . 60 111989 IBUPROFEN TABS ,MEDIUM 1 $19 . 45 $19 . 45 111999 IBUPROFEN TABS LRG 1 $35 . 95 $35 . 95 112239 DECONGEST NASAL/SINUS MED 1 $17 .46 $17 . 46 112439 SINUS RELIEF DUAL ACTN MD 1 $20 . 85 $20 . 85 113639 _HONEYLMN MNTHL COUGH DR LG 1 $19 . 71 $19 . 71 115099 ANTACID FRUIT FLAVOR LRG 1 $28 .56 $28 .56 121629 NAPROXEN SODIUM MEDIUM 1 $10 . 95 $10 .95 130000 THERA TEARS , SMALL 1 $9 . 92 $9 .92 163020 BURN RELIEF 4X4 DRESSING 1 $8 . 83 $8 . 83 163050 BURN RELIEF PACKET/ 6 PK 1 $11 . 55 $11 .55 UNIT SUBTOTAL $319 .08 6633597 MAINTENANCE BLD 01560256 110 CABINET CLEANED 1 $0 . 00 $0 . 00 120 CABINET ORGANIZED 1 $0 . 00 $0 . 00 130 EXPIRATION DATES CHECKED 1 $0 .00 $0 .00 44429 LARGE PATCH 21IX311 , MED 1 $10 .45 $10 .45 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit,etc. Payee Purchase Order No. Terms Date Due Invoice Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s) or bill(s)) 01/19/16 5004343262 $355.86 2201 201 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 ZEE MEDICAL, INC. CINTAS CORPORATION IN SUM OF$ PO BOX 631025 CINCINNATI, OH 45263-1025 $355.86 ON ACCOUNT OF APPROPRIATION FOR Street Department PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Member I 5004343262 I 42-390.12 I $355.86 1 hereby certify that the attached invoice(s), or 2201 201 bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday, January 21, 2016 Ua" d/ � U Street Commissioner Cost distribution ledger classification if claim paid motor vehicle highway fund