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255727 03/01/16
CITY OF CARMEL, INDIANA VENDOR: 343500 / I ONE CIVIC SQUARE CINTAS FIRST AID &SAFETY CHECK AMOUNT: $*****2,166.47* ?� CARMEL, INDIANA 46032 CINTAS CORPORATION CHECK NUMBER: 255727 •y.�oN PO BOX 631025 CHECK DATE: 03/01/16 CINCINNATI OH 45263-1025 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 5004405016 301.88 OTHER EXPENSES 2201 4239012 5004405081 290.41 SAFETY SUPPLIES 651 5023990 5004405082 124.34 OTHER EXPENSES 601 5023990 5004524603 678.31 OTHER EXPENSES 2201 4239012 5004524606 185.85 SAFETY SUPPLIES 601 5023990 5004524607 585.68 OTHER EXPENSES Cintas First Aid&Safety 0388 Service/Billing (317)264-5103 1435 Brookville Way,Suite P Fax# (317)644-0870 Indianapolis, IN 46239 Payment Inquiry (888)994-2468 Invoice Ship To CARMEL WATER UTILITIES 3450 W 131ST ST Invoice#5004524603 WESTFIELD, IN 46074-8267 Invoice Date 02/16/2016 Credit Terms NET 10 DAYS Customer# 10652788 Cintas Route Loc#0388 Route 0020 Bill To CARMEL WATER UTILITIES Order#0003954915 3450 W 131 ST ST Payer-# 10652788 WESTFIELD, IN 46074-8267 Material# Descripfidn, Quantity, - Unit Price Ext Price Tax Unit 000000000006633129 Unit Description:, 400 SERVICE CHARGE 1 EA $9.95 $9.95 Unit Subtotal: $9.95 Unit 000000000006633133 Unit Description: MECHANIC SHOP 110 CABINET CLEANED 1 EA $0.00 $0.00 120 CABINET ORGANIZED 1 EA $0.00 $0.00 130 EXPIRATION DATES CHECKED 1 EA $0.00 $0.00 12221 LIQUID BANDAGE SMALL 1 BAG $12.16 $12.16 31069 1X3 PLASTIC BANDAGE MED 1 BOX $9.42 $9.42 43059 FINGERTIP BANDAGE MED 1 BOX $10.95 $10.95 43259 KNUCKLE BANDAGE MEDIUM 1 BOX $10.58 $10.58 43729 X-LONG BANDAGE MEDIUM 1 BOX $10.96 $10.96 44269 ELASTIC STRIP MEDIUM 1 BOX $9.78 $9.78 44429 LARGE PATCH 2"X3",MED 1 BOX $10.38 $10.38 50009 ANTISEPTIC WIPES MEDIUM 1 BOX $8.47 $8.47 55556 DISINFECTANT WIPE 1 EA $5.95 $5.95 61029 ANTISEPTIC PUMP 2 OZ 1 EA $8.14 $8.14 62029 BURN CARE PUMP 2 OZ 1 EA $9.76 $9.76 70819 GAUZE PADS 3"X3"SMALL 1 BOX $6.82 $6.82 71019 GAUZE PADS 4"X4"SMALL 1 BOX $8.54 $8.54 72220 ROLLER GAUZE,2"NON-STER 1 EA $5.63 $5.63 72240 ROLLER GAUZE,4"NON-STER 1 EA $6.35 $6.35- 82430 MEDI-RIP 3" 2 ROL $9.10 $18.20 91019 COLD PACK,SMALL,1/BOX 4 BOX $5.63 $22.52 100019 TRIPLE ANTIBIOTIC OINT MD 1 BOX $11.55 $11.55 100419 HYDROCORTISONE CREAM MED 1 BOX $11.68 $11.68 101239 FIRST AID CREAM SMALL 3 BAG $7.58 $22.74 102640 BIOFREEZE MUSCLE RLF SM 2 BAG $9.25 $18.50 Note: Page 1 of 2 Cintas First Aid&Safety 0388 Invoice# 5004524603 1435 Brookville Way,Suite P Invoice Date 02/16/2016 Indianapolis, IN 46239 Invoice Material# Description Quantity Unit Price Ext Price Tax 103030 WOUNDSEAL POUR PACK 2/BOX 2 BOX $16.22 $32.44 103040 WOUNDSEAL PLUS APPLCTR2BX 1 BOX $18.80 $18.80 130000 THERA TEARS,SMALL 2 PAC $9.93 $19.86 130209 INDUST EYE RELIEF 1/2 OZ 1 EA $8.27 $8.27 130429 EYE/SKIN BUFFERED SOL 40Z 1 EA $8.60 $8.60 130479 EYEWASH, 1/20Z MEDIUM 2 BOX $16.21 $32.42 130840 EYE/SKIN FLUSH 16 OZ 3 EA $15.56 $46.68 150620 SPLINTER-OUT DISP MED 1 PAC $7.74 $7.74 163020 BURN RELIEF 4X4 DRESSING 2 EA $8.84 $17.68 163050 BURN RELIEF PACKET/6 PK 3 PAC $13.43 $40.29 164010 COOL&SOOTHE 6/BOX 1 BOX $16.06 $16.06 170429 CPR MICRO SHIELD 1 EA $19.56 $19.56 180069 TRIANGULAR BNDG UNITIZE/1 BX 1 BOX $4.95 $4.95 181429 EYE PADS 4/BOX,UNIT BOX 1 BOX $12.75 $12.75 182309 EMERGENCY MEDICAL GLV/8BX 1 BOX $8.53 $8.53 250119 BODY FLUID CLEANUP KIT 1 EA $58.60 $58.60 292120 HL MAX LITE 200 PR/BX 1 BOX $38.09 $38.09 562567 BLOODSTOPPER WRAP 2" 1 ROL $10.35 $10.35 592242 TRAUMA PAD VACUUM SLD/4BX 1 BOX $13.33 $13.33 592243 SPLINT 24" 1 EA $14.28 $14.28 Unit Subtotal: $668.36 Invoice Sub-total $678.31 Tax $0.00 Invoice Total $678.31 Remit To CINTAS CORPORATION PO BOX 631025 CINCINNATI, OH 45263-1025 Note n Signature: v Page 2 of 2 Cintas First Aid&Safety 0388 Service/Billing (317)264-5103 1435 Brookville Way,Suite P Fax# (317)644-0870 Indianapolis, IN 46239 Invoice Payment Inquiry (888)994-2468 Ship To CARMEL WATER UTILITIES 3450 W 131 ST ST Invoice#5004524607 WESTFIELD, IN 46074-8267 Invoice Date 02/17/2016 Credit Terms NET 10 DAYS Customer# 10652788 Cintas Route Loc#0388 Route 0020 Bill To CARMEL WATER UTILITIES Order#0003959482 3450 W 131 ST ST Payer# 10652788 WESTFIELD, IN 46074-8267 Material# Description Quantity Unit Price Ext Price Tax Unit 000000000006633129 Unit Description: 400 SERVICE CHARGE 1 EA $9.95 $9.95 Unit Subtotal: $9.95 Unit 000000000006633133 Unit Description: MECHANIC SHOP 43059 FINGERTIP BANDAGE MED 1 BOX $10.95 $10.95 43259 KNUCKLE BANDAGE MEDIUM 1 BOX $10.58 $10.58 43859 JUNIOR STRIP MED 1 BOX $8.47 $8.47 44269 ELASTIC STRIP MEDIUM 2 BOX $9.78 $19.56 44429 LARGE PATCH 2"X3",MED 1 BOX $10.38 $10.38 50009 ANTISEPTIC WIPES MEDIUM 1 BOX $8.47 $8.47 50239 HYDROGEN PEROXIDE 2 OZ 1 EA $4.95 $4.95 50429 ALCOHOL PREP PADS MEDIUM 1 BOX $8.38 $8.38 61029 ANTISEPTIC PUMP 2 OZ 1 EA $8.14 $8.14 62029 BURN CARE PUMP 2 OZ 1 EA $9.76 $9.76 70010 COTTONTIP APP 3"100NIAL 1 EA $5.00 $5.00 71019 GAUZE PADS 4"X4"SMALL 1 BOX $8.54 $8.54 72220 ROLLER GAUZE,2"NON-STER 1 EA $5.63 $5.63 72240 ROLLER GAUZE,4"NON-STER 1 EA $6.35 $6.35 82420 MEDI-RIP 2" 1 ROL $7.50 $7.50 91019 COLD PACK,SMALL, 1/BOX 2 BOX $5.64 $11.28 100019 TRIPLE ANTIBIOTIC OINT MD 1 BOX $11.55 $11.55 100419 HYDROCORTISONE CREAM MED 1 BOX $11.68 $11.68 103030 WOUNDSEAL POUR PACK 2/BOX 1 BOX $16.23 $16.23 130000 THERA TEARS,SMALL 1 PAC $9.92 $9.92 130209 INDUST EYE RELIEF 1/2 OZ 1 EA $8.27 $8.27 130429 EYEISKIN BUFFERED SOL 40Z 1 EA $8.60 $8.60 130479 EYEWASH, 1/20Z MEDIUM 1 BOX $16.21 $16.21 150060 TWEEZER,DISP PLASTIC 1 EA $3.05 $3.05 Note: Page 1 of 3 Cintas First Aid&Safety 0388 Invoice# 5004524607 1435 Brookville Way,Suite P Invoice Date 02/17/2016 Indianapolis,IN 46239 Invoice Material# Description Quantity UnitPriceExt Price Tax 163020 BURN RELIEF 4X4 DRESSING 2 EA $8.84 $17.68 163050 BURN RELIEF PACKET/6 PK 2 PAC $13.43 $26.86 182309 EMERGENCY MEDICAL GLV/8BX 1 BOX $8.53 $8.53 592242 TRAUMA PAD VACUUM SLD/4BX 1 BOX $13.33 $13.33 592243 SPLINT 24" 1 EA $14.28 $14.28 Unit Subtotal: $310.13 Unit 000000000006633134 Unit Description: SHOP CENTER 12221 LIQUID BANDAGE SMALL 1 BAG $12.16 $12.16 43129 FINGERTIP BANDAGE XL MED 1 BOX $10.91 $10.91 44269 ELASTIC STRIP MEDIUM 2 BOX $9.78 $19.56 44429 LARGE PATCH 2"X3",MED 1 BOX $10.38 $10.38 50009 ANTISEPTIC WIPES MEDIUM 1 BOX $8.47 $8.47 50429 ALCOHOL PREP PADS MEDIUM 1 BOX $8.38 $8.38 61029 ANTISEPTIC PUMP 2 OZ 1 EA $8.14 $8.14 62029 BURN CARE PUMP 2 OZ 1 EA $9.76 $9.76 71019 GAUZE PADS 4"X4"SMALL 1 BOX $8.54 $8.54 72220 ROLLER GAUZE,2"NON-STER 1 EA $5.63 $5.63 72240 ROLLER GAUZE,4"NON-STER 1 EA $6.35 $6.35 82420 MEDI-RIP 2" 1 ROL $7.50 $7.50 91019 COLD PACK,SMALL,1/BOX 2 BOX $5.64 $11.28 100019 TRIPLE ANTIBIOTIC OINT MD 1 BOX $11.55 $11.55 100419 HYDROCORTISONE CREAM MED 1 BOX $11.66 $11.68 103030 WOUNDSEAL POUR PACK 2/BOX 1 BOX $16.23 $16.23 130000 THERA TEARS,SMALL 1 PAC $9.92 $9.92 130209 INDUST EYE RELIEF 1/2 OZ 1 EA $8.27 $8.27 130429 EYE/SKIN BUFFERED SOL 4OZ 1 EA $8.60 $8.60 130479 EYEWASH, 1/2OZ MEDIUM 1 BOX $16.21 $16.21 150060 TWEEZER,DISP PLASTIC 1 EA $3.05 $3.05 150620 SPLINTER-OUT DISP MED 1 PAC $7.74 $7.74 163020 BURN RELIEF 4X4 DRESSING 2 EA $8.84 $17.68 592242 TRAUMA PAD VACUUM SLD/4BX 1. BOX $13.33 $13.33 592243 SPLINT 24" 1 EA $14.28 $14.28 Unit Subtotal: $265.60 Invoice Sub-total $585.68 Tax $0.00 Invoice Total $585.68 Page 2 of 3 Cintas First Aid&Safety 0388 Invoice# 5004524607 1435 Brookville Way,Suite P Invoice Date 02/17/2016 Indianapolis, IN 46239 Invoice Material# Description Quantity Unit Price Ext Price Tax Remit To CINTAS CORPORATION PO BOX 631025 CINCINNATI, OH 45263-1025 Note Signature: Page 3 of 3 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 343500 CINTAS FIRST AID&SAFETY Purchase Order No. PO BOX 631025 Terms CINCINNATI, OH 45263 Due Date 2/22/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/22/2016 5004524603 $678.31 hereby certify that the attached invoice(s), or bill(s) is(are)true and ;orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer VOUCHER# 154409 WARRANT# ALLOWED 343500 IN SUM OF $ CINTAS FIRST AID & SAFETY PO BOX 631025 CINCINNATI, OH 45263 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT j Audit Trail Code 5004524603 01-6200-03 $67831 Voucher Total Cost distribution ledger classification if claim paid under vehicle highway fund Cintas First Aid&-Safety.0388 Service/Billing _ (317)264=5103 1435 Brookville,Way,Suite P . fax# (317)644-0870 . Indianapolis,IN 46239 Payment Inquiry (888)994'2468 -invoice Ship To -CITY OF CARMEL H.H.W. 901 N RANGELINE RD. Invoice#5004405082 . CARMEL, IN 46032-1361 Invoice Date 02/10/2016 . Credit Terms NET 10 DAYS Customer# 10653294 Cintas Route Loc#0388 Route 0020 Order#0003923585 . Bill To CITY OF CARMEL H.H.W."BILLING 30 W MAIN ST payer# 10664113 STE 220 CARMEL,-IN 46032-1938 Material#. .. DescriptionQuantity Unit Price ExtPrice'Tax Unit 000000000006625532 Unit Description:• MAIN 110 CABINET CLEANED 1. EA $0.00 --$0.00 . 120 CABINET ORGANIZED 1 EA $0.00 $0.00 130 EXPIRATION DATES CHECKED 1 :EA $0.00 - $0.00 400 SERVICE CHARGE 1 EA $9.95 $9:95 55556 DISINFECTANT WIPE 1_ EA $5.95 $5.95 70819 GAUZE PADS.3"X3"SMALL 1 .BOX $6.82 - $6.82'. 71019 GAUZE PADS 4"X4"SMALL 1 BOX -$8.54 $8.54 103030 WOUNDSEAL POUR PACK 2/13OX 1 BOX $16.23 $16.23 1.03040 : WOUNDSEAL PLUS APPLCTR2BX 1 BOX $17.57 $17.57 130479 EYEWASH, 1/202 MEDIUM 2 ..BOX $16.21 $32.42 163050 BURN RELIEF PACKET/6 PK 2 PAC $13.43 $26.86 Unit Subtotal: $124.34 Invoice Sub-total $124.34 - Tax $.0.00 . Invoice Total. $124.34. Remit To CINTAS CORPORATION PO BOX 631025 CINCINNATI, OH 45263-1025 Note Signature: Note: --- - t . .'. .Page 1-of.1 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 343500 CINTAS FIRST AID & SAFETY Purchase Order No. PO BOX 631025 Terms CINCINNATI, OH 45263 Due Date 2/15/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/15/2016 5004405082 $124.34 hereby certify that the attached invoice(s), or bill(s) is (are) true and orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer VOUCHER # 157227 WARRANT # ALLOWED 343500 IN SUM OF $ CINTAS FIRST AID & SAFETY PO BOX 631025 CINCINNATI, OH 45263 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 5004405082 01-720H-08 $124.34 I I' Voucher Total $124.34 Cost distribution ledger classification if claim paid under vehicle highway fund • �3CINEA6,. Page 1 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-644-0870 Indianapolis, IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 INVOICE PLEASE PAY DIRECTLY FROM THIS INVOICE CARMEL STREET DEPT INVOICE # 5004524606 3400 W 131ST ST DATE 2/17/16 WESTFIELD, IN 46074-8267 PO # N/A 317-733-2001 CUSTOMER # 0010652787 PAYER # 0010664222 SVC ORDER # 8012004693 CREDIT TERMS NET 10 DAYS UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 6633596 MAIN BLD MENS R 01560255 400 SERVICE CHARGE 1 $9 . 95 $9 . 95 55556 DISINFECTANT WIPE 1 $5 . 95 $5 . 95 100039 TRIPLE ANTIBIOTIC OINT SM 1 $8 . 86 $8 . 86 111999 IBUPROFEN TABS LRG 1 $35 .95 $35 . 95 112239 DECONGEST NASAL/SINUS MED 1 $17 .46 $17 . 46 119260 ALLERGY RELIEF` TABLET MED 1 $19 . 59 $19 . 59 121629 NAPROXEN SODIUM MEDIUM 1 $10 . 95 $10 .95 592242 TRAUMA PAD VACUUM SLD/4BX 1 $13 . 33 $13 . 33 592243 SPLINT 24" 1 $14 .28 $14 .28 UNIT SUBTOTAL $136 .32 6633597 MAINTENANCE BLD 121629 NAPROXEN SODIUM MEDIUM 2 $10 . 96 $21 .92 592242 TRAUMA PAD VACUUM SLD/4BX 1 $13 .33 $13 .33 592243 SPLINT 24" 1 $14 .28 $14 . 28 UNIT SUBTOTAL $49 .53 REMIT TO CINTAS CORPORATION SUB-TOTAL $185 . 85 PO BOX 631025 TAX $0 . 00 CINCINNATI, OH 45263-1025 TOTAL $185 .85 SIGNATURE : _ _ __-,- ll --- -------------- DATE : ------____-- NAME : ----------- • CiNrAs. . Page 1 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-644-0870 Indianapolis , IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 INVOICE PLEASE PAY DIRECTLY FROM THIS INVOICE CITY OF CARMEL INVOICE # 5004405081 1 CIVIC SQ DATE 2/10/16 CARMEL, IN 46032-7569 PO # N/A 317-571-2414 CUSTOMER # 0010653293 PAYER # 0010653293 SVC ORDER # 8012002786 CREDIT TERMS NET 10 DAYS UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 6628328 MAIN I 01923133 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 43059 FINGERTIP BANDAGE MED 1 $10 . 66 $10 .66 50009 ANTISEPTIC WIPES MEDIUM 1 $8 . 47 $8 .47 50239 HYDROGEN PEROXIDE 2 OZ 1 $7 . 51 $7 . 51 50429 ALCOHOL PREP PADS MEDIUM 1 - $8 . 38 $8 .38 51030 HAND SANITIZER SMALL 1 $6 . 81 $6 .81 55556 DISINFECTANT WIPE 1 $5 . 95 $5 .95 71019 GAUZE PADS 41IX4" SMALL 1 $8 . 54 $8 .54 72220 ROLLER GAUZE, 2" NON-STER 1 $5 . 63 $5 .63 100019 TRIPLE ANTIBIOTIC OINT MD 1 $13 . 49 $13 . 49 111589 PAIN AWAY X-STRENGTH MED 1 $17 .71 $17 .71 111999 IBUPROFEN TABS LRG 1 $35 . 34 $35 .34 '112239 DECONGEST NASAL/SINUS MED 1 $17 . 46 $17 . 46 112439 SINUS RELIEF DUAL ACTN MD 1 $20 . 85 $20 . 85 119260 ALLERGY RELIEF TABLET MED 1 $19 . 59 $19 . 59 119310 PEPTUM TABS SMALL 1 $14 .69 $14 .69 130209 INDUST EYE RELIEF 1/2 OZ 1 $8 . 27 $8 .27 150620 SPLINTER-OUT DISP MED 1 $5 . 45 $5 .45 163020 BURN RELIEF 4X4 DRESSING 2 $8 .84 $17 . 68 163050 BURN RELIEF PACKET/ 6 PK 3 $11 .55 $34 .65 592242 TRAUMA PAD VACUUM SLD/4BX 1 $13 . 33 $13 .33 UNIT SUBTOTAL $290 . 41 • CINEASe Page 2 INVOICE # 5004405081 PAYER # 0010653293 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-644-0870 Indianapolis, IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 REMIT TO CINTAS CORPORATION SUB-TOTAL $290 .41 PO BOX 631025 TAX $0 . 00 CINCINNATI , OH 45263-1025 TOTAL $290 .41 SIGNATURE : ------------------------------ DATE : ------------------ NAME : ------------------------------ 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)) 02/10/16 5004405081 $290.41 2201 201 02/17/16 5004524606 $185.85 2201 201 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 CINTAS FIRST AID&SAFETY CINTAS CORPORATION IN SUM OF$ PO BOX 631025 CINCINNATI, OH 45263-1025 $476.26 ON ACCOUNT OF APPROPRIATION FOR Street Department PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member 5004405081 42-390.12 $290.41 1 hereby certify that the attached invoice(s), or 2201 201 5004524606 42-390.12 $185.85 bill(s) is (are)true and correct and that the 2201 201 materials or services itemized thereon for which charge is made were ordered and received except Tuesday, February 23, 2016 fi Street Commisslone� Cost distribution ledger classification if claim paid motor vehicle highway fund • CINEA6, Page 1 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-644-0870 Indianapolis , IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 INVOICE PLEASE PAY DIRECTLY FROM THIS INVOICE CITY OF CARMEL UTILITIES INVOICE # 5004405016 9609 HAZEL DELL PKWY DATE 1/28/16 INDIANAPOLIS, IN 46280-2935 PO # s15790 317-571-2634 CUSTOMER # 0010653296 PAYER # 0010653296 SVC ORDER # 8012102113 CREDIT TERMS NET 10 DAYS UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 6626410 COLLECT OFFICE 01560334 130 EXPIRATION DATES CHECKED 1 $0 .00 $0 . 00 400 SERVICE CHARGE 1 $9 .95 $9 . 95 55556 DISINFECTANT WIPE 1 $5 .95 $5 . 95 71019 GAUZE PADS 41IX4" SMALL 1 $8 . 54 $8 . 54 100019 TRIPLE ANTIBIOTIC OINT MD 1 $11 .55 $11 . 55 100439 HYDROCORTISONE CREAM SM 1 $7 .63 $7 . 63 101239 FIRST AID CREAM SMALL 2 $7 .58 $15 . 16 112439 SINUS RELIEF DUAL ACTN MD 1 $20 . 85 $20 .85 115089 ANTACID FRUIT FLAVOR MED 1 $16 .15 $16 .15 UNIT SUBTOTAL $95 .78 6626411 COLLECTION MENS - 01560337 110 CABINET CLEANED 1 $0 . 00 $0 . 00 130 EXPIRATION DATES CHECKED 1 $0 . 00 $0 . 00 43259 KNUCKLE BANDAGE MEDIUM 1 $10 .58 $10 .58 55556 DISINFECTANT WIPE 1 $5 .95 $5 . 95 71019 GAUZE PADS 41IX4" SMALL 1 $8 . 54 $8 . 54 100439 HYDROCORTISONE CREAM SM 1 $7 . 63 $7 . 63 111589 PAIN AWAY X-STRENGTH MED 1 $17 . 71 $17 . 71 111989 IBUPROFEN TABS MEDIUM 1 $19 .45 $19 . 45 112039 COLD RELIEF MAX/STR MED 1 $24 . 45 $24 .45 115089 ANTACID FRUIT FLAVOR MED 1 $16 .15 $16 .15 UNIT SUBTOTAL $110 .46 6626412 LAB 01560338 110 CABINET CLEANED 1 $0 .00 $0 . 00 130 EXPIRATION DATES CHECKED 1 $0 .00 $0 . 00 55556 DISINFECTANT WIPE 1 $5 . 95 $5 . 95 163020 BURN RELIEF 4X4 DRESSING 2 $15 . 35 $30 . 70 163050 BURN RELIEF PACKET/ 6 PK 2 $11 . 55 $23 .10 UNIT SUBTOTAL $59 . 75 • CI Page 2 INVOICE # 5004405016 PAYER # 0010653296 0388 - Indianapolis FAS Svc/Billing Questions : 317-264-5103 1435 Brookville Way FAX : 317-644-0870 Indianapolis, IN 46239 Payment Inquiry : 888-994-2468 ROUTE # Loc #0388 Route 0020 UNIT EXT MATERIAL # DESCRIPTION QTY PRICE PRICE TAX ---------- --------------------------- --- ------ -------- --- 6626416 MAINTENANCE 01560342 110 CABINET CLEANED 1 $0 .00 $0 . 00 120 CABINET ORGANIZED 1 $0 . 00 $0 . 00 43059 FINGERTIP BANDAGE MED 1 $10 . 95 $10 .95 44429 LARGE PATCH 211X311 , MED 1 $10 .45 $10 . 45 55556 DISINFECTANT WIPE 1 $5 . 95 $5 .95 71019 GAUZE PADS 411X4" SMALL 1 $8 .54 $8 .54 UNIT SUBTOTAL $35 .89 REMIT TO CINTAS CORPORATION SUB-TOTAL $301 .88 PO BOX 631025 TAX $0 . 00 CINCINNATI , OH 45263-1025 TOTAL $301 . 88 SIGNATURE : ------------------------------ DATE : ------------------ NAME : ------------------------------ +i i n tas First . i,d a�fet ,New Rernit�ta�nce Addr � � °� a > _� � ess for Paey y,�ent�s Cintfa�sCorp®r-a�toio�r . - - _ PO Box 631025 Cincinnati, OH 45263-1025 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. - Payee 343500 . CINTAS FIRST AID &SAFETY Purchase Order No. PO BOX 631025 Terms CINCINNATI, OH 45263 Due Date 2/3/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/3/2016 5004405016 $301.88 hereby certify that the attached invoice(s), or bill(s) is (are)true and ;orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer i VOUCHER # 157140 WARRANT # i ALLOWED IN SUM OF $ 343500 CINTAS FIRST AID & SAFETY PO BOX 631025 CINCINNATI, OH 45263 Carmel Wastewater Utility I ON ACCOUNT OF APPROPRIATION FOR Board members i i, PO# INV# ACCT# AMOUNT Audit Trail Code i 5004405016 01-7200-01 $95.78 5004405016 01-7202-05 $170.21 5004405016 01-7202-06 $35.89 I Voucher Total $301.88 Cost distribution ledger classification if claim paid under vehicle highway fund