183057 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
o ONE CIVIC SQUARE Z -COIL
CARMEL, INDIANA 46032 1362 S RANGELINE ROAD CHECK AMOUNT: $127.99
CARMEL IN 46032 CHECK NUMBER: 183057
CHECK DATE: 3/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 3553 127.99 SHOES
1/8/20id2: PM Sales Recelpt #3553
Store: 1
Z -Coil Pain Relief Footwear
1362 S. Range Line Rd,
Carmel, IN 46032
(317) 843 -2645 (COIL)
v ivw. hooisersdemate.corn
Bill To: Carmel Water Department
Trent Morgan
Cashier: Sysadmin
Item Na Qty Price E P rice_
Cofra Vancouver 1 X159.99 $159.99
Wide M11.0
Subtotal:
20 Disc: -S32.00
Exempt 0 Tax: +$0.00
RECEIPT TOTAL: $127.99
Account: $127.99
Signature '1r�:•� j/'�����v. JFf�CP
I agree to pay above amount according to card
issuer agreement (merchant agreement
if credit voucher). r
Previous Account Balance: $0.00
Account Balance: $127.99
Total Sales Discounts: 532.00
RETURN POLICY ON Z -COIL FOOTWEAR
Z -Coil Pain Relief Footwear is highly adjustable and
designed for comfort and pain relief. We encourage
you to get an
adjustment rather than returning your footwear.
Often, the problem with the shoes can be fixed and it
may provide you
with the comfort and pain relief you are seeking. The
footwear is returnable for 14 days after purch
minus a $25
restocking fee; the shoe must be in like new /saleable
condition. Footwear not in like new condition will be
charged a $50
restocking fee, condition to be determined byZ -CoiL
Management.
NO RETURNS OR EXCHANGES ON WORN:
FitFlops; MBTs; Klogs; Orthotics; Aetrex; Cofra;
Socks and Accesories. Any of these brands may be
returned for store
credit within 14 days of purchase if they show no
visible wear /use.
(317) 843 -2645
1 1111! 1111 1!! 1' 11111 JqJ 11111111
3553
VOUCHER 094382 WARRANT ALLOWED
36221,7 IN SUM OF
Z -COIL PAIN RELEIF FOOTWE�i
1362 -S RANGELINE RD
CARMEL, IN 46032 U
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
3553 01- 6200 -06 $127.99
Voucher Total $127.99
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL t'
An invoice or bill to be properly itemized must show, kind of service, where 42
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
362217
Z -COIL PAIN RELEIF FOOTWEAR Purchase Order No,
1362 S RANGELINE RD Terms
CARMEL, IN 46032 Due Date 2/23/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/2010 3553 $127.99
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
Date Officer