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190527 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1 ONE CIVIC SQUARE ZEE MEDICAL, INC. CARMEL, INDIANA 46032 PO BOX 781554 CHECK AMOUNT: $140.16 INDIANAPOLIS IN 46278 -8554 CHECK NUMBER: 190527 CHECK DATE: 9/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4239012 0158375908 140.16 SAFETY SUPPLIES ZEE MEDICAL PROPRIETARY AND CONFIDENTIAL r Tn ,;a Flay YEARS OF SERVICE I N V O I C E ZEE MEDICAL INC. WAGE 1 910 PDX 781554 DATE 09/15 INDIANAPOLIS IN 46:78 -8554 TIME 14:20 :05 877-2 75-4933 JOE WEBSTER ext509 09/009/19 ORDER /INVOICE# 0158375908 Alt: P.O. BILL TO M03609 SHIP TO# 003609 CARMEL CLAY COMMUNICATIONS CARMEL -CLAY COMMUNICATIONS 31 1ST. AVE. N. W. 31 1ST AVE N. W. CARMEL IN 46032 CARMEL IN 46032 3 1 7-5 71 5780 317 DIANE PART QTY DESCRIPTION $PRICE $EXTENDED TAX 0924 1 GAUZE PADS 4" X 4 25/BX (ZEE) 8.20 8.20 N 0921 1 GAUZE FADS 3" X 3 25 /RX (ZEE) 6.40 6.40 N 0740 1 BNDG, NON -LTX ELASTIC STRIP, 50 /BX. 5.99 5.99 N 1817 1 HYDROCORT I ZONE CREAM 1%, 0. 9GM 25 /PK 9.40 9.40 N 1801 1 3- ANTIBIOTIC OINT, 0. 9GM, 25/BX (ZEE) 8.10 8.10 N 0995 3 ZEE FLEX 2" X 5 YDS 4.55 13.65 N 1486 1 DILOTAB II, 100 /BX 13.99 13.99 N 1421 1 ZEE IBUTAB 250 /BX 27.99 27.99 N 2629 2 EYE WASH, STERILE 1 -OZ., 2 /UNIT 9.95 19.90 N 0601 1 EYE CUES, PLASTIC 6 /VIAL 3.85 3.85 N 0204 1 ANTISEPTIC SWAPS, 50 /BX (ZEE) 5.75 5.75 N 0795 1 OR WOUND SEAL, 2 /PK 10.99 10.99 N 9900 1 HANDLING 5.95 5.95 T LOCATION# 1 LOCATION DESCRIPTION A SUBTOTAL: 140.16 SAFETY: .00 FIRST AID: 140.16 NONTAXABLE: 134.21 TAXABLE: 5.95 SUBTOTAL: 140.16 TAX 1: .00 TAX 2: .00 TOTAL 140.16 North America's #1 provider of first aid, safety, and training PQCI CUSTOMER COPY 888 CALL ZEE (225 -5933) zeemedicai.com VO NO. WARRANT NO. ALLOWED 20 Zee Medical, Inc. IN SUM OF P.O. Box 781554 Indianapolis, IN 46278 -8554 $140.16 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. I ACCT #!TITLE AMOUNT Board Members 1115 0158375908 42- 390.12 $140.16 1 hereby certify that the attached invoice(s), or 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 Wednesday, September 22, 2010 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1,995) 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 Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/15/10 I 0158375908 I I $140.16 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 20 Clerk- Treasurer