191018 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
ONE CIVIC SQUARE Z -COIL CHECK AMOUNT: $94.99
CARMEL, INDIANA 46032 1362 S RANGELINE ROAD
CARMEL IN 46032 CHECK NUMBER: 191018
CHECK DATE: 10113/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 5614 94.99 SAFETY ACCESSORIES
10/6/2010 2:05 PM Sales Receipt #5614
Stare: 1
Z -Coil Pain Relief Footwear
1362 S. Range Line Rd.
Carmel, IN 46032
(317) 843 -2645 (COIL)
www. h oos i e rs d e m a t e. c on
Bill To: City of Carmel- Street Department
Eric Russell
Cashier: Sysadmin
Item Nam Qty Price Ext Price
Cofra Analyst 1 $94.99 $94.99
Wide M12.0
Subtotal: $94.99
Exempt 0 Tax: $0.00
RECEIPT TOTAL: $94.99
Account: $94.99
Signature
I agree to pay above amount according to card
issuer agreement (merchant agreement
if credit voucher).
Previous Account Balance: $0.00
Account Balance: $94.99
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 fired and it
may provide you
with the comfort and pain- relief you are seeking. The
footwear is returnable for 14 days after purchase
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
1111111111 1111 111l Jill
5614
VOUCHER NO. WARRANT NO.
ALLOWED 20
Z -Coil
IN SUM OF
1362 S. Rangeline Road
Carmel, IN 46032
$94.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
2201 5614 43- 560.03 $94.99 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
Thursday, Ol' o 07, 2010
Street Commissioner
r d
Street c;fr issloner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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 Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/06/10 5614 $94.99
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