191891 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
ONE CIVIC SQUARE ZEE MEDICAL, INC. CHECK AMOUNT: $202.33
CARMEL, INDIANA 46032 PO BOX 781554
INDIANAPOLIS IN 46278 -8554 CHECK NUMBER: 191891
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239012 0158376128 202.33 SAFETY SUPPLIES
ZEE MEDICAL PROPRIETARY AND CONFIDENTIAL
Fim Yenns of SEFFACE
I N V 0 I C E
ZEE MEDICAL INC. GAGE 1
PO PDX 781554 DATE 10/29/2010
INDIANAPOLIS IN 46278°-8554 TIME 13:49:24
877-275-4933
.743E WEBSTER ext509 09/009/19 ORDER /INVOICE# 0158376128
Alt-. P.O.
BILL TO M004BG S14IP TO# 000486
CARMEL STREET DEPT CARMEL STREET DEFT
3400 WEST 131ST STREET 3400 WEST 131ST STREET
Westfield IN 46074 Westfield IN 46074
317-- 733 -2001 317- 733 2 001
BONNIE
FART QTY DESCRIPTION $PRICE $EXTENDED TAX
2207 2 IVY X PRE— CONTACT TOWELETTE, 25 /BX 35.00 70.00 *N
2 2 IVY X CLEANSER TOWELETTE, 2 5 BX 22.95 45.90 *N
9500 1 HANDLING 5.95 5. 7 5 N
LOCATION# 1 LOCATION DESCRIPTION A SUBTOTAL: 121.85
1421 1 ZEE IBUTAB 250 /BX 27.99 27.99 tV
1418 1 ZEE PAIN —AID 250 /BX 23.99 23.99 N
1487 1 DILOTAB II, 250 /BX 28.50 28.50 N
LOCATION# 2 LOCATION DESCRIPTION OFFICE SUBTOTAL: 80.48
SAFETY: 115.90
FIRST AID: 86.43
NONTAXABLE: 202.33
TAXABLE: .00
SUBTOTAL: 202.33
TAX 1: .00
TAX 2: .00
TOTAL-. 202.
ON ACCOUNT
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CUSTOMER COPY 888 CALL ZEE (225 -5933) zeemedical.com
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VOUCHER NO. WARRANT N
ALLOWED 20
Zee Medical
IN SUM OF
P. O. Box 781554
Indianapolis, IN 46278 -8554
$202.33
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# I Dept. INVOICE NO. ACCT #(TITLE AMOUNT
P Board MemberC
2201 0158376128 42- 390.12 $202.33 i 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
T T.' II R
hursday /November 04, 2010
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Steet
Commssoner,
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Title
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))
10/29/10 0158376128 $202.33
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