166957 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
0 ONE CIVIC SQUARE Z -COIL CHECK AMOUNT: $227.99
CARMEL, INDIANA 46032 1362 S RANGELINE ROAD
CARMEL IN 46032 CHECK NUMBER: 166957
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 969 227.99 SAFETY ACCESSORIES
1
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11/21/2008 11 23 fkM Sales Receipt #969
Store. I
Z-Coif_ Pain Relief Footwear
13 6-2 3 Ranae I ine Rd
Cannel, ij r C132
Bill TcQD
city of cairnei street dept.
Cashier: Sysacimin
]ten) Name Qty Price ExI Price
F W-b 1 6 9 i M 1' 0 C, 1 $227 cj�j
rlt D% 5°4,
SLlblotad: 5227.99
Exempt 0 Tax: 50.00
RECEIPT T OTAL: $227.99
Account: $227 99
Signature
I agree to pay above amot.. rit actor' n to card
issuer agreement (merchant agree iei
ii CredH VOUChef)
Pi Pvious AccOUHt Bill,11)(AY $0.00
Account Balar;cu: $227.99
T Sales $1200
RETURN POLICY ON Z-COIL FOOTWEAR
1 s 'Ill Days After 5 re- stocking fee
will be applied (ove( the costs of insole
relD la Ce M: eT, I ',,Ii c, sa nitation
ar.d
Shoes not in like-nCv✓ condii,on niay !)e a
restocking fef: -,.p to $50 00.
NO RETURNS OR EXCHANGES ON:
FiiFiof-) Crocs, Orthotics, Knoty Boys. A, ,Irex: or
Opened 5o,;Vs
I Mill Hill 19111 11111111111 IN M!
i All! MI; 1014 IRS 1 loll A!
i 11111111 Hill 16111 11th 111111111 Al
9 6 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 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))
11/21/08, 969 $227.99
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
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Z -Coil
IN SUM OF
1362 S. Rangeline Road
Carmel, IN 46032
$227.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 969 43- 560.03 $227.99 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
/1 Thursday, December 04, 2008
1
Street Com sinner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund