167208 12/17/2008 CITY OF CARMEL, INDIANA \JENDOk 362217 Page 1 of 1
ONE CIVIC SQUARE Z -COIL
CARMEL, INDIANA 46032 1362 S RANGELINE ROAD CHECK AMOUNT: $197.99
CARMEL IN 46032
CHECK NUMBER: 167208
CHECK DATE: 12/17/2008
DEPART AC COUNT PO N INVOICE NUMB AMOUNT DESCRIPTION
2201 4356003 1042 197.99 SAFETY ACCESSORIES
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Store: 1
Z-CoiL Pain Relief Fo(Avvear
1 362 Ran g� I ine NJ
ji4 '16C32
Bill To: City of Coi-m.1 Sueet Deparlw—it
Jeff Stewart
Ca5mer. Sysadmin
Ile") Nat ally PI;(.e F-.1 PlIce
CofiaWinchester I
(VI 00
-"btotai, $.19.99
10 Disc: $2 ".00
Exempt 0 Tax: $0 00
RECE!PT TOTAL $197.99
Ac count $'19 7 S-9
SiglIALIVe
I agree tc )ay CWy .1wurit accc'166 "to Card
issuer ag en i I (mer agreerieni
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if cr edit v uc to
Previous Acc0L1111 Balance: $0.00
AcCOLVA Balance: $197.99
Total Sales Discounts. $22.00
RETURN POLICY ON Z-COIL FOOTVVEAR
I st 14 Days After Purchase $25.00 re-stocking fee
,vill be applied to cover the costs of insole
replacement, shoe sanitation
and re.packaging.
Shoes not in like.-new condition may be as-;essed a
restocking fee of up to S50.00.
NO RETURh, OR EXCHANGES ON
FitFlops Crocs; Gfihotics Kiv)ty3oys 1 oi
Opened Sccks
i 118111 111111111111 Hill Will 11111/11
1511111111111111111 pill, 1111 gi
1042
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))
12/08/08 1042 $197.99
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
VOUCH NO. "VVARRANT NO.
ALLOWED 20
Z -Coil
IN SUM OF
1362 S. Rangeline Road
Carmel, IN 46032
$197.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 1042 43- 560.03 $197.99 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
Friday, December 12, 2008
Al
J
Stre t ommissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund