203631 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 362351 Page 1 of 1
ONE CIVIC SQUARE SUNSHINE MEDICAL
;o CARMEL, INDIANA 46032 31575 GLENDALE CHECK AMOUNT: $173.95
LIVONIAMI 48150 CHECK NUMBER: 203631
CHECK DATE: 1119/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1110 4239012 101803 173.95 SAFETY SUPPLIES
Sunshine Medical Supply, Inc. invoice
31575 Glendale St.
Livonia, MI 48150 Date Invoice
734 -293 -7500 fax 734- 293 -7505 11/2/2011 101803
www. sunshinemedical supply. net
Bill To Ship To
Carmel Police Dept Carmel Police Dept
3 Civic Square 3 Civic Square
Carmel, Indiana 46032 Carmel, IN 46032
i1TTN: Robert Robinson
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 15 KMG 11/2/2011
Quantity Item Code Description Price Each Amount
10 SUPRENO-EC-XL... SUPRENO EC NTTRILE POWDER FREE 8.50 85.00T
GLOVES BY MICROPLEX
50/BX -10 BX /CS SIZE XL.
EXTENDED CUFF, POLYMER COATED
10 SUPRENO-EC-L-... SUPRENO EC NITRILE POWDER FREE 8.50 85.00T
EXAM GLOVE BY MICROFLEX
50/BX -10 BX /CS SIZE L
EXTENDED CUFF, POLYMER COATED
MISCELLANEOU... FUEL SURCHARGE 3.95 3.95T
Out -of -state sale, exempt from sales tax 0.00% 0.00
Thank: you i'or your business.
Total $173.95
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sunshine Medical Supply, Inc.
IN SUM OF
31575 Glendale Street
Livonia, MI 48150
$173.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 I 101803 I 42- 390.12 $173.95 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, November 04, 2011
Chief of Police
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))
11/02/11 101803 latex gloves $173.95
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