179909 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
ONE CIVIC SQUARE Z -COIL
CARMEL, INDIANA 46032 1362 5 RANGELINE ROAD CHECK AMOUNT: $555.95
CARMEL IN 46032 CHECK NUMBER: 179909
CHECK DATE: 11/24/2009
DI`PARTMENT A CCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
1047 4239012 3150 91.99 SAFETY SUPPLIES
1047 4239012 3171 127.99 SAFETY SUPPLIES
1125 4239012 3187 111.99 SAFETY SUPPLIES
1125 4239012 3216 111.99 SAFETY SUPPLIES
1125 4239012 3217 111.99 SAFETY SUPPLIES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
362217 Z -Coil Pain Relief Footwear Terms
1362 S. Range Line Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/3/09 3150 Maintenance footwear/ Fred Hagemier 91.99
11/10/09 3216 Maintenance footwear Meredith Bentley 111.99
11/10/09 3217 Maintenance footwear Mike Jackson 111.99
11/5/09 3171 Maintenance footwear Juan Mercado 127.99
11/6/09 3187 Maintenance footwear /Rebecca Schmiesing 111.99
Total 555.95
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
1
Voucher No. Warrant No.
362217 Z -Coil Pain Relief Footwear Allowed 20
1362 S. Range Line Rd
Carmel, IN 46032
In Sum of
555.95
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1047 31 -50 4239012 91.99 1 hereby certify that the attached invoice(s), or
1125 3216 4239012 111.99 bill(s) is (are) true and correct and that the
1125 3217 4239012 111.99 materials or services itemized thereon for
1047 3171 4239012 127.99 which charge is made were ordered and
1125 3187 4239012 111.99 received except
19 -Nov 2009
Signature
555.95 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund