178461 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
ONE CIVIC SQUARE Z -COIL
1 CHECK AMOUNT: $455.98
CARMEL, INDIANA 46032 1362 S RANGELME ROAD
CARMEL IN 46032 CHECK NUMBER: 178461
CHECK DATE: 10114/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
?201 4356003 2837 129.99 SAFETY ACCESSORIES
.1 601 5023990 2872 150.00 OTHER EXPENSES
2'0,1 4356003 2929 175.99 SAFETY ACCESSORIES
10/12009 1:43 PM Sales Receipt #2872
Store: 1
Customer Copy
Z -Coil- Pain Relief Footwear
1362 S. Range Line Rd,
Carmel, IN 46032
(317) 843 -2645 (COIL)
www. h ooi sers olenlat e. cons
Bill To: City of Carmel Water Department
Josh Davis
Cashier: Sysadmin
Item N ame _C _Pri Ext P
Fiebing's Prime Neat 1 55.00 55.00
Cofra Vancouver 1 $159.99 $159.99
r
V NO. WARRANT NO.
Z -Coil ALLOWED 20
IN SUM OF
1362 S. Rangeline Road
Carmel, IN 46032
$305.98
C
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 2837 43- 560.03 $129.99 1 hereby certify that the attached invoice(s), or
2201 2929 43- 560.03 $175.99 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
4
Frida ct 09, 2 09
UW-/VY 4W
I If
Streetpgom m(s $1RA%ner
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))
09/28/09 2837 $129.99
10/08/09 2929 $175.99
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
VOUCHER 093143 WARRANT ALLOWED
362217 IN SUM OF
Z -COIL PAIN RELEIF FOOTWEAR
1362 S RANGELINE RD
r' CARMEL, IN 46032 v
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
i
Board members
PO INV ACCT AMOUNT Audit Trail Code
2872 01- 6200 -06 $150.00
Voucher Total $150.00
b Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
362217
Z -COIL PAIN RELEIF FOOTWEAR Purchase Order No,
1362 S RANGELINE RD Terms
CARMEL, IN 46032 Due Date 10/5/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/5 /2009 2872 $150.00
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 t
o
Date icer