174559 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 362217 Page 1 of 1
ONE CIVIC SQUARE Z -COIL
1, CARMEL, INDIANA 46032 1362 S RANGELINE ROAD CHECK AMOUNT: $255.98
CARMEL IN 46032
o CHECK NUMBER: 174559
CHECK DATE: 7/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1958 127.99 OTHER EXPENSES
601 5023990 2043 127.99 OTHER EXPENSES
6117/2009 2:01 PM Sales Receipt #1958
Store: 1
Z -GoiL Pain Relief Footwear 6!2512009 3:39 PM Sales Receipt #2043
1362 S Range Line Rd Store' 1
Carmel, IN 46032 Z -GoiL Pain Relief Footwear
13
Bill To: City of Carmel Water Department artment C 5 Range Line Rd
Carmel. IN 46032
Jerry Smith
Bill To: City of Carmel Water Department
ashier Sysadmin Sean Whitlow
It Name Qty Price E xt Pri ce Cashier. Sysadmin
Cofra Vancouver
Wide M10.0 1 $159.99 $159.99
item Name Qty Price Ext
Cofra Vancouver 1 5159.99 5159.39
Subtotal: 5159.99 Wide MO 7.5
20 Disc: 532.00
Exempt 0 Subtotal: $159.99 Tax: 50.00 20 %Disc: $32.00
RECEIPT TOTAL: $127.99 Exempt 0 Tax: 50.00
Account $12}7.99 f� RECEIPT TOTAL $127.99
Jury S `r Account: $127.99 •-F
Signature 3
I agree to above mount according to card
issuer agreement (merchant agreement
if credit votlther). I agree to pay above amount according to card
issuer agreement (merchant agreement
if credit voucher).
Previous Account Balance: $0.00
Account Balance: $127.99 Previous Account Balance: $0.00
Total Sales Discounts: $32.00 Account Balance: $127.99
RETURN POLICY ON Z -COIL FOOTWEAR Total Sales Discounts: $32.00
1 st 14 Days After Purchase 525.00 re- stocking fee RETURN POLICY ON Z -COIL FOOTWEAR
will be applied to cover the costs of insole
replacement, shoe sanitation 1 st 14 Days After Purchase $25.00 re- stocking fee
and repackaging. will be applied to cover the costs of insole
Shoes not in like -new condition may be assessed a replacement, siloe sanitation
restocking fee of up to $50.00. and repackaging.
Shoes not in like -new condition may be assessed a
NO RETURNS OR EXCHANGES ON: restocking fee of up to $50.00.
FitFiops, MBTs; Kiogs; Orthotics; Knoty Boys; Aetrex; NO RETURNS OR EXCHANGES ON:
or Opened Socks
Fit Flops, MBTs; Klog5; Orthotics: Knoty Boys; Aetrex;
pp (317) 843 -2645 or Opened Socks
1 (317) 843 -2645
1958
2043
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 6/29/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/29/2009 2043 $127.99
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
n
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date ffic r
VOUCHER 092196 WARRANT ALLOWED
362217 IN SUM OF
`Z.COIL PAIN RELEIF FOOTWEAF�-�� I
1362 S RANGELINE RD
-CARMEL, IN 46032 z
0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
2043 01- 6200 -06 $127.99
,4
Voucher Total
j v
Cost distribution ledger classification if
claim paid under vehicle highway fund