178923 10/28/2009 a CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
ONE CIVIC SQUARE ZEE MEDICAL, INC.
CARMEL, INDIANA 46032 PO BOX 781554 CHECK AMOUNT: $85.77
INDIANAPOLIS IN 46278 -8554 CHECK NUMBER: 178923
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4239012 158374120 85.77 SAFETY SUPPLIES
ZEE MEDICAL PROPRIETARY AND CONFIDENTIAL
O
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 10/19/2009
INDIANAPOLIS IN 46278-8554 TIME 13:49:12
317-872-2492
JOE WEBSTER 09/009/19 ORDER/INVOICEK 0158374120
Alt: P.O.*
BILL TO M03609 SHIP TO# 003609
CARMEL CLAY COMMUNICATIONS CARMEL—CLAY COMMUNICATIONS
31 1ST. AVE. N.W. 31 1ST AVE N.W.
CARMEL IN 46032 CARMEL IN 46032
317-571-5780 317-571-5780
DIANE
PART QTY DESCRIPTION $PRICE $EXTENDED TAX
1410 1 TRIPLE BUFFERED ASPIRIN 100/BX (ZEE) 7.45 7.45 N
1446 1 ANTACID, TRIAL 100/BX (ZEE) 10.99 10.99 N
1487 1 DILOTAB II, 250/BX 28.50 28.50 N
1453 1 CHERRY COUGH DROPS 50/BX (ZEE) 8.69 8.69 N
0225 1 ANTI—BACTERIAL TOWELETTE 20/BOX 5.65 5.65 N
3537 1 SPLINTER OUT (ZEE), 10/PK 3.99 3.99 N
0206 1 HYDROGEN PEROXIDE, NON—AEROSOL, 2CZ. 3.25 3.25 *N
0602 2 EYE WASH, STERILE 1—OZ 01E) 4.95 9.90 N
0923 1 GAUZE PADS 4" X 4", 10/BX (ZEE) 4.40 4.40 N
9900 1 HANDLING 2.95 2.95 N
LOCATION# 1 LOCATION DESCRIPTION A SUBTOTAL: 85.77
SAFETY: 3.25
FIRST AID: 82.52
SUBTOTAL: 85.77
TAX In .00
TAX 2:
TOTAL
Your preferred customer savings; 3.00
North America's #1 provider offirst ad, yafey, and taking
519291 TOY WN limp MUSNAUM@ CLMTOMER COPY 888 CALL ZEE P215933) zeemedical.corn
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))
10/19/09 I 158374120 I I $85.77
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 NO. W NO.
ALLOWED 20
Zee Medical, Inc.
IN SUM OF
P.O. Box 781554
Indianapolis, IN 46278 -8554
$85.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 158374120 42- 390.12 $85.77 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
Tuesday, October 20, 2009
Directo
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund