178462 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 343500 Pegg 1 of 1
6 ONE CIVIC SQUARE ZEE MEDICAL, INC. CHECK AMOUNT: $93.66
ra CARMEL, INDIANA 46032 PO BOX 781554
INDIANAPOLIS IN 46278 -8554 CHECK NUMBER: 178462
CHECK DATE: 10!14!2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
'201 4239012 0158374009 93.66 SAFETY SUPPLIES
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ZEE MEDICAL PROPRIETARY AND CONFIDENTIAL
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 09/29/2009
INDIANAPOLIS IN 46278-8554 TIME 13:28:47
317-872-2492
JOE WEBSTER 09/009/19 ORDER/INVOICE# 0158374009
Alt: P.O.#
BILL TO M00486 SHIP TO# 000486
CARMEL STREET DEPT CARMEL STREET DEPT
3400 WEST 131ST STREET 3400 WEST 131ST STREET
WESTFIELD IN 46074 WESTFIELD IN 46074
317-733-2001 317-733-2061
BONNIE
PART QTY DESCRIPTION $PRICE $EXTENDED TAX
0740 1 BNDG, NON—LTX ELASTIC STRIP, 50/BX 5.99 5.99 N
0305 1 TAPIE, 2" X 5 YD. 3 CUT SPOOL (ZEE) 5.60 5.60 N
0995 1 ZEE FLEX 2" X 5 YDS 4.55 4.55 N
0794 1 OR WOUND SEAL RAPID RESPONSE 17.95 17.95 *N
1420 1 ZEE IBUTAB 100/BX 13.15 13.15 N
1486 1 DILOTAB II, 100/BX 13.99 13.99 N
0602 1 EYE WASH STERILE 1—OZ (ZEE) 4.95 4.95 N
LOCATION# 1 LOCATION DESCRIPTION SHOP SUBTOTAL: 66.18
2209 1 CLEANSE—AWAY 4 OZ BTL (POISON IVY) 7.70 7.70 *N
0740 2 BNDG, NON—LTX ELASTIC STRIP, 50/BX 5.99 11.98 N
3538 1 DISPOSABLE FORCEP, STERILE 1.85 1.85 N
9900 1 HANDLING 5.95 5.95 N
LOCATION# 2 LOCATION DESCRIPTION BATHROOM SUBTOTAL: 27.48
SAFETY: 25.65
FIRST AID: 68.01
GUBTOTAL: 93.66
TAX 1: .00
TAX 2: .00
TOTAL 93.66
North America's #1 provider of first aid, safety, and traini
CUSTOMER COPY 888' CALL ZEE (225-5933) zeened|cal.com
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))
09/29/09 0158374009 $93.66
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
IN SUM OF
P. O. Box 781554
Indianapolis, IN 46278 -8554
$93.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 0158374009 42- 390.12 $93.66 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, Octob� 09, 2009
�I
I
Street Commissioner
.A'.fran+
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund