211475 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 362351 Page 1 of 1
ONE CIVIC SQUARE SUNSHINE MEDICAL
CARMEL, INDIANA 46032 31575 GLENDALE CHECK AMOUNT: $91.45
LIVONIA MI 48150 CHECK NUMBER: 211475
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239012 106725 91 . 45 SAFETY SUPPLIES
Sunshine Medical Supply, Inc. Invoice
31575 Glendale St. Date Invoice#
Livonia, MI 48150
734-293-7500 fax 734-293-7505 7/11/2012 106725
www.sunshinemedicalsupply.net
Bill To Ship To
Carmel Police Dept Carmel Police Dept
3 Civic Square 3 Civic Square
Carmel,Indiana 46032 Carmel,IN 46032
ATTN:Robert Robinson
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 15 KMG 7/11/2012
Quantity Item Code Description Price Each Amount
10 SUPRENO-EC-L-... SUPRENO EC NITRILE POWDER FREE 8.75 87.50T
EXAM GLOVE BY MICROFLEX
50/BX--10 BX/CS SIZE L
EXTENDED CUFF,POLYMER COATED
MISCELLANEOU... FUEL SURCHARGE 3.95 3.95T
Out-of-state sale,exempt from sales tax 0.00% 0.00
Thank you for your business.
Total I $91.45
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))
07/11/12 106725 latex gloves $91.45
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. WARRANT NO. _
ALLOWED 20
Sunshine Medical Supply, Inc.
IN SUM OF $
31575 Glendale Street
Livonia, MI 48150
$91.45
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1110 106725 42-390.12 $91.45
I hereby certify that the attached invoice(s), or
I
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
Thursday, July 26, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund