222623 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
ONE CIVIC SQUARE ZEE MEDICAL, INC.
CARMEL, INDIANA 46032 PO BOX 781554 CHECK AMOUNT: $137.95
INDIANAPOLIS IN 46278-8554
CHECK NUMBER: 222623
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 0158503454 137 . 95 MATERIALS & SUPPLIES
ZEE
1
m
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 07118!2013
INDIANAPOLIS IN 46278.8554 TIME 13:53:27
877-275-4933
JOE WEBSTER ext509 091009119 ORDERIINVOICE# 0158503454
Alt: ! 1 P.0.#
BILL TO a 007748 SHIP TO# 007748
CARMEL WATER UTILITIES CARMEL WATER UTILITIES
3450 W 131ST STREET 3450 W 131ST STREET
Westfield IN 46074 Westfield . IN 46074
317-733-2855 317-733-2855
JACK SPEARS
PART # OTY DESCRIPTION $PRICE $EXTENDED TAX
------ --- ----------- ------ --------- ---
2331 1 EMERGENCY FIRST AID POCKET GUIDE 5.60 5.60 N
3538 3 FORCEPS, STERILE DISPOSABLE 2.45 7.35 N
0618 1 EYE DROPS - THERA TEARS 4/PK 5.95 5.95 N
2354 2 ICE PACK, DELUXE, SMALL (ZEE) 3.00 6.00 N
0740 1 BNDG, NON-LTX ELASTIC STRIP, 500 7.95 7.95 N
0206 1 HYDROGEN PEROXIDE, NON-AEROSOL, 20Z. � 4.50 4.50 N
0608 1 EYE & SKIN BUF. FLUSHING SOL. 8 OZ 13.95 13.95 N
2629 2 EYE WASH, STERILE 1-OZ., 21UNIT 11.35 22.70 N
5641 1 MUSCLE JEL 3.5 m, 24 CT. 18.40 18.40 N
9900 1 HANDLING CHARGE -6.95 6.95 N
0794 1 QR WOUND SEAL RAPID RESPONSE 20.45 20.45 N
0614 1 TETRAHYDRO. EYE DROPS, 112 OZ. 8.45 8.45 N
0995 1 ZEE FLEX 2" X 5 YOS 5.30 5.30 N
0501 1 COTTON TIP APPLICATOR 3", NS, 1001VL 4.40 4.40 N
LOCATION# 1 LOCATION DESCRIPTION - 126TH ST LOCATI SUBTOTAL: 137.95
" SAFETY: .00
D FIRST AID: 137.95
NONTAXABLE: 137.95
TAXABLE: .00
SUBTOTAL: 137.95
TAX 1: .00
TAX 2: .00
TOTAL 137.95
INVOICE
ZEE MEDICAL INC. PAGE 2
PO BOX 781554 DATE 0711812013
INDIANAPOLIS IN 46278-8554 TIME 13:53:27
877-275-4933
JOE WEBSTER ext509 09!009119 ORDERIINVOICE# 0158503454
Alt: ! 1 P.O.#
PART # QTY DESCRIPTION $PRICE $EXTENDED TAX
------ --- ----------- ------ --------- ---
SIGNATURE : DATE: 1 !
PRINT NAME: TITLE:
ASK US ABOUT FIRST AID AND AED PROGRAMS
THANK YOU FOR YOUR BUSINESS!!
INVOICE IS CONFIDENTIAL - MAY BE SUBJECT TO LATE FEES
VOUCHER # 132244 WARRANT # ALLOWED
343500 IN SUM OF $
ZEE MEDICAL
P.O. BOX 781554
INDIANAPOLIS, IN 46278-8554
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT i Audit Trail Code
i
0158503454 01-6200-03 $137.95
�i
i
Voucher Total $137.95
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
343500
ZEE MEDICAL Purchase Order No.
P.O. BOX 781554 Terms
INDIANAPOLIS, IN 46278-8554 Due Date 7/23/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/2013 0158503454 $137.95
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
Date Officer