223306 08/14/2013 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
` ONE CIVIC SQUARE ZEE MEDICAL, INC.
CARMEL, INDIANA 46032 PO BOX 781554 CHECK AMOUNT: $116.40
INDIANAPOLIS IN 46278-8554 CHECK NUMBER: 223306
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CHECK DATE: 8/14/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4239099 0158503579 116 .40 OTHER MISCELLANOUS
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ZEE
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 08113/2013
INDIANAPOLIS IN 46278-8554 TIME 14:04:43
877-275-4933
JOE WEBSTER ext509 09/009/19 ORDER/INVOICE# 0158503579
Alt: / 1 P,0.#
BILL TO # 000712 SHIP TO# 000712
CITY OF CARMEL CITY OF CARMEL
ONE CIVIC SQUARE ONE CIVIC SQUARE
CLERK TREASURER CLERK TREASURER
Carmel IN 46032 Carmel IN 46032
317-571.2414 317-571-2414
Ann
PART # QTY DESCRIPTION $PRICE $EXTENDED TAX
------ --- ----------- ------ --------- ---
1487 1 DILOTAB 11, 250 18X 35.50 35.50 N
1453 1 CHERRY COUGH DROPS 50 1BX (ZEE) 10.10 10.10 N
1492 1 CONGEST AID 11, 100/BX 17.50 17.50 N
1457 1 ANTI-DIARRHEAL CAPLETS,2mg,12CT 7.50 7.50 N
0795 1 QR WOUND SEAL, 2 1PK 13.95 13.95 N
2629 1 EYE WASH, STERILE 1 OZ, 2/UNIT 11.35 11.35 N
0370 1 TAPE, ELASTIC lin X 5 YD. SPOOL 7.95 7.95 N
2331 1 EMERGENCY FIRST AID POCKET GUIDE 5.60 5,60 N
9900 1 HANDLING CHARGE 6.95 6.95 N
LOCATION# 1 LOCATION DESCRIPTION - OFFICE SUBTOTAL: 116.40
" SAFETY: ,00
FIRST AID: 116.40
NONTAXABLE: 116.40
TAXABLE: .00
SUBTOTAL: 116.40
TAX 1: .00
TAX 2: .00
TOTAL 116.40
INVOICE
ZEE MEDICAL INC. PAGE 2
PO BOX 781554 DATE 08/13/2013
INDIANAPOLIS IN 46278-8554 TIME 14:04:43
877-275-4933
JOE WEBSTER ext509 09/009/19 ORDER/INVOICE# 0158503579
Alt: 1 / P.O.#
SIGNATURE DATE: I !
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
Prescribed by Slate Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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.
aPa ee
�1 Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
2er - ALLOWED 20
( / �`" "��' IN SUM OF
-T S;-4
1�j Aa--k�n-v
$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
` 01553 l 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
20
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund