226870 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
Q� ONE CIVIC SQUARE ZEE MEDICAL,INC. CHECK AMOUNT: $36.35
®tr CARMEL, INDIANA 46032 PO BOX 781554
INDIANAPOLIS IN 46278-8554 CHECK NUMBER: 226870
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239012 0158607122 36 . 35 SAFETY SUPPLIES
E
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 1112112013
INDIANAPOLIS IN 46278-8554 TIME 10:40:45
877-275-4933
JOE WEBSTER ext509 091009/19 ORDER/INVOICE# 0158607122
Alt: 1 1 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 317-733-2001
AMY LUNN
PART # QTY DESCRIPTION $PRICE $EXTENDED TAX
------ --- ----------- ------ --------- ---
0580 1 HL MAX-LITE EARPLUGS WO/CD,200PR/BX 29.40 29.40 "N
9900 _1 HANDLING CHARGE 6,95 6.95 N
LOCATION# 1 LOCATION DESCRIPTION - SHOP SUBTOTAL: 36.35
" SAFETY: 29.40
FIRST AID: 6.95
NONTAXABLE: 36.35
TAXABLE: .00
SUBTOTAL: 36.35
TAX 1: .00
TAX 2: .00
TOTAL 36.35
SIGNATURE : DATE: t t
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 NO. WARRANT NO.
ALLOWED 20
Zee Medical
IN SUM OF $
P. O. Box 781554
Indianapolis, IN 46278-8554
$36.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 0158607122 I 42-390.121 $36.35 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
0 Tuesd y No e 2 13
treet�SRR Mt r
Title
Cost distribution ledger classification if
claim paid motor 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 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))
11/21/13 0158607122 $36.35
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