227165 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
�t� I�f. ONE CIVIC SQUARE ZEE MEDICAL, INC. CHECK AMOUNT: $98.00
? CARMEL, INDIANA 46032 PO BOX 781554
INDIANAPOLIS IN 46278-8554 CHECK NUMBER: 227165
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4239099 0158607189 98 . 00 OTHER MISCELLANOUS
INVOICE
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 12!0312013
INDIANAPOLIS IN 46278-8554 TIME 13:42:52
877-275-4933
JOE WEBSTER ext509 091009!19 ORDERlINVOICE# 0158607189
Alt: ! ! P.O.#
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
------ --- ----------- ------ --------- ---
2629 1 EYE WASH, STERILE 1 OZ, 2/UNIT 11.35 11.35 N
0618 1 EYE DROPS - THERA TEARS 41PK 5.95 5.95 N
0225 1 TOWELETTE,MOIST CLEANSING,201BX ZEE 6.40 6.40 N
0203 1 CLEAN WIPES 50lBX (ZEE) 6.95 6.95 N
0740 1 BNDG-NON-LTX ELASTIC STRIP, 5018% 7.95 7.95 N
1420 1 IBUTAB 100lBX (ZEE) 16.75 15.75 N
1417 1 PAIN-AID 1001BX (ZEE) 14.95 14.95 N
0995 1 ZEE FLEX 2" X 5 YDS 5.30 5,30 N
0370 1 TAPE, ELASTIC lin X 5 YD. SPOOL 7.95 7.95 N
1457 1 ANTI-DIARRHEAL CAPLETS,2mg,12CT 7.50 7.50 N
9900 1 HANDLING CHARGE 6.95 6.95 N
LOCATION# 1 LOCATION DESCRIPTION - MAIN SUBTOTAL: 98.00
" SAFETY: .00
FIRST AID: 98.00
NONTAXABLE: 98.00
TAXABLE: .00
SUBTOTAL: 98.00
TAX 1: .00
TAX 2: .00
TOTAL 98.00
INVOICE
ZEE MEDICAL INC. PAGE 2
PO BOX 781554 DATE 1210312013
INDIANAPOLIS IN 46278-8554 TIME 13:42:52
877.275-4933
JOE WEBSTER ext509 09!009119 OROERlINVOICE# 0158607189
Alt: 1 1 P.O.#
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
Prescribed by State 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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
� c
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.
ALLOWED 20
7—ff T enlL -'I IN SUM OF $
D && -7 t;��q
5 w
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund