227536 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 343500 Page 1 of 1
+F ONE CIVIC SQUARE ZEE MEDICAL, INC. CHECK AMOUNT: $110.95
CARMEL, INDIANA 46032 PO BOX 781554
INDIANAPOLIS IN 46278-8554 CHECK NUMBER: 227536
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239012 0158503757 110 . 95 SAFETY SUPPLIES
I N V O I C E
ZEE MEDICAL INC. PAGE 1
PO BOX 781554 DATE 09/17/2013
INDIANAPOLIS IN 46278-8554 TIME 14 : 39: 02
877-275-4933
JOE WEBSTER ext509 09/009/19 ORDER/INVOICE# 0158503757
Alt: / / P.O.#
BILL TO # 000486 SHIP TO# 011420
CARMEL STREET DEPT CARMEL STREET DEPARTMENT
3400 WEST 131ST STREET 2 CIVIC SQUARE
Westfield IN 46074 Carmel IN 46032
317-733-2001 317-650-8282
PARKS PIFER
PART # QTY DESCRIPTION $PRICE $EXTENDED TAX
------ --- ----------- ------ --------- ---
2354 2 ICE PACK, DELUXE, SMALL (ZEE) 3 . 00 6 . 00 N
0608 1 EYE & SKIN BUF. FLUSHING SOL. 8 OZ 13 . 95 13 . 95 N
2629 1 EYE WASH, STERILE 1 OZ, 2/UNIT 11 . 35 11 .35 N
1451 1 PEPT-EEZ 42/BX (ZEE) 12 . 75 12 . 75 N
0614 1 TETRAHYDRO. EYE DROPS, 1/2 OZ. 8 .45 8 .45 N
0206 1 HYDROGEN PEROXIDE, NON-AEROSOL, 2OZ 4 . 50 4 .50 N
3538 1 DISPOSABLE FORCEP, STERILE 2 .45 2 .45 N
3537 1 SPLINTER OUT (ZEE) , 10/PK 4 . 75 4 . 75 N
1486 1 DILOTAB II, 100/BX 17 .45 17 .45 N
1435 1 E.S. UN-ASPIRIN 100/BX (ZEE) 14 .40 14 .40 N
0740 1 BNDG-NON-LTX ELASTIC STRIP, 50/BX 7 . 95 7 . 95 N
9900 1 HANDLING CHARGE 6 . 95 6 . 95 N
LOCATION# 1 LOCATION DESCRIPTION - CIVIC SQUARE SUBTOTAL: 110 . 95
* SAFETY: . 00
FIRST AID: 110 . 95
NONTAXABLE: 110. 95
TAXABLE: . 00
SUBTOTAL: 110 . 95
TAX 1: . 00
TAX 2 : . 00
TOTAL 110 . 95
ON ACCOUNT
VOUCHER NO. WARRANT NO.
ALLOWED 20
Zee Medical
IN SUM OF $
P. O. Box 781554
Indianapolis, IN 46278-8554
$110.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 0158503757 I 42-390.121 $110.95 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
�rj Fri txY` i013
treet Commissioner
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))
09/17/13 0158503757 $110.95
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