166837 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00350595 Page 1 of 1
ONE CIVIC SQUARE PEN PRODUCTS CHECK AMOUNT: $22,323.20
CARMEL, INDIANA 46032 6075 LAKESIDE BLVD
INDIANAPOLIS IN 46278 CHECK NUMBER: 166837
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1 853 5023990 22069 22,323.20 OTHER EXPENSES
1. PEN Products
6075 Lakeside Boulevard
I NVOI C E Indianapolis, IN 46278
1- 800 -PEN -2550
Fo rm m approved PRODUCFS m wed y
Form by State Board of Accounts, 2003 317 388 -8580
PH— Em rpi— Network
Ship to Address Invoice Date Invoiced
THE MONON CENTER 22069 11/05/08
1235 CENTRAL PARK DRIVE EAST PEN order#
CARMEL, IN
46032 213121
Bill to Address State Purchase Order Number
CARMEL CLAY PARKS RECREATION
1411 E. 116TH STREET Page#
CARMEL, IN 3
46032
Cust. Order /Requisition Date Ordered Date Shipped Shipped BY
18844 06/27/08 09/19/08 PEN Products
UNIT OF UNIT
LINE# OTY. MEASURE CATALOG DESCRIPTION PRICE AMOUNT
35 FABRIC #724.006 SHADOW TRACERY (MAYER)
36 EAST LOBBY
37 5 EA 83311CDO ADAMS CHAIR 936.00 4680.00
38 FABRIC #WC780.001 POMPEII ON THE SPOT.
39 (MAYER)
40 2 EA SP5150B 36" DIA.COFFEE TABLE w /HD 250.00 500.00
41 LAMINATE #1844 -45 ALPINE PASSAGE (WILSONART)
42 2 EA 83313CDO ADAMS SOFA 1654.00 3308.00
43 FABRIC #WC781.001 CINNABAR IN THE LOOP
44 (MAYER)
45 4 EA SP5152 FOlOT2020 w /HD LAMINATE 197.00 788.00
46 LAMINATE #1844 -45 ALPINE PASSAGE (WILSONART)
47 1 EA INSTALLATION SETUP 3794.90 3794.90
RECEIVED
Purdwm
(V) o r NOV 0 7 2008
t�L R O BY:
gib« FT fu rn►
a► i SUBTOTAL 41743.90
11181
7% Sales Tax prappricabiel 0.00
Misc.Revenue /Expenses 0.00
r�
1 TOTAL 41743-90
INFORMATION FOR AUDITOR RNkDl FF4 E
C State Agency Name C Appr. Name FAy nE 3a3, Agency
H CARMEL CLAY PARKS RECREATION R PEN Products 5150
A Fund /Object/Center State Agency E Fund /Object /Center
R D
G l
E Appropriation Name T
Q Indiana Department of Correction V130•1403/03
f. PEN Products
p t` 6075 Lakeside Boulevard
P,
INVOICE OICE Indianapolis, IN 46278
SF 47709 (R2/3 -03) ORIGINAL 1 -800 -PEN -2550
a PRODUCTS a Form approved by State Board of Accounts, 2003 317- 388 -8580
Ship to Address Invoice Date Invoiced
THE MONON CENTER 22069 11/05/08
1235 CENTRAL PARK DRIVE EAST PEN Order#
CARMEL, IN
46032- 213121
Bill to Address State Purchase Order Number
CARMEL CLAY PARKS RECREATION
1411 E. 116TH STREET Page#
CARMEL, IN I
46032
Cust. Order /Requisition Date Ordered Date Shipped Shipped BY
18844 06/27/08 09/19/08 PEN Products
UNIT OF UNIT
LINE# CITY. MEASURE CATALOG DESCRIPTION PRICE AMOUNT
1 AREA 1210 HEALTH SCREENING ROOM
2 2 EA 83311CDO ADAMS CHAIR 936.00 1872.00
3 FABRIC #WC781 -006 GRANITE IN THE LOOP
4 (MAYER)
5 1 EA SP5152 FOlOT2020 w /HD LAMINATE 197.00 197.00
6 LAMINATE #1844 -45 ALPINE PASSAGE (WILSONART)
7 AREA 1106 CORRIDOR
8 4 EA 83311CDO ADAMS CHAIR 936.00 3744.00
9 FABRIC #WC780 -001 POMPEII ON THE SPOT
10 (MAYER)
11 2 EA SP5152 FOlOT2020 WHO LAMINATE 197.00 394.00
12 LAMINATE #1844 -45 ALPINE PASSAGE (WILSONART)
13 1 EA SP5150B 36" CIA COFFEE TABLE WHO 250.00 250.00
14 LAMINATE #1844 -45 ALPINE PASSAGE (WILSONART)
15 2 EA 83313CDO ADAMS SOFA 1654.00 3308.00
16 FABRIC #WC792.001 CINNABAR RATIO (MAYER)
17 AREA UNDER THE STAIRS
R /E D
NOV 0 7 2008
BX:
SUBTOTAL
211181
7% Sales Tax (if applicable)
Misc. Revenue /Expenses
TOTAL
INFORMATION FOR AUDITOR
C State Agency Name A r. Name Agency
App
r. R PEN Products 5150
A Fund /Object/Center State Agency Fund /Object/Center
E
R D
G I
E Appropriation Name T
0 Indiana Department of Correction V130- RO3103
PEN Products
6075 Lakeside Boulevard
INVOICE Indianapolis, IN 46278
SF 47709 (R2i3 -03) ORIGINAL 1- 800 -PEN -2550
®PRODUCTS o Form approved by State Board of Accounts, 2003 317- 388 -8580
Prison E —pises Network
Ship to Address Invoice Date Invoiced
THE MONON CENTER 22069 11/05/08
1235 CENTRAL PARK DRIVE EAST PEN Order#
CARMEL, IN
46032- 213121
Bill to Address State Purchase Order Number
i
CARMEL CLAY PARKS RECREATION
1411 E. 116TH STREET Page#
CARMEL, IN 2
46032
Cust: Order /Requisition Date Ordered Date Shipped Shipped BY
18844 06/27/08 09/19/08 PEN Products
UNIT OF UNIT
LINE# CITY. MEASURE CATALOG DESCRIPTION PRICE AMOUNT
18 2 EA 83311CDO ADAMS CHAIR 936.00 1872.00
19 FABRIC #WC780 -001 POMPEII ON THE SPOT
20 (MAYER)
21 1 EA SP5150B 36" DIA COFFEE TABLE w /HD 250.00 250.00
22 LAMINATE #1844.45 ALPINE PASSAGE .(WILSONART)
23 2 EA 83313CDO ADAMS SOFA 1654.00 3308.00
24 FABRIC #WC792.001 CINNABAR RATIO (MAYER)
25 2 EA SP5152 FOlOT2020 w /HD LAMINATE 197.00 394.00
26 LAMINATE #1844.45 ALPINE PASSAGE (WILSONART)
27 AREA WEST LOBBY
28 5 EA 83311CDO ADAMS CHAIR 936.00 4680.00
29 FABRIC #791.000 TRUFFLE REBOUND (MAYER)
30 4 EA SP5152 FOlOT2020 w /HD LAMINATE 197.00 788.00
31 LAMINATE #1844.45 ALPINE.PASSAGE.(WILSONART)
32 4 EA SP51501J 36" DIA COFFEE TABLE w /HD 250.00 1000.00
33 LAMINATE #1844.45 ALPINE.PASSAGE (WILSONART)
34 4 EA 83313CDO ADAMS SOFA 1654.00 6616.00
7 NO C VO 7 2008
SUBTOTAL
BY: 211181
T% Sales Tax iifapplicablel
Misc. Revenue /Expenses
TOTAL
INFORMATION FOR AUDITOR
C State Agency Name C Appr. Name Agency
H R PEN Products 5150
A Fund /Object/Center State Agency E Fund /Object/Center
R D
G
E Appropriation Name T
Q Indiana Department of Correction V130- R03f03
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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. 18844 F
Pen Products Terms
6075 Lakeside Boulevard Date Due
Indianapolis, IN 46278
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/08 22069 Monon Center Furniture 22,323.20
Total 22,323.20
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Pen Products Allowed 20
6075 Lakeside Boulevard
Indianapolis, IN 46278
In Sum of
22,323.20
ON ACCOUNT OF APPROPRIATION FOR
853 Gift Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
853 22069 5023990 22,323.20 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
i
1 -Dec 2008
Signature
22,323.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund