223377 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 366531 Page 1 of 1
ONE CIVIC SQUARE ADAM'S FLOORING, LLC.
CARMEL, INDIANA 46032 912 AUMAN DRIVE WEST CHECK AMOUNT: $3,499.27
CARMEL IN 46032 CHECK NUMBER: 223377
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350100 1977 3 , 499 . 27 BUILDING REPAIRS & MA
" Adam's Flooring, LLC
Invoice
� - 1063 South Rangeline Rd.
Carmel, IN 46032 Date Invoice#
adam @adamsflooring.info
www.adamsflooring.biz 8/19/2013 1977
Bill To
Carmel Fire Dept.
Station 42
Attn: Mike Lux
P.O. No. Terms Project
Description Qty U/M Rate Amount
132sgyrds of J&J"Merge"(3520)(1456) a$9.99sgyd 132 9.99 1,318.68
49pcs of standard black 4"Cove Base a$3.50each 49 3.50 171.50
241nft of EG-XX-L Carpet Reducer to concrete a$1.501nft 24 1.50 36.00
Four pales of J&J's premium carpet adhesive @$70per 4 70.00 280.00
One bottle of seam sealer a$19.99 1 19.99 19.99
Install 132sgyd of carpeting a$4.50yd 132 4.50 594.00
Remove carpet and VCT the under the carpet a$.55sgft 1,188 0.55 653.40
Install 49pct of 4"cove base a$teach 49 2.00 98.00
Dumpster fee l 150.00 150.00
Freight and fuel surcharge na_$178.20 1 178.20 178.20
I
Total $3.499.77
Payments/Credits $0.00
Balance Due $3.499.77
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))
1977 $3,499.27
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
Adam's Flooring
IN SUM OF $
912 Auman Drive West
Carmel, IN 46032
$3,499.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
24478 I 1977 I 43-501.00 I $3,499.27 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
AUG 2 6 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund