224395 09/25/2013 i
CITY OF CARMEL, INDIANA VENDOR: 366531 Page 1 of 1
ONE CIVIC SQUARE ADAM'S FLOORING, LLC. CHECK AMOUNT: $894.47
CARMEL, INDIANA 46032 912 ADMAN DRIVE WEST
CARMEL IN 46032 CHECK NUMBER: 224395
CHECK DATE: 9/2512013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350100 1987 574 .47 BUILDING REPAIRS & MA
1120 4350100 1991 320 . 00 BUILDING REPAIRS & MA
Adam's Flooring, LLC Invoice
1063 South Rangeline Rd.
Carmel, IN 46032 Date Invoice#
adam @adamsflooring.info
www.adamsflooring.biz 9/9/2013 1987
317- 5-9967
Bill To
Carmel Fire Dept.
Station 44
P.O. No. Terms Project
Description Qty U/M Rate Amount
35.95sgft of Shaw's Fresco"Cole"(5400V 00502)tile 35.95 3.49 125.47
u$3.49sgft
1 box of Shaw s 4100 premium adhesive n$149 1 149.00 149.00
Emboss level floor.Prep; install vinyl tile,repair carpet due 1 300.00 300.00
to installation of new doorway @$300.
Total $574.47
Payments/Credits $0.00
Balance Due $574.47
Adam's Flooring, LLC nv®I Ce
1063 South Rangeline Rd.
Carmel, IN 46032 Date Invoice#
adam @adamsflooring.info
www.adamsflooring.biz 9/17/2013 t9�t
Bill To
Carmel Fire Dept.
Station 43
P.O. No. Terms Project
Description Qty U/M Rate Amount
Binding and installation on steps in the bay 1$250 1 250.00 250.00
One pail of adhesive «$70 1 70.00 70.00
Total $320.00
Payments/Credits $0.00
Balance Due $320.00
ig
IN
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))
1991 $320.00
1987 $574.47
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
$894.47
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 1991 43-501.00 j $320.00 1 hereby certify that the attached invoice(s), or
1120 1987 43-501.00 $574.47 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
F
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund