LSJ Approval/Purchase Items/Payment Request Form Date of Request: 1-22-08 Status: Urgent: Inventory: Item/Items Requested: 8 Pallets 8" Concrete Blocks Purchase Price: $135.00/pallet $1,080.00 shipping, tax and Our Truck 150.00 all related costs. Lafayette Barge 225.00 Total Expected Cost: $1,455.00 Deposit Required? Yes: No: List Dept: Purpose/Description: Walls for New Locker Room and Misc. projects Purchased From: MSI Company Name & Address or Web Site St. Thomas Requested By: Dan Chipman Time Frame for Purchase/Repair: Special Instructions: Attach Quote: Yes: No: Were Competitive Quotes Obtained? Yes: No: If No, Why Not: Authorization: EFTA00591339