189417 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 00353209 Page 1 of 1
ONE CIVIC SQUARE LAWSON PRODUCTS, INC CHECK AMOUNT: $35.72
CARMEL, INDIANA 46032 PO BOX 809401
CHICAGO IL 60680 -9401 CHECK NUMBER: 189417
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 9486121 35.72 GARAGE MOTOR SUPPIE
ORIGINAL INVOICE
0 LAWS
Products
Des Plaines, IL Corporate Headquarters
Addison, IL 9 Vernon Hills, IL Fairfield, NJ
Reno, NV •Suwanee, GA• Mississauga, ONT
www. I awson products. I PAGE 1 MRM7
CARMEL STREET DEPT
SHIPPED ACADUNT NO- IN �E NO. INVPICE DATE
TO: 34odo w 13 ST 033 05 92487 94 6121 08/10)2010 CARMEL 001
WESTFIELD IN 46074
M
AVUE.
CARMEL
$09:
SOLD
TO: 3400 W 131ST ST 68'
WESTFIELD IN 46074
DUNS NO. 00 0101
FED. I.D. #80-0496603
GSA 4 GS-06F-0027L
CUSTOMER ORDER NO.IBUYERS NAME U-S A MT.''
OUR 4 0A E
GE D
GARRkER
Xv v
YAWWG.LlF;E :08, b:::20: :M7rD0:'
R sG� MIKE HENRICKS 7,11 /1 ::TO
U i R
UNIT 0R0e#tb FPi
�7
BUYER:JEFF STEWART
81765 16 OZ ANTI/FRICTN COOLANT 9.12 EA 3 3 27-36
FRT. CHRGS. 8.36
Please note our new remittance address and new Fed ID#
XX
M
SALES OR USE TAX OTHER
I
CASH DISCOUNT IF
PAY THI INVOICE BY
fi EXCLUDI G CREDIT CARDS
TOTAL AMOUNT
TERMS: 1% TEN DAYS NET 30 DAYS aa
NIC NO CHARGE 810 BACK ORDERED CID CANCELLED 7 5.72
DETACH
RETURN LOWER PORTION
DATE 0 UNT NUMBE OTAUiAMOUNIT�.
DUE]
CARMEL 01 0330805 92487 9486121 o8/10/2010 35-72
REMIT TO:
LAWSON PRODUCTS, INC. TO ENSURE PROPER CREDIT PLEASE RETURN THIS PORTION
P.O. Box 809401 WITH YOUR PAYMENT.
CHICAGO IL 6o68o-94o1
AMOUNT PAID:
IF AMOUNT PAID IS NOT AMOUNT DUE PLEASE EXPLAIN ON REVERSE.
We accept
VSA Epp THANK YOU FOR YOUR BUSINESS
1A%mleiCaid)
Col l at 1 -ASA-LAW-qii 11 -ARA- Ii nn. --u—+ f- I CAr, i T—i Ave new i ii rnni m
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lawson Products
IN SUM OF
P.O. Box 809401
Chicago, IL 60680 -9401
$35.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Member
2201 9486121 42 321.00 $35.72 i 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
fi Thursday, flgust 26, 2010
Street Commissib r
�:r�s �qTitfe� g° er
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))
08/10/10 9486121 $35.72
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