159960 05/28/2008 y o.LAgf CITY OF CARMEL, INDIANA VENDOR: 354612 Page 1 of 1
b ONE CIVIC SQUARE LAWSON FLOORING
y� CARMEL, INDIANA 46032 2689 PAYSPHERE CIRCLE CHECK AMOUNT: $203.44
CHICAGO IL 60674 CHECK NUMBER: 159960
CHECK DATE: 5/28/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 6815379 203.94 MATERIALS SUPPLIES
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onxa�AL INVOICE
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Des Plaines, L' Corporate headquarters
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CITY OF CARMEL
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TO- WATER-WASTEWATER OZ 92487 U CARM[L OOl
9609 HAZEL DELL PKWY
INDIANAPOLIS IN 46280
CITY OF CARM[L
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9i HAZEL DELL PKWY
INDIANAPOLIS IN 46280 DUNS NO. 00-543-88g8 0701
FED. I.D. #36
GSA #oa-nep-oocrL
CUSTOMER ORDER NO.IBUYERS NAME SALE S AAE i
Mau
NIT
IT
REFORM
Buyer: JEFF COOPER
65115 3/4X2 PERMA PLATED LAWSON 5 C/S 1 .35 EA 25 25 33-75
88447 3/8 USS TRU-TORQ FLAT WASHER 13.94 C 100 100 13.94
88451 5/8 LISS TRU-TORQ FLAT WASHER .60 EA 50 50 30-00
giio6 5/16-18 18-8 ST/ST HEX NUT 22.23 C 50 50 11.12
91113 5P6 18-8 ST/ST FLAT WASHER 15-32 C 100 100 15-32
91114 3/8 18-8 ST/ST FLAT WASHER 23.67 C 100 100 23.
95227 M6 ST/ST METRIC FLT WASHER 7.87 c 100 100 7.87
95684 3/4-10 GO 5 HEX NUT .85 EA 25 25 21.25
29588 WHR32"LX.35W NYLON CABLE TIES 1.02 EA 25 25 25-50
FRT. CHRGS. 9.34
SALES OR USE TAX OTHER
EXCLUDING CREDIT CARDS
TERMS: 1% TEN DAYS NET 30 DAYS
W NO CHARGE BID BACK ORDERED CID CANCELLED 203.94
VOUCHER 085496 WARRANT ALLOWED
354612 IN SUM OF
LAWSON FLOORING
'2689 Paysphere Circle
"p hicago, IL 60674
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
6815379 01- 7202 -06 $203.94
Voucher Total $203.94
'lost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
354612
LAWSON FLOORING Purchase Order No.
2689 Paysphere Circle Terms
Chicago, IL 60674 Due Date 5/14/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/14/2008 6815379 $203.94
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer