205216 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 354612 Page 1 of 1
ONE CIVIC SQUARE LAWSON FLOORING
CHECK AMOUNT: $74.19
CARMEL, INDIANA 46032 P o. eox 609401
CHICAGO IL 60680 -9401 CHECK NUMBER: 205216
CHECK DATE: 115!2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9300445295 74.19 OTHER EXPENSES
Ll� 1666 East Touhy Avenue, Des Plaines, IL 60018
LAWSON Products 866- LAWSON4U (86 529 -7664) lawsonproducts.com
Invoice
Federal ID No. 800496603 Information
DUNS No. 00- 543 -8890 Sales Order No. 295472
Invoice No. 9300445295
CITY OF CARMEL
760 3RD AVE SW STE 110 Invoice Date 12/14!2011
CARMEL IN 46032 -2070
AOS Order No. MRJ319
Customer No. 10020692
P.O. No. JEFF COOPER
n CITY OF CARMEL Currency USD
F I 9609 -HAZE L- DELI_ pKW -Y— Sales Representative: RYAN WOLFE
INDIANAPOLIS IN 46280 -2935
va
Attention:
Buyer JEFF COOPER
Cash Discount 0.75
PLEASE RETURN REMITTANCE STUB Cash
FOB Free on board
WITH YOUR PAYMENT Term of Payment 10 days 1% Discount, Net 30
Chicago IL 068 6068 0 -9401 X 8 Up to 1 2/2 41201 1 you receive 1.000 discount
Chicag
Up to 01113/2012 without deduction
Line Item No. Description Price Per Price Per Unit Qty.Shipped Amount T
10 94613 15.25 Nylon Cable Ties $0.29 1 EA $0.2900 100 $29.00
20 29587 BIk32 "Lx.35Wnylon Cable $0.47 1 EA $0.4700 25 $11.75
Ties
30 97878 200 Ft Caution Baricad $4.98 1 EA $4.9800 3 $14.94
---Tapp
40 85244 #102 Hex Wash Hd $0.37 1 EA $0.3700 50 $18.50
Self -Drill Screw
50 A20 Drawer 0.00 0 0.00 1 0.00
Page 1 of 2
00 1666 East Touhy Avenue, Des Plaines, IL 60018
SON Products 866- LAWSON4U(866 -529 -7664) lawsonproducts.com
Invoice
PLEASE RETURN REMITTANCE STUB
WITH YOUR PAYMENT
Sales Order No. 295472
P.O.BOX 809401
Chicago IL 60680 -9401 Invoice No. 9300445295
Line "Item No. Description Price Per
Price. Per Unit Qtys'Shipped Amount. T
Total Before Tax and Freight $74.19
Total- Freight-
Total Tax
Page 2 of 2
Total $74.19
T Detach and Return Lower PortionT
Bill To Customer No Invoice No. Total Amount Due AMOUNT PAID:
CITY OF CARMEL 10020692 9300445295 74.19 USD
To ensure proper service, please return this portion with your payment
We Accept
Remit To:
P.O.BOX 809401
Chicago IL 60680 -9401 To pay by credit card, call 1 -800- 821 -7660 (option 3)
THANK YOU FOR YOUR BUSINESS
9300445295500000074199
VOUCHER 116529 WARRANT ALLOWED
354612 IN SUM OF
LAWSON
PO Box 809401
Chicago, IL 60680
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
9300445295 01- 7202 -05 $74.19
9kL dap
Voucher Total $74.19
Cost 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 Purchase Order No.
PO Box 809401 Terms
Chicago, IL 60680 Due Date 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 9300445295 $74.19
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have J audited same in accordance with IC 5- 11- 10 -1.6
Date Officer