173417 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 354612 Page 1 of 1
ONE CIVIC SQUARE LAWSON FLOORING CHECK AMOUNT: $274.36
CARMEL, INDIANA 46032 2689 PAYSPHERE CIRCLE
CHICAGO IL 60674
CHECK NUMBER: 173417
CHECK DATE: 6/1012009
DEPART ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
651 5023990 8099124 274.36 OTHER EXPENSES
F
ORIGINAL INVOICE
LAWSON Products
Des Plaines, IL-Co rporate
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CITY OF CARM[L
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TO WATER-WASTEWATER O2 4�7 g CARMEL OOl
9609 HAZEL DELL PKWY
INDIANAPOLIS IN 4828D
CITY OF CARMEL
SOLD WATER-WASTEWATER
760 3RD AVE 3W ST[ llD
CARMEL IN 46032 DUNS ND. 00 O101
FED' I.D. #36
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CUSTOMER ORDER NO./BUYERS NAME SALES.-AUNT a E Sm Pp
HUR NO.
Buyer: JEFF COOPER
gio6i 1/2-13X2 18-8 ST/ST CAPSCREW 1.73 EA 10 10 17-30
96439 5/8xl TUFF-CUT CARBIDE BUR 67-11 EA 1 1 67-11'
96440 5/8xl TUFF-CUT CARBIDE BUR 61.o4 EA 1 1 61.o4
FA 505 1/2 USS FLAT WASHER 13-15 C 100 100 13-15-
FA 5217 METRIC 3/8 DRIVE HEX SKT SET 22.04 EA 1 1 22.04
FA65100 5/8-11X2-1/2 GRADE 5 HEX HD C/S .47 EA 25 25 11-75-/
FA65121 3/4 GRADE 5 HEX HD C/S 1.11 EA 30 30 33-30-
FA95681 1/2-13 GRADE 5 HEX NUT 11-59 C 50 50 5.8o
FA95683 5/8-11 GRADE 5 HEX NUT .29 EA 50 50 14.50A/
FRT. CHRGS. 12-37
S SALES OR USE TAX OTHER
TERMS: 1% TEN DAYS NET 30 DAYS
NIC NO CHARGE B/O BACK ORDERED C/O CANCELLED 274-IA Am
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 6/1/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/1/2009 8099124 $274.36
1)
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
4 1 V",
Date Officer
VOUCHER 095730 WARRANT ALLOWED
34612 IN SUM OF
LAWSON FLOORING
2689 Paysphere Circle
Chicago, IL 60674
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
8099124 01- 7202 -06 $111.80
8099124 01- 720T -06 $150.19
8099124' 01- 7202 -06 $12.37
Voucher Total $274.36
Cost distribution ledger classification if
claim paid under vehicle highway fund