172413 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 354612 Page 1 of 1
0 ONE CIVIC SQUARE LAWSON FLOORING CHECK AMOUNT: $677.59
CARMEL, INDIANA 46032 2689 PAYSPHERE CIRCLE
CHICAGO IL 60674
CHECK NUMBER: 172413
CHECK DATE: 5/13/2009
DEPAR A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
'651 5023990 511697 8038039 677.59 SEALANT, SCREWS, ANCH
ORIGINAL INVOICE
L D
�SON Products
Des Plaines, /L Corporate Headquarters
7 Admm".u"oh�m�wo"om/�m°�mom.wJ
�m.wv°o�nee, GA* Vernon Hills, u° Mississau mn
mmmmJmwaonprpductm.cPm PACE l MRL194
S OF C&RMEL
D NO. VOICLINO. �V�ICE DATE
`u WATER-WASTEWATER 02 9 7= 9 g CARMEL UOl
36 HAZEL DELL PKWY
INDIANAPOLIS IN 4628O
CITY OF CARM[L 1.68 A PH
SOLD
TO: WATER-WASTEWATER
760 3RD AVE SW 5TE 110
CARMEL IN 46032 DUNS NU. 00 O101
FED. I.D. #36
GSA GS-06F-0027L
Buyer: JEFF COOPER
91025 5/16-i8xi 18-8 ST/ST CAPSCREW 29-58 c 25 25 7.4o,
91042 3/8-16xi 18-8 ST/ST CAPSCREW .41 EA 25 25 10.25-
27512 m6xi.oxl6 SS HX HEAD METRIC C/S 23-90 C 50 50 011-95-
27514 m6xi.OX25 SS HX HEAD METRIC C/S 29-53 C 50 50 14-77-
27530 m8x1.25X3O SS HX HEAD METRIC C/S .71 EA 25 25 17-75-
FA95679 3/8-16 GRADE 5 HEX NUT 5.50 C 100 100 5.50-
FA95683 5/8-11 GRADE 5 HEX NUT .29 EA 25 25 7.25-
FA95684 3/4-10 GRADE 5 HEX NUT .56 EA 25 25 14.00-
91395 3/8-16 ST/ST NYL INS NUT .45 EA 100 100 45-00-
91044 3/8-16xl-1/2 18-8 ST/ST CAPSCREW .58 EA 100 100 58.00-
91114 3/8 18-8 ST/ST FLAT WASHER 16.49 c 200 200 6
g1625 3/8X2-1/4 ST/ST WEDGE ANCHOR BOLT 3.62 EA 10 10 36.20
91626 3/8X2 ST/ST WEDGE ANCHOR BOLT 3.80 EA 10 10 38.00-
91627 3/8X3 ST/ST WEDGE ANCHOR BOLT 4.05 EA 10 10 40-50-
91628 3/8X5 ST/ST WEDGE ANCHOR BOLT 5.45 EA 10 10 54-50-
91622 1/4X1-3/4 ST/ST WEDGE ANCHOR BOLT 2.00 EA 10 10 20.00-
91623 1/4X2-1/4 ST/ST WEDGE ANCHOR BOLT 2.22 EA 10 10 22.20-
91624 1/4x3 ST/ST WEDGE ANCHOR BOLT 2.88 EA 10 10 28.8o-
X, PAY THIS INVOICE BY
EXCLUDING CREDIT CARDS
TERMS: 1% TEN DAYS NET 30 DAYS
NIC NO CHARGE 010 BACK ORDERED C/D CANCELLED
ORIGINAL INVOICE
LAWSON Products
Des Plaines, IL Corporate Headquarters
Addison, IL Charlotte, NC Dallas, TX Fairfield, NJ
Reno, NV •Suwanee, GA* Vernon Hills, IL Mississauga, ONT
www.lawsonproducts.com PAGE 2 MRL 194
CITY OF CARMEL
Sh�PPED AC O T NO. VOIC NO. I V ICE DATE
TO: WATER WASTEWATER 0297�+��+ 92487 X036039 5/0P2009 CARMEL 001
9609 HAZEL DELL PKWY
INDIANAPOLIS IN 46280
1
CITY OF CARMEL €i8.: AYSPHERE C: GRC1
SOLD
TO: WATER- WASTEWATER I CAGO) [L .,60674
760 3RD AVE SW STE 110
CARMEL IN 46032 DUNS NO 00- 543 -8890 0101
FED I.D. #36- 2229304
GSA GS- 06F -0027L
OAAAEEA: CUSTOMER ORDER N0. /BUYERS NAME SALES.AGENi: OATE:SHIPPED. :i OUAOAOEA:NO
t!F "eta S 1 16 RYAC WO1F E 0 :::0!� K (#.0 MRL.1. 4
pow
g 1776 10.3 FL. OZ. SILICONE SEALANT 9 79 EA 3 3 2.37
3042 CLEAR SILICONE SEALANT 8.91 EA 3 3 2 •73'
83841 13 OZ NET WT GASKET REMOVER 6. EA 6 6 38.64-
17054 KOMATSU BLUE MA I NT PAINT H I -SLD P 8.74 EA 6 6 52.44'
FRT. CHRGS. 30.26
Y
CASH DI NT IF OU I
SCOU A OR TAX ER
SALES 0 OTHER
M PAY THIS INVOICE BY> .....�.........>f...........
EXCLUDIN CREDIT CARDS
GC
TOTAL AMOUNT
TERMS: 1% TEN DAYS NET 30 DAYS
N/C NO CHARGE BID BACK ORDERED C/D CANCELLED 7 6
DETACH
RETURN LOWER PORTION
30Lp9 ACCOUNT NUM$EAi!' EEfliDtCE IY BiV DATE is TOTA.:iAt @IOT pUl
CITY OF CARMEL of 0297464 92487 8038039 05/04/2009 677.59
REMIT TO:
LAWSON PRODUCTS INC. TO ENSURE PROPER CREDIT PLEASE RETURN THIS PORTION
2689 PAYSPHERE CIRCLE WITH YOUR PAYMENT.
CHICAGO IL 60674
AMOUNT PAID:
IF AMOUNT PAID IS NOT AMOUNT DUE PLEASE EXPLAIN ON REVERSE.
We accept
VISA THANK YOU FOR YOUR BUSINESS
E
AWSferCa/d RE
Contact us at 1- 866- LAWSON4U (1- 866- 529 -7664) Direct any non payment inquiries to 1666 E. Touhy Ave., Des Plaines, IL 60018
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 5/8/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/8/2009 8038039 $677.59
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
VOUCHER WARRANT ALLOWED
354612 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
8038039 01- 7202 -06 $647.33
8038039 01- 7202 -06 $30.26
r�
P
o��
Voucher Total $677.59
Cost distribution ledger classification if
claim paid under vehicle highway fund