208370 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00353209 Page 1 of 1
ONE CIVIC SQUARE LAWSON PRODUCTS, INC
CARMEL, INDIANA 46032 PO BOX 809401 CHECK AMOUNT: $248.20
CHICAGO IL 60680 -9401 CHECK NUMBER: 208370
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9300763051 248.20 MATERIALS SUPPLIES
LI! 1666 East Touhy Avenue, Des Plaines, IL 60018
LAWS ®N Products 866- LAWSON4U(866 -529 -7664) lawsonproducts.com
Invoice
Federal ID 800496603 Invoice No. 9300763051
DUNS No. 00- 543 -8890 Invoice Date 04/13/2012
CITY OF CARMEL Sales Order No. 547919
760 3RD AVE SW STE 110
CARMEL IN 46032 -2070 AOS Order No. YYN446
Customer No. 10020692
PO No. S13075
CITY OF CARMEL Currency USD
r
9609 HAZEL DELL PKWY Sales Rep. RYAN WOLFE
r INDIANAPOLIS IN 46280 -2935
Attention
Buyer
Cash Discount 2.47
PLEASE RETURN REMITTANCE STUB Incoterm FOB Free on board
WITH YOUR PAYMENT Term of Payment 10 days 1% Discount, Net 30
PABOX 809401
Chicago IL 60680 -9401 Up to 04/23/2012 you receive 1.000 %discount
Up to 05/13/2012 without deduction
Line item No. Description Price Per Price Per Unit Qty.Shipped Amount T
10 17054 Komatsu Blue $6.00 1 EA $6.0000 3 $18.00
Maintenance
Paint HSP
20 91623 1/4X2 -1/4 S.S. Wedge $1.38 1 EA $1.3800 10 $13.80
Anchor Bolt
30 91625 3/8X2 -1/4 St/St Wedge $2.12 1 EA $2.1200 10 $21.20
Anchor Bolt
40 91627 3/8X3 -3/4 S.S. Wedge $3.02 1 EA $3.0200 10 $30.20
Anchor Bolt
50 91629 1/2X2 -3/4 St/St Wedge $4.24 1 EA $4.2400 10 $42.40
Anchor Bolt
60 95646 Hardflex Recip. Bid, 6 $5.07 1 EA $5.0700 5 $25.35
8 -12TPI
Page 1 of 2
1666 East Touhy Avenue, Des Plaines, IL 60018
LAWSON Products 866- LAWSON4U (866 -529 -7664) lawsonproducts.com
Invoice
PLEASE RETURN REMITTANCE STUB Sales Order No. 547919
WITH YOUR PAYMENT
P.O.BOX 809401 Invoice No. 9300763051
Chicago IL 60680 -9401
Line Item No. Description Price Per Price Per Unit Qty.Shipped Amount T
70 95648 Hardflex Recip. Bld, 6 $5.07 1 EA $5.0700 5 $25.35
10 -14TPI
80 98764 Light Gray Maintenance $6.00 1 EA $6.0000 3 $18.00
Paint HSP
90 DA6152 Aerosol Nut Bolt Open $8.80 1 EA $8.8000 3
$26.40
Shut
100 FA65119 3/4 -10 X 3 Hex Cap Screw $1.10 1 EA $1.1000 25
$27.50
Grade 5
Total Before Tax and Freight $248.20
Total- Freight
Total Tax
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 4/19/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/19/2012 9300763051 $248.20
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
r
Date ffic
VOUCHER 117187 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
9300763051 01- 7202 -06 $248.20
Voucher Total $248.20
Cost distribution ledger classification if
claim paid under vehicle highway fund