216786 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 00353209 Page 1 of 1
ONE CIVIC SQUARE LAWSON PRODUCTS, INC
CARMEL, INDIANA 46032 PO BOX 809401 CHECK AMOUNT: $153.42
CHICAGO IL 60680-9401
CHECK NUMBER: 216786
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 9301368193 153 .42 REPAIR PARTS
Lawson Products,Inc.
®® ® Products 8770 West Bryn Mawr Ave., Suite 900, Chicago,IL 6063 1-351 5
�®
866-LAWSONN4U(866-529-7664) lawsonproducts.com
® Invoice
Federal ID 800496603 Invoice No. 9301368193
DUNS No. 00-543-8890
Invoice Date 01/14/2013
CARMEL FIRE DEPT Sales Order No. 1079540
2 CIVIC SQ
CARMEL IN 46032 AOS Order No. UM5377
Customer No. 10177555
PO No. STOCK-J.FORCE
CARMEL FIRE DEPT Currency USD
-- r L CIVIC-SQ -- - Sa!es Rep. Mr-CHRISTOPHER ORR
CARMEL IN 46032
Attention
Buyer
Cash Discount 1.31-
PLEASE RETURN REMITTANCE STUB Cash
FOB Free on board
WITH YOUR PAYMENT Term of Payment 10 days 1%Discount,Net 30
Chicago X 809401 6068 Up to 01/24/2013 you receive 1.000 %discount
Chicago IL 60680-9401 Up to 02/13/2013 without deduction
Line Item No. Description Price Per Price Per Unit Qty.Shipped Amount T
10 93425 10-24 Nutsert Conversion $27.65 1 EA $27.6500 1 $27.65
Kit
20 93426 10-32 Nutsert Conversion $27.65 1 EA $27.6500 1 $27.65
Kit
30 ^93427 �1/4-20 Nutsert $27.65 1 EA $27.6500 1 $27.65
Conversion Kit
.......... -- - .. .....
_. . ..........
40 81086 10-24 Nutsert $38.02 100 EA $0.3802 50 $19.01
50 81088 1/4-20 Nutsert $0.56 1 EA $0.5600 50 $28.00
60 DE6V30 Lawson US Catalog $0.00 0 $0.00 1 $0.00
Page 1 of 2
Lawson Products,Inc.
LI! 8770 West Bryn Mawr Ave., Suite 900, Chicago,IL 6063 1-351 5
S® Products 866-LA/WSSOONN4U(866-529-7664) lawsonproducts.com
Invoice
PLEASE RETURN REMITTANCE STUB Sales Order No. 1079540
WITH YOUR PAYMENT
P.O.BOX 809401 Invoice No. 9301368193
Chicago IL 60680-9401
Line Item No. Description Price Per Price Per Unit Oty.Shipped Amount T
Total Before Tax and Freight $129.96
- Total Freight $13.42
Total Tax $10.04
VOUCHER NO. WARRANT NO.
ALLOWED 20
Lawson Products
IN SUM OF $
PO Box 809401
Chicago, IL 60680-9401
$153.42
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1120 I 9301368193 I 42-370.00 I $153.42 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
JAN 2 8 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9301368193 Misc. Parts $153.42
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer