236212 08/19/14 CITY OF CARMEL, INDIANA VENDOR: 361174
® i1 ONE CIVIC SQUARE WORRELL CORPORATION CHECK AMOUNT: $*******166.05*
CARMEL, INDIANA 46032 305 SOUTH POST ROAD CHECK NUMBER: 236212
INDIANAPOLIS IN 46219-7900 CHECK DATE: 08/19/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 255468 166.05 OTHER EXPENSES
=��x,�.�s �u�k"$"'v:=:�,. r�h,., +` -kms � � ® � •
Invoice Date Involco No.
305 South Post Rood 08/06/2014 0255468
Indianapolis, IN 46219-7900 certified as
o
Women Business Enterprise4j_
(317)895-9708 by the state of Indo.ro and the
Gry of Indianapolis hNUBE Programs Terms
www.worrelicorp.com Net 30 Days
Sold To Shipped To 0001
CITY OF CARMEL CITY OF CARMEL
WATER-WASTEWATER UTILITIES TERESA LEWIS
30 W MAIN STREET- STE 220 WATER -WASTEWATER UTILITIES
CARMEL, IN 46032 30 W MAIN STREET, STE 220
IrI��I�II��II�r��rlL��l�lllrr�llr� llrrrll����lrl�l CARMEL, IN 46032 TERESA LEWIS
emjSelo' J Worrell 12"'N-7 TERESA.LEWIS No 093441 oto 08/04/2014 velPPed
PoreoUPS GROUND
Person
Description
ASI-K420 3 Shirt, PA Pique Knit Polo 20.40 EACH 61.20
ASI-PC90H 4 Sweatshirt, Port & Co, Pullover Hooded 24.00 EACH 96.00
Freight: 8,85
---- ---- — —Sales—Tax. ( 00
A FINANCE CHARGE of 2%per month(24%ANNUAL PERCENTAGE RATE)will be applied to all PAST DUE accounts. TOTAL DUE 166.05
All claims or returns must be made within 30 days of receipt and require a return authorization.
All invoices are payable in U.S. Funds. Thank you for your continued business.
VOUCHER # 145319 WARRANT #' ALLOWED
361174 IN SUM OF $
WORRELL CORP
305 SOUTH POST ROAD
INDIANAPOLIS, IN 46219
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
255468 01-720H-08 $166.05
I
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Voucher Total $166.05
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
361174
WORRELL CORP Purchase Order No.
305 SOUTH POST ROAD Terms
INDIANAPOLIS, IN 46219 Due Date 8/14/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/14/2014 255468 $166.05
•
• I
I
i
I 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
Date Officer