239656 11/25/2014 CITY OF CARMEL, INDIANA VENDOR: 361174
CHECK AMOUNT: $*****1,657.76*(9,
ONE CIVIC SQUARE WORRELL CORPORATIONCARMEL, INDIANA 46032 305 SOUTH POST ROAD CHECK NUMBER: 239656
INDIANAPOLIS IN 46219-7900 CHECK DATE: 11/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 258830 1,657.76 OTHER EXPENSES
Invoice Date Invoice No.
305 South Post Rood 1J/14/2014 0258830
Indianapolis, IN 46219-7900 Certified os o
Women Business Enterprise ,
(317)895-9708 by the state of Indiono and the Terms
Qty of Indrnopolis AMllBE Programs
www.worrellcorp.com Net 30 Days
Sold To Shipped To
WCO
CITY OF CARMEL WORRELL CORPORATION
WATER-WASTEWATER UTILITIES GINA-City of Carmel Newsletter
30 W MAIN STREET- STE 220 305 S POST RD
CARMEL, IN 46032 INDIANAPOLIS, IN 46219
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Sales Customer - _ - ___ Job - ship - - -- Shipped
Person J'Worrell - No.No. - SUE MAKI Nn. 094799- Da2e 11/07/2014 �a UPS GROUND
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COC-NEW004 27,0001 Monthly Newsletter, 11 x17 57.571 M f 1,554.39
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i Freight: i 103.37
--- jl Sales Tax: —
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A FINANCE CHARGE of 2%per month(24%ANNUAL PERCENTAGE RATE)will be applied to all PAST DUE accounts. TOTAL DUE 1,657.76
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 # 146055 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
258830 01-7360-08 $1,657.76
I'
1
I
i
Voucher Total $1,657.76
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
j 361174
WORRELL CORP Purchase Order No.
305 SOUTH POST ROAD Terms
INDIANAPOLIS, IN 46219 Due Date - 11/20/2014
j Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/20/201, 258830 $1,657.76
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 5-111,-,10-1.6
/�/l.//� Cr•v-�J-��i lam-....Y 1LN✓v.�2.-�'—_
Date Officer