181686 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
z' ONE CIVIC SQUARE WORRELL CORPORATION
CARMEL, INDIANA 46032 305 SOUTH POST ROAD CHECK AMOUNT: $6,729.47
s:- INDIANAPOLIS IN 46219 -7900 CHECK NUMBER: 181686
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 189298 15.00 OTHER EXPENSES
601 5023990 190374 4,196.54 OTHER EXPENSES
651 5023990 190374 2,517.93 OTHER EXPENSES
WORRELL I NVOICE DATE
11/13/2009 INVOICE NUMBER
0189298 JOB FILE COPY
CUSTOMER NUMBER CUSTOMER ORDER NO. INVOICE
CORPORATION
126952 SCOTT CAMPBELL
ORDERED BY: TOTAL:
SCOTT CAMPBELL 15.00
SOLD TO SHIPPED TO
0001
CITY OF CARMEL CITY OF CARMEL
i
WATER WASTEWATER UTILITIES WATER WASTEWATER UTILITIES
760 3RD AVE SW 760 3RD AVE SW
CARMEL, IN 46032 CARMEL, IN 46032
SCOTT CAMPBELL
J
OUR ORDER NO DATE SHIPPED SHIPPED VIA SALESPERSON TERMS
0001
264378 11/12/2009 WORRELL TRUCK J Worrell Net 30 Days
QTY ORDERED QTY SHIPPED DESCRIPTION STARTING /ENDING NUMBER UNIT PRICE UNIT AMOUNT Profit/Commission Analysis
E -Mail invoices to Ikempa @carmel.in.gov
8 8 Statements BOX .00
COC -F01 9001 .00
.00
.00
.00
A
COMMENTS: FREIGHT 15.00 Net Sale: 15.00
Total Cost: 00
SALES TAX .00 GP$: 15.00
Commission: .00
TOTAL 15.00 Total Inv. GP% 100.00
DIRECT ALL BILLING INQUIRIES TO: AT (317) 695 -9708 Fax (317) 895 -9705
VOUCHER 097141 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
189298 01- 7360 -07 $15.00
Voucher Total $15.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
_DC)1 Por-i&
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 12/30/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/2005 189298 $15.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
!I IN VOICE �o
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t,. S o lutio UJork
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PRIN T I N G MARKETING -*'OFFICE i Invoice Date Invoice No.
CertiFied as
Wo B usiness En 3 01/05/2010 0190374
w w w w o r r e l l c o r •can by the State of Indiana sing the t j
X,.. P r City of Indionapol)s MAUBE Programs .r
Terms
305 South. Post Road Indi 46219 7900 Net 30 Days
{31;7) 89 Fax 31' 7) 895 -9705
Sold To Shipped To 0001
CITY OF CARMEL CITY OF CARMEL
WATER- WASTEWATER UTILITIES WATER WASTEWATER UTILITIES
760 3RD AVE SW 760 3RD AVE SW
CARMEL, IN 46032 CARMEL, IN 46032
M.111111111 IIIIIIIIIIuIIIIttuIIIIIIIIIIIIIIII SCOTT CAMPBELL
Sates s s Customer Job Ship 7 Shipped
Person J "Worrell P No Scott; Ca mpbell
N 074321 Date 12/30/2009 via U S.'Mall
Item Code Quantity r' Descriptio Unit Price U /Nl Extension
COC -PROC 1 City of Carmel Utility Mailings 6539.47 EACH 6,539:47
5
Freight: 175.00
Sales Tax: 00
A FINANCE CHARGE of 2% per month (24% ANNUAL PERCENTAGE RATE) will be applied to all PAST DUE accounts TOTAL DUE IP 6,714.47
All claims or returns must be made within 30 days of receipt and require a return authorization. YYY
All invoices are payable in U.S. Funds. Thank you for your continued business.
VOUCHER 094084 WARRANT ALLOWED
361174 IN SUM OF$.
WORRELL CORPORATION
305 SOUTH POST ROAD
INDIANAPOLIS, IN 46219 -7900
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
190374 01- 6360 -07 $4,196.54
S
Voucher Total $4,196.54
Cost distribution ledger classification if
claim paid under vehicle highway f i
()c)(-1,
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 CORPORATION Purchase Order No.
305 SOUTH POST ROAD Terms
INDIANAPOLIS, IN 46219 -7900 Due Date 12/30/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12130/200! 190374 $4,196.54
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
1l 511 /7 Date Officer
Officer
VOUCHER 097131 WARRANT ALLOWED
361174 IN SUM OF
WORRELL CORP
305 SOUTH POST ROAD
INDIANAPOLIS, IN 46219
Carmel Wastewater Utility
ON ACCOUNT APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
190374 01- 7360 -07 $2,517.93
Voucher Total $2,517.93
Cost distribution ledger classification if
claim paid under vehicle highway fund
9,x..)
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 12/30/2009
Invoice Invoice Description'
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/2001 190374 $2,517.93
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
iASL?
Date Officer