183055 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
ONE CIVIC SQUARE WORRELL CORPORATION
i CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 305 SOUTH POST ROAD
INDIANAPOLIS IN 46219 -7900 CHECK NUMBER: 183055
CHECK DATE: 3/312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 191437 15.00 CONT SVS -OTHER
Invoice date Invoice No.
AM
02/10/2010 0191437
Terms
Net 30 Days
Sold To Shipped To 0005
CITY OF CARMEL HUNTINGTON BANK
WATER WASTEWATER UTILITIES 4000 PENDLETON WAY
760 3RD AVE SW INDIANAPOLIS, IN 46226
CARMEL, IN 46032
PRINT MAIL
Sales Customer Job Ship Shi ed
Person J Worrell Po No.
N o-', 627649. (Date 02/09/2010 IVia PP wO RRELL TRUCK
Do 4 RI
COC -EDG1 8 Envelope, #10 Double Window, Printed BOX 00
WC -EN09 8 Envelope, #9 Window Reply BOX 00
f
Freight: 15.00
Sales Tax: ':0
A FINANCE CHARGE of 2% per month (24% ANNUAL PERCENTAGE RATE) will be applied to all PAST DUE accounts. TOTAL DUE 15.00
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 097388 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
191437 01- 7360 -07 $15.00
Voucher Total $15.00
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 shove, 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 2/23/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/2010 191437 $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
k /'V
Date Wicer