210173 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
1J ONE CIVIC SQUARE WORRELL CORPORATION CHECK AMOUNT: $663.64
t o CARMEL, INDIANA 46032 305 SOUTH POST ROAD
INDIANAPOLIS IN 46219 -7900 CHECK NUMBER: 210173
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 225803/22593 396.03 OTHER EXPENSES
651 5023990 225803/22593 252.61 OTHER EXPENSES
601 5023990 225804 15.00 OTHER EXPENSES
M
Y
ll
e•
1`1111 ,1I'� O
r
t7lJ
0
Invoice Date Invoice No,
305 south Post Rood 06/08/2012 0225930
Indianapolis, IN 46219 -7900 Certified as o
Women Business Enterprise
(317) 895 -9708 by the S o of Ind ono and the terms
City of Indlonopors NVWBE Programs
www.worrellcorp.com Net 30 Days
Sold To Shipped To
WCO
CITY OF CARMEL WORRELL CORPORATION
WATER WASTEWATER UTILITIES
760 3RD AVE SW 305 S POST RD
CARMEL, IN 46032 INDIANAPOLIS, IN 46219
IIItlltrllttttlltttllllrrlllltllttltltl SCOTT CAMPBELL
Sales Customer Job Ship Shipped
Person J Worrell Pa. No. S Campbell l No. 082678 Date 06/04/2012 via UPS GROUND
ASI -85080 27 Polo, Men's Performance Pique 16.50 EACH 445.50
ASI -75046 1 Polo, Ladies Performance Pique 16.50 EACH 16.50
ASI -1_431 1 Polo, Ladies Cool Mesh w Tipping 25.98 EACH 25.98
ASI -L469 1 Polo, Ladies Dri -Mesh V -Neck 21.98 EACH 21.98
ASI -1_801 1 Polo, Ladies Pique 3/4 sleeve 25.98 EACH 25.98
ASI- LST306 1 T- Shirt, Ladies Long Sleeve Double Layer 15.98 EACH 15.98
ASI- LST650 1 Polo, Ladies Micropique Sport Wick 19.98 EACH 19.98
ASI -77037 1 Shirt, Ladies Woven 35.90 EACH 35.90
Freight: 25.84
Sales Tax: OU—
A FINANCE CHARGE of 2% per month (24% ANNUAL PERCENTAGE RATE) will be applied to all PAST DUE accounts. TOTAL DUE 633.64
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.
TI
0
Invoice Date F Invoice No. r
305 south Post Road 06/06/2012 0225803
Indianapolis, IN 46219 -7900 certified as a
UJomen Business Enterprise �i
(317) 895-9708 by the of he
\ES/ hNll.MAUB and t j
City of Ind -e fz E Pm the GGG- ��++���"`Vbb1
cot¢ cccl/fi Terms
tuww.worrellcorp.com Net 30 Days
Sold To Shipped To WCO
CITY OF CARMEL WORRELL CORPORATION
WATER WASTEWATER UTILITIES CARMEL MAILING
760 3RD AVE SW 305 S POST RD
CARMEL, IN 46032 INDIANAPOLIS, IN 46219
I�I��I�Ilr�llrrrr�ll���l�lll���llr�rll���ll�r��l�l�l SCOTT CAMPBELL
Sales Customer Job Ship ShIpoed
Person J Worrell P.O. No. release N� 267355 Date 05/31/2012 pia WORRELLTRUCK
COC -EDG1 10 Envelope, #10 Double Window, Printed BOX .00
COC -F01 10 Statements BOX .00
WC -EN09 10 Envelope, #9 Window Reply BOX .00
i
I
i
I
Freight: 15.00
Sale Tax: .00
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.
FoPrescrd by rm No. 301St-S (eBoRev. 1995) ccounts ACCOUNTS PAYABLE VOUCHER
Form 301 1995)
TO
ADDRESS
Invoice Date Invoice Number Item Amount
<ft
I 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
19
Signature Title
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.
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT ANOCT.
CARMEL, INDIANA
Favor Of
WDu Z W 3(p fr)
Total Amount of Voucher
Deductions
19 ps bob /5- 0
O C 5Pcr�
�.�r. S l
Amount of Warrant
Month of 19
Acct.
VOUCHER RECORD No.
Collection System
Operation
Plant
OF
Comme ial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1- 800 382 -8702 325
Q w
o o
In voice I nvoice
30S South Post Road 06/06/2012 022580
4
Indianapolis, IN 46219 -7900 Certified as a ff
Women Business Enterprise���
(317) 89S -9708 the 5tote of iAdo o the
c V of 1,donopor5 M/WBE aoy,om, Terms
www.worrellcorp.com Net 30 Days
Sold To Shipped To
0001
CITY OF CARMEL CITY OF CARMEL
WATER WASTEWATER UTILITIES SCOTT CAMPBELL
760 3RD AVE SW WATER WASTEWATER UTILITIES
CARMEL, IN 46032 760 3RD AVE SW
liliililliill�rr�rllii�lilllirrlliiillrr�ll��i�lrlrl CARMEL, IN 46032 SCOTT CAMPBELL
Sales Customer Job Ship Shipped
Person J Worrell P No. Scott Campbell N o. 267358 Data 06/01/2012 Ala WORRELL TRUCK
COC -EDG1 4 Envelope, #10 Double Window, Printed BOX .00
WC -EN09 4 Envelope, #9 Window Reply BOX .00
COC -F01 4 Statements BOX .00
Freight: 15.00
Sales Tn
vG.GJ u... .00
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.
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
To l/U,7$JL�u l
ADDRESS
Invoice Date Invoice Number Item Amount
0
C bw? �k 5
I 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
19
Signature Title
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.
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
N0.
CARMEL, INDIANA
Favor Of
Total Amount of Voucher
Deductions
a
5 w
(�3rp o, v i1
I
!dam L7, 0 7 0-2) Amount of Warrant f f
Month of 19
i
VOUCHER RECORD Acct.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts I
Admin' raLl G neral
Operatio
I
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits i
i
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1- 800 -382 -8702 325