216929 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
ONE CIVIC SQUARE WORRELL CORPORATION
' CARMEL INDIANA 46032 305 SOUTH POST ROAD CHECK AMOUNT: $9,362.76
,
INDIANAPOLIS IN 46219-7900 CHECK NUMBER: 216929
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 233861 5, 851 . 72 OTHER EXPENSES
651 5023990 233861 3 , 511 . 04 MATERIALS & SUPPLIES
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Invoice Date invoice No
-__ 305 South Post Rood x `r ,° 01/14/2013 023386.1
Indianapolis, IN 46219-7900 Certified as a , ."t
Ulomen Business Enterprise ��:' .-f � ;;,_;. _s_,
(317) 895-9708 Gty of Indianopohs NyWBE Ragmms >� %����� -
erms
tututu.uiorrellcorp.com Net 30 Days
Sold To Shipped To
M
CITY OF CARMEL WORRELL CORPORATION
WATER-WASTEWATER UTILITIES City of Carmel
760 3RD AVE SW 305 SOUTH POST ROAD
CARMEL, IN 46032 INDIAN4POLIS, IN 46219
IrII�I�II��II�rr��Ilr�iI�Illrrrll�i�Ilrr�Il�rrllrl�l �,
SCOTT CAMPBELL
,Sales-
- -- Cusiosr+e S ��ed
Person _J Worre�ill�° P6�i�-SCOTT`CAM�PBELL k�=`�i�_085371 n � 12/28/201-2'' Ya DAYTONFREIGrHT
WC-EN09 346,000 Envelope, 49 Window Reply 27.06 M I 9;362:76
At our warehouse in INDIANAPOLIS, IN`.
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11 ji ' f
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Freight: i
Sales Tax: I ' .pp=
A FINANCE CHARGE of 2%per month(24%ANNUAL PERCENTAGE RATE)will be applied to all PAST DUE accounts, TOTAL DUE 9,362.76
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.
:A� Please detach this receipt along perforation and enclose.with.remittance: w s ._ Y
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'« 'p"'ci?ntinVg';?n'morkeEi'n offke�proedu�fs+_;•
Invoice^Number 0233861 _
126952 ', P
`- CITY OF CARMEL T ` _jnvoice`DAtb1'£ 01/14/2013
WATER-WASTEWATER UTILITIES Amount Dtie f 9,362.76 r
760 3RD AVE SW
CARMEL, IN 46032
4 p
VOUCHER # 123414 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
233861 01-6200-07 $5,851.72
i
f
t �
Voucher Total $5,851.72
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 CORPORATION Purchase Order No.
305 SOUTH POST ROAD Terms
INDIANAPOLIS, IN 46219-7900 Due Date 12/28/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/28/201: 233861 $5,851.72
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
Invoice Date Invoice No.
305 south Post Road 01/14/2013 10233161
Indianapolis, IN 46219-7900 Certified as o
Women Business Enterprise
(317)895-9708 by me sere of 1 d e. me
G[y&1,dw. hs MU Progroms Terms
www.worrellcorp.com Net 30 Days
r
Sold To Shipped To
M
CITY OF CARMEL WORRELL CORPORATION
WATER-WASTEWATER UTILITIES City of Carmel
760 3RD AVE SW 305 SOUTH POST ROAD
CARMEL, IN 46032 INDIANNAPOLIS, IN 46219
SCOTT CAMPBELL
_I Sates Customer b Shy Shipped
Person J Worrell — �Po-No-SCOTT CAMPBELL IJNO-. 085371 �Dat ` 12/28/2012 �V DAYTON FREIGHT
_:.Descrip .
WC-EN09 346,000 Envelope, #9 Window Reply 7.06 M 9,362.76
At our warehouse in INDIANAPOLIS, IN
i
i
}
i
Freight: .00
— - -- - Sales Tax: - - --- - — --i - -UO --
A FINANCE CHARGE of 2%per month(24%ANNUAL PERCENTAGE RATE)will be applied to all PAST DUE accounts. TOTAL DUE 9,362.76
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 # 126573 WARRANT # ALLOWED
361174 IN SUM OF $
WORRELL CORP
305 SOUTH POST ROAD
INDIANAPOLIS, IN 46219
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR 4
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
233861 01-7200-07 $3,511.04
I
,I
d i
t
I
Voucher Total $3,511.04
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 12/28/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/28/201; 233861 $3,511.04
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