219953 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
` ONE CIVIC SQUARE WORRELL CORPORATION
' CARMEL, INDIANA 46032 CHECK AMOUNT: $833.09
305 SOUTH POST ROAD
INDIANAPOLIS IN 46219-7900 CHECK NUMBER: 219953
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 237399 833 . 09 OTHER EXPENSES
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Invoice Date Invoice No
305 South Post Rood 04/23/2013 0237399
Indianapolis, IN 46419-7900 7of o
Womenterprise
(317) 895-9708 by the nd the C,ty of Programs nns
www.wo rrellcorp.com Net 30 Days
Sold To Shipped To WCO
CITY OF CARMEL WORRELL CORPORATION
WATER-WASTEWATER UTILITIES MARK HEISER - Carmel Insert
760 3RD AVE SW 305 S POST RD
CARMEL, IN 46032 INDIANAPOLIS, IN 46219
SUE MAKI
Pe1eo J Worrell P0Noef SUE MAKI No 086949 a8 04/17/2013 v�Bp UPS GROUND
Person
COC-IN004 27,500 Insert - Summertime Watering 26.82 M 737.55
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Freight: 95.54
Sales Tax: _. _ ____ on
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A FINANCE CHARGE of 2%per month(24o ANNUAL PERCENTAGE RATE)will be applied to all PAST DUE accounts. TOTAL DUE 833.09
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. , � � "`-
VOUCHER # 131524 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
Ly5p
237399 01761D2M-08 $833.09
Voucher Total $833.09
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 5/1/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/1/2013 237399 $833.09
i
i
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer