226868 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 361174 Page 1 of 1
ONE CIVIC SQUARE WORRELL CORPORATION CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 05 SOUTH I8 N ROAD 7900
CHECK NUMBER: 226868
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 245408 15 . 00 OTHER EXPENSES
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bywoice Date trrvo5ce ems.
305 South Post Rood --__ 10/30/2013 0245408
Indianapolis, IN 46219-7900 certified as a
Women BsiIess a Ent[erpris
(317) 895-9708 by the Sol n e Teffm City of Indianapolis MIME Programs
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
IIIII �II���� llllllr�ll�� illl����l�l�l CARMEL, IN 46032 SCOTT CAMPBELL
Sales
Person J Worrell 1=7SCOTT CAMPBELL IjNcob 269110 IsDh,,'P- 10/23/2013 j:MWORRELL TRUCK
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COC-1`01 2E Statements BOX .00
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Freight: 15.00
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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 # 136910 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
245408 01-7360-07 $15.00
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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 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 11/21/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/21/201: 245408 $15.00
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