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Home My WebLink About250261 10/07/15 (9, CITY OF CARMEL, INDIANA VENDOR: 131130 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $ "*""'*406.11"CARMEL, INDIANA 46032 PO BOX 660579 CHECK NUMBER: 250261 DALLAS TX 75266-0579 CHECK DATE: 10/07/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 12553186091 406.11 OTHER EXPENSES 1-800-4-WATERS 1-800-492-8377 www.HinckleySprings.com Upcoming Delivery Dates Hinckley. 6TAMA% Springs We Deliver! October November December Bottled Water• Filtration • Coffee Thursday, 1 Thursday, 12 Thursday, 10 Thursday, 15 Thursday, 24 Sparkletts Sparkling and Sparkletts ice help keep you Thursday,29 refreshed this fall! Choose from six flavor options like Raspberry and Orange Mango. Just$12 for 12 this September! Ask your Route Sales Representative for more details. Customer Account#: 172094612553186 TARA WASHINGTON Invoice Date: 09-19-15 CITY OF CARMEL UTILITIES Invoice#: 12553186 091915 9609 HAZEL DELL PKWY INDIANAPOLIS , IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 1,831.67 08-24-15 P248370 Payment-Check-248370-Thank You -653.89 Remaining Balance 1,177.78 09-03-15 T152463043066 HINCKLEY SPRINGS 5G DRINKING WATER 13.0 9.99 129.87 HINCKLEY SPRINGS 5G DISTILLED WATER 2.0 9.99 19.98 HINCKLEY SPRINGS.51-T PURIFIED WATER 24 PK 4.0 5.99 23.96 5.0 GALLON BOTTLE RETURN -23.0 6.00 -138.00 5.0 GALLON BOTTLE DEPOSIT 13.0 6.00 78.00 5.0 GALLON BOTTLE DEPOSIT 2.0 6.00 12.00 ENERGY SURCHARGE 1.0 2.34 2.34 Total 128.15 Rec'd By: Not Available or Refused R1524610140866 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.99 9.99 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.25 11.25 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 Tota 1 74.71 09-17-15 T152603043055 HINCKLEY SPRINGS 5G DRINKING WATER 11.0 9.99 109.89 CUP PLASTIC FLAT 9 OZ MULTI BRAND 50 CT 24.0 3.89 93.36 5.0 GALLON BOTTLE DEPOSIT 11.0 6.00 66.00 5.0 GALLON BOTTLE RETURN -11.0 6.00 -66.00 Total 203.25 Ready to streamline your life? View your delivery schedule and account history,manage your payment options,pay your bill and much more with your own online account at water.comimyaccount. 30356-P-0038 CPrevious Balance Payment Total New Charges o Pay This Amount $1,831.67 0 $653.89 $406.11 0 $1,583.89 �Write.the complete.account,number_on.your check..Detach remittance and mail with.payment in the enclosed envelope To_pay-online go to A Kngkleyspnngs.comv How to Read Your Statement w",EA° —1—.— Important Monthly Promotions: U,—,.,D0—,Dates i� ' W.D.I-rl $�^�°r Register online for access to your Delivery Calendar: J— W. "~a9�`°°' m ., �.� �� account.You can view and pay your bill, a .v ° 'a: Your scheduled deliveries for "" "° M 17 �� "° "x^� check delivery schedule and order the next three months. «ten�Ar" "`� products all online. Customer Account Number: °' "°" Bottle Deposits: For prompt service,please use this Highlights bottle deposits and returns. number when referring to your account. "° °° E""° ,�,,�,°„ ^".�",� ° Easy to Pay: Pay your invoice through the mail,online at Summary: www.water.com or call us to expedite your Previous balance and posted remittance with automatic credit card payments payments since last bill. mMa G r2/,�s.: w,v,.�v 9¢mNO Total New Charges: This information provides totals for Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail ❑ -P" ❑ „a �_ f using business envelope provided. IIILI,LLIIILIL...LILIILdIILIdl ,-1 a.mm....-h 1-— Important Monthly Message ""`x'XEPE OSE;T"'°i°B IIIIIdlllllll .LLIIIJLILIL,,II - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Billing Rights Summary Electronic Funds Transfer Notice - In case of Errors or Questions About Your Bill: If you pay by check,it will be converted into an"Electronic Funds Transfer" If you think your bill is incorrect,or if you need more information about a (EFT),a process in which your financial institution is electronically instructed to transaction on your bill,write us as soon as possible on a separate sheet,at transfer funds from your account to ours in lieu of processing the check.By P.O.Box 660579,Dallas,TX 75266-0579.We must hear from you no later sending your completed check to us,you authorize us to use the account than 60 days after we sent you the first bill on which the error or problem information therein to create an EFT for the amount indicated on the check.If appeared.Your bill shall be deemed correct unless disputed within 60 days the EFT cannot be processed for technical or other reasons,you authorize us from receipt.You can telephone us,but doing so will not preserve your rights. to process an image replacement document,draft,or copy of your check. In your letter,give us the following information: OPT OUT NOTICE:If you do not wish to participate in this check conversion program,please write to us on a separate sheet at: ® Your name and complete account number. P.O.Box 660579, Dallas,TX 75266-0579. • The dollar amount of the suspected error. • Describe the error and explain why you believe there is an error. If you need Insufficient Funds Notice more information,describe the item you are unsure about. If your check is returned for insufficient or uncollected funds(NSF),your signature You do not have to pay any amount in question while we are investigating,but on your check gives us permission to debit your checking account electronically you are still obligated to a the amount of our bill that is not in question.While for the uncollected amount.Payment by check constitutes your acceptance of y g pay y q these terms. we investigate your questions,we cannot report you as delinquent or take any , action to collect the amount you question. We appreciate your business. As a food product,bottled water is subject to rules and regulations promulgated by the Federal Food and Drug Administration(FDA). ` For further information,please write DS Services of America,Inc.at P.O.Box 660579,Dallas,TX 75266-0579 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 131130 HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms DALLAS, TX 75266-0579 Due Date 9/29/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/29/2015 1255318609' $406.11 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 VOUCHER # 156378 WARRANT# ALLOWED 131130 IN SUM OF $ HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266-0579 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 12553186091 01-7202-05 $406.11 Voucher Total $406.11 Cost distribution ledger classification if claim paid under vehicle highway fund