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Home My WebLink About250709 10/21/15 �,_Coq"" ''� CITY OF CARMEL, INDIANA VENDOR: 131130 ;, ® I ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $*****...51.34* �. � CARMEL, INDIANA 46032 PO BOX 660579 CHECK NUMBER: 250709 'e;,ir�N.�` DALLAS TX 75266-0579 CHECK DATE: 10/21/15 r DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 506 4239099 267785910101 51.34 OTHER MISCELLANOUS 1-800-4-WATERS (1-800-492-8377) www.HinckioySprings.com Upcoming Delivery Dates Hinckiey- 6WIDA% Springs We Deliver! October November December Bottled Water- Filtration - Coffee Thursday, 15 Thursday, 12 Thursday, 10 Thursday, 29 Thursday, 24 Did you know we offer an integrated bottled water cooler and single-cup brewer system?Our AquaCafe provides both coffee and water technologies in one sleek, space saving, piece of equipment. Available with either a Pod or K-Cup brewer. Ask your sales representative for more details. Customer Account#: 17220042677859 PAM BAKER Invoice Date: 10-10-15 CARMEL CITY COURT 1 CIVIC SO Invoice#: 2677859 101015 CARMEL, IN 46032 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 43.63 Payment 0.00 Remaining Balance 43.63 R1525810140050 EVEREST BLACK HOT AND COLD COOLER WITH CUP 1.0 11.25 11.25 Total 11.25 09-17-15 T152603042055 HINCKLEY SPRINGS 5G DRINKING WATER 1.0 9.99 9.99 5.0 GALLON BOTTLE RETURN -1.0 6.00 -6.00 5.0 GALLON BOTTLE DEPOSIT 1.0 6.00 6.00 ENERGY SURCHARGE 1.0 2.34 2.34 Total 12.33 Recd By: Not Available or Refused 10-01-15 T152743042039 HINCKLEY SPRINGS 5G DRINKING WATER 2.0 9.99 19.98 CUP PLASTIC FLAT 9 OZ MULTI BRAND 50 CT 2.0 3.89 7.78 5.0 GALLON BOTTLE DEPOSIT 2.0 6.00 12.00 5.0 GALLON BOTTLE RETURN -2.0 6.00 -12.00 Total 27.76 Rec'd By:Not Available or Refused Total New Charges 51.34 Ready to streamline your life. View your(- ourelive schedule and accou his ry,manage your payment options,pay your bill and much more wi your own online acc nt at w ter.comlmyaccount. ) i 30356-P-0038 Previous Balance CPayment Total New Charges = Pay This Amount $43.63 c' $0.00 $51.34 $94.97 D Write the complete account number on your check.Detach remittance and mail with l rd.in the enclosed envelope.To pay ine go to www HinckleySpnngs.com D How to Read Your Statement 1-4WATERS Important Monthly Promotions: °--9°6—yD.— We Deliver! Register online for access to your Delivery Calendar: '""`2°°' My 2W9 ""9""-16 �' ° �, �.W account.You can view and pay your bill, Your scheduled deliveries for check delivery schedule and order the next three months. 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. nOIRM ° m �� .°�,.,°„ ° ° 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. ,: o o ye:::::° �` �.,• v o„�o Fa am Total New Charges: « This information provides totals for ",o.. "" opo „gym Mail Remittance With Payment To: various products and transactions. ZPlease detach remittance and mail ❑ ❑ q-„dq s using business envelope provided. Important Monthly Message - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 � #�' f7r �pyy• # -a-,` �. �-y '_#•t i l "�.� �..� 1� k,,fir, ,k-. , r Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995) � CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee / ,J r4l p 1 e�� / �1 ��/� Cs Purchase Order No. 1y 15 ot Terms A-( _(._A S Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) AtC 513 Total J I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accor- dance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. / R ALLOWED 20 IN SUM OF $ �� Co os-7 1 T)A LL/A- s -�—y 75 , $ ON ACCOUNT OF APPROPRIATION FOR Board Members P§67mrO INVOICE NO. ACCT#/TITLE AMOUNT DI hereby certify that the attached invoice(s), C� or bill(s) is (are) true and correct and that q6, -3 the materials or services itemized thereon for which charge is made were ordered and received except 20 Si Title Cost distribution ledger classification if claim paid motor vehicle highway fund