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Home My WebLink About253087 01/11/16 a°�-��AM y.,® CITY OF CARMEL, INDIANA VENDOR: 131130 y \; ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $*******648.07* CARMEL, INDIANA 46032 PO BOX 660579 CHECK NUMBER: 253087 9��7pN�O` DALLAS TX 75265-0579 CHECK DATE: 01/11/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 12553186121 648.07 OTHER EXPENSES 1-800-4-WATERS(1-800-492-8377) www.Hinckle S rin s.com Upcoming Delivery Dates Hinckiey V V - - Springs We Deliver! December January February Bottled Water- Filtration - coffee Thursday,24 Thursday,7 Thursday,4 NOW OPEN! New Customer Care Center in Lakeland, FL Thursday,21 Thursday, 18 This new state of the art facility equips us with tools to enhance your service experience to better meet your needs! Hours open: 8am-9pm EST Mon-Fri and 9am-6pm EST Sat We appreciate your patience and your business. Customer Account#: 172094612553186 TARA WASHINGTON Invoice Date: 12-12-15 CITY OF CARMEL UTILITIES Invoice#: 12553186 121215 9609 HAZEL DELL PKWY INDIANAPOLIS IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 1,400.17 11-25-15 P251111 Payment-Check-251111 -Thank You -799.93 Remaining Balance 600.24 11-24-15 T153283043046 HINCKLEY SPRINGS 5G DRINKING WATER 11.0 9.99 109.89 HINCKLEY SPRINGS 5G DISTILLED WATER 10.0-- 9.99 99.90 CUP PLASTIC FLAT 9 OZ MULTI BRAND 50 CT 20.0 3.89 77.80 5.0 GALLON BOTTLE DEPOSIT 11.0 6.00 66.00 5.0 GALLON BOTTLE DEPOSIT 10.0 6.00 60.00 5.0 GALLON BOTTLE RETURN -20.0 6.00 -120.00 ENERGY SURCHARGE 1.0 2.17 2.17 Total 295.76 Rec'd By:Not Available or Refused R1533010140866 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 Total 74.71 12-10-15 T153443043048 HINCKLEY SPRINGS 5G DRINKING WATER 7.0 9.99 69.93 HINCKLEY SPRINGS 5G DISTILLED WATER 13.0 9.99 129.87 CUP PLASTIC FLAT 9 OZ MULTI BRAND 50 CT 20.0 3.89 77.80 5.0 GALLON BOTTLE DEPOSIT 7.0 6.00 42.00 5.0 GALLON BOTTLE RETURN -20.0 6.00 -120.00 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.com/myaccount. �j 30356-P-0038 Previous Balance ' Payment + CrTotal New.Charges ® Pay-This Amount $1,400.17 $799.93 $648.07 $1,248.31 ®Write the complete account number on your check Detach remittance and mail with payment in the enclosed envelope.To pay online go to _www.HincklevSprings.com How to Read Your Statement 14004-WATERS D,ri°E--- Important Monthly Promotions: Upcoming Delivery Dam '{ wa oElmEd �A�, Register online for access to your °"'°°' M°";;°"' °� "p`°"w account.You can view and pay your bill, Delivery Calendar: � tbro.y �°� sP�.w�.ayE� .r°r a u �a p to �°�-..,y�.�P«m".�< check delivery schedule and order Your scheduled deliveries for ,1 ;"� �„ �n.p"� products all online. the next three months. Customer Account Number: Bottle Deposits For prompt service,please use this Highlights bottle deposits and returns. number when referring to your account. U "e" °11 1Z m Easy to Pay: s"WoE 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—�'� .-.as�ti�• — ryO .....a..,........�....- .m.m ..-m.o.,..."r,.. _ Total New Charges: ---- s This information provides totals for `mm" Mail Remittance With Payment To: various products and transactions. "sem° mm P Please detach remittance and mail ❑ „� ❑ ,a 8 s using business envelope provided. IIrrLILIIrIIrIIrIIrdrlIrr,IlIrrlrIIrIArll I leml p.min.nce wnM1 Payment m:, r�uw�i SiOEET Important Monthly Message uaM,ranE.u°,ea.x,en ILrIdL..IrLII�II"IIunIIInIIILllrlrrlrll - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 pay the amount of your bill that is not in question.While for the uncollected amount. Payment by check constitutes your acceptance of we investigate your questions,we cannot report you as delinquent or take any these terms. 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 12/18/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/18/201: 12553186 12 $648.07 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and I have audited same in accordance 'with pIC 5-11-10-1.6 Date Officer VOUCHER # 156895 WARRANT # ALLOWED '. IN SUM OF $ 131.130 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 i 12553186 121 01-7202-05 $648.07 .i ,I i i! i Voucher Total $648.07 Cost distribution ledger classification if claim paid under vehicle highway fund