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301697 08/08/16
%.c�qM'` CITY OF CARMEL, INDIANA VENDOR: 131130 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $*******895.46* x. � CARMEL, INDIANA 46032 PO BOX 660579 CHECK NUMBER: 301697 9a'�ros�°` DALLAi TX 75266-0579 CHECK DATE: 08/08/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 125531860723 895.46 OTHER EXPENSES VOUCHER # 165837 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 12553186072 01-7202-05 895.46 Voucher Total 895.46 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 131130 HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms DALLAS, TX 75266-0579 Due Date 8/1/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/1/2016 1255318607 895.46 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 1-800-4-WATERS 1-800-492-8377 www.HinckleySprings.com Upcoming Delivery Dates Hinckley. ��xp Springs We Deliver! August September October I Bottled water• Filtration • Coffee Thursday,4 Thursday, 1 Thursday, 13 As summer heats up,cool down with your favorite bottled Thursday, 18 Thursday, 15 Thursday,27 water. Choose from still,sparkling,flavored and brands Thursday,29 I like VOSS and FIJI. Current offers mean big savings. To learn more, speak to your RSR or call 1-800-4-WATERS. Customer Account#: 172094612553186 TARA WASHINGTON Invoice Date: 07-23-16 CITY OF CARMEL UTILITIES Invoice#: 12553186 072316 9609 HAZEL DELL PKWY INDIANAPOLIS , IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 1,474.08 06-29-16 P259570 Payment-Check-259570-Thank You -716.13 Remaining Balance 757.95 R1618910140866 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 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 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 Total 74.71 07-08-16 T161903043049 HINCKLEY SPRINGS 5G DRINKING WATER 26.0 9.99 259.74 HINCKLEY SPRINGS 5G DISTILLED.WATER 14.0 9.99 139.86 CUP PLASTIC FLAT 9 OZ MULTI BRAND 50 CT 27.0 3.89 105.03 5.0 GALLON BOTTLE DEPOSIT 14.0 6.00 •84.00 5.0 GALLON BOTTLE RETURN -40.0 6.00 -240.00 5.0 GALLON BOTTLE DEPOSIT 26.0 6.00 156.00 ENERGY SURCHARGE 1.0 2.04 2.04 Total 506.67 Rec'd By:Not Available or RefuI sed 07-21-16 20962113 PAPER INVOICE FEE 1.0 2.00 2.00 Total 2.00 07-21-16 T162033043063 HINCKLEY SPRINGS 5G DRINKING WATER 10.0 9.99 99.90 HINCKLEY SPRINGS 5G DISTILLED WATER 13.0 9.99 129.87 Ready to streamline your life? View yourldelivery schedule and account history,manage your payment options,pay your bill and much more with your own online account at water.com/myaccount. j 30355-P-M Previous Balance Payment Total New Charges ® Pay This Amount $1,474.08 $716.13 $895.46 $1,653.41 V Write the complete account number on vour check.Detach remittance and mail with oavment in the enclosed envelope.To oav online ao to www.HincklevSt)dnas.com 0 How to Read Your Statement Important Monthly Promotions: —J'g `'"`ry°°°`° : weoelvEd Register online for access to your ; ' account.You can view and pay your bill, Delivery Calendar. w,mre "�° "�� u�m�es�s.R.°..nr•aR....aw� Your scheduled deliveries for """" °"°"°"'° """"" �� ° �� m .m check delivery schedule and order the next three months. I products all online. Customer Account Number: Bottle Deposits: For prompt service,please use this number when referring to your account. Highlights bottle deposits and returns. "� °" °'° Ern "D " °m ° D • 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. ° �� {yr DISCOVER �y _ ------ ____________ ______ ___-___-__ Ikd Total New Charges: -�a This information provides totals for p 4 Mail Remittance With Payment To: various products and transactions. = wn;� Please detach remittance and mail ❑_;„ �: ❑�=B© _ using business envelope provided. II„.I,IInIiIII.IIIII,IJIIIIIII„I„II rwnR•mlmnc•vnu c°ym•o,t°:f Important-Monthly Message- — ^^ �, ^^ �L1AI.1„IIoF 161111 ,ILII III GIrI I Ar — —— - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 • Your name and complete account number. program,please write to us on a separate sheet at: 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