308148 02/13/17 (9,
CITY OF CARMEL, INDIANA VENDOR: 146900
ONE CIVIC SQUARE IN DEPT OF ENVIRONMENTAL MGMT CHECK AMOUNT: $*"""`"350.00'
CARMEL, INDIANA 46032 PO BOX 3295 CHECK NUMBER: 308148
INDIANAPOLIS IN 45205-3295 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 000238235 350.00 OTHER EXPENSES
VOUCHER # 163944 WARRANT # ALLOWED
146900 IN SUM OF $
IN DEPT. OF ENVIRONMENTAL MGT.
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INDIANAPOLIS, IN
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
000238235 01-6750-08 350.00
Voucher Total 350.00 P4
Cost distribution ledger classification if
claim paid under vehicle highway fund
INVOICE
Please Remit To: Page: 1
INDIANA DEPT.OF ENVIRONMENTAL MANAGEMENT Invoice No: 000238235
PO BOX 3295 Invoice Date: 01/11/2017
INDIANAPOLIS IN 46206-3295 Customer Number: CST100026471
Bill Type: 060
Payment Terms: NET 60
Due Date: 03/12/2017
Bill To:
CARMEL WATER&WASTEWATER
MR JOHN DUFFY AMOUNT DUE: 350.00 USD
30 WEST MAIN STREET
SUITE 220
CARMEL IN 46032
Amount Remitted
❑ Note Address Changes Above F1Email Address:
Write the invoice number on your check and return the upper portion of this invoice.
For billing questions, please email us at WATER@IDEM.IN.GOV
Line Ad' Identifier Description Quantity UOM Unit Amt Net Amount
1 17-IN5229024C-0 PWS Fee - SVC:385 1.00 EA 350.00 350.00
- Accounts Receivable is accepting payments online by e-Check, Master Card or Visa. Please visit
www.IN.gov/IDEM. Under Online Services, click Online Payment Options and follow the prompts.
-You may also call us at 317-234-3099 and follow the instructions for Master Card or Visa payments.
-A processing fee of $1 plus 2s will be charged for credit card payments. A processing fee of $1.00
will be charged for eCheck payments.
- This annual fee billing is required for active Public Water Systems (to defray the costs of
administering activities of the federal Safe Drinking Water Act) under Indiana Code: IC 13-18-20.5.
To view via the internet, visit:
- http://www.IN.gov/legislative/ic/code/titlel3/arl8/ch2O.5.html
- Fees are based on the activity status as of December 31 of the previous year.
- Fees on Community Water Systems will be based on the number of service connections on record as of
December 31 of the previous year.
- Fees are not pro-rated. If a system is sold or inactivated during the billing year, the amount of
the assessed fee remains due and payable.
- If payment of the assessed fee amount imposes an undue burden on the public water system, the
facility may notify this Agency within forty-five (45) days of this invoice date to pay in four
equal installments within a year.
- Payments not received or received after the DUE date are subject to a delinquency charge equal to
_--—10%_of_the_assessed_fee_.__The_complete_fee_payment or the_lst installment is due_within 60_days_of _—_
the date of this invoice.
- If several invoices.are to be paid by one check, you MUST INCLUDE A COPY OF EACH BILLING INVOICE
in order to ensure proper credit for each fee assessment.
-- For questions regarding your assessed fee amount, please contact Carol Guidry in the Office of
Water Quality at (317) 232-8472 or e-mail cguidry@idem.in.gov.
-IDEM may pursue enforcement action for non payment of annual fees.
TOTALAMOUNT DUE: 350.00
Please write the invoice number on your check and return the upper portion of this invoice with remittance.
495-IDEM Printed on Recycled Paper original