HomeMy WebLinkAbout180834 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1
:',1 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $33.91
s CARMEL, INDIANA 46032 PO 80X 660579
1, 6”, DALLAS TX 75266 -0579 CHECK NUMBER: 180834
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
,1301 4239099 1722004 33.91 OTHER MISCELLANOUS
1- 800 -4- WATERS (492 -8377) www.HinckleySprings.com
Upcoming Delivery Dates
H nC I g/® ti I R..
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Customer Account 17220042677859
KIM ROTT Invoice Date: 12 -12 -09
CARMEL CITY COURT Invoice 1209 1722004 2677859
1 CIVIC SQ
CARMEL, IN 46032 Purchase Order
Date Transaction Details Qty. Each Amount
Previous Balance 52.87
12 -04 -09 P179699 Payment Check 179699 Thank You -37.38
Remaining Balance 15.49
R093212494748 WHITE HOT AND COLD COOLER RENTAL 1.0 13.00 13.00
12 -10 -09 T093443042007 HINCKLEY SPRINGS 5G DRINK NON -SPILL 2.0 9.49 18.98
5.0 GAL BOTTLE RETURN -2.0 6.00 -12.00
5.0 GAL BOTTLE DEPOSIT 2.0 6.00 12.00
Recd By: Not Available or Refused
12 -10 -09 47650107 ENERGY SURCHARGE 1.0 1.93 1.93
Total New Charges 33.91
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30356 -P -0035
Previous Balance
C $52.87 Payment New Charg Pay This Amount
$37.38 Total
$33.91 $49.40
V Write the complete account number on your check. Detach remittance and mail with payment in the enclosed envelope. To pay online go to www.HinckleySprings.com V
L ,....- J
HINCKLEY SPRINGS WATER
800- 444 -PURE
WATER,COM
ORIGINAL <i
CUSTOMER 1722004 TICKET 093443042007
LOCATION 2677868 PO
CARMEL CITY COURT Date: 12/10/2009 Time: 08:36:14 AN
1 CIVIC SO ROUTE #3042 DAVID
CARMEL, IN 46032
as Payirent Date: 12/04/2009 Last Payment Amount: 37.38
Product Delivered UTY PRICE AMOUNT($)
HS 5G DR NS 2 9.49 18.98
BOT 5.0G PLS 2 6.00 12.00
BOT 5.00 PLS -2 6.00 -12.00
(2 Bottles Delivered 2 Eopty Relulned 0 D Deposited)
Subtotal Sales 18.98
Sales Tax 0,00
DELIVERY TICKET TU1AL 18.98
Previous Account Balance 28.49
Total Balance Due 47.47
Payments 0,00
ENDING BALANCE F 47.47
We bill monthly by summary Invoice
Retain for your records.
Next Delivery Date 12/24/2009
We bill monthly by summary Invoice.
Retain for your records.
Prescribed by Slate Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An irivoice 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
1 Purchase Order No.
o. jp b& 57 9 Terms
f .(.1,.v J 7 5 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
.0/0 409 laloolid67715 s l C n lJ� f 4f
1
/,L) 1- i ,12_,I u_
yi v1'4 o/704 0
Total 33. �1
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
41/t-t'Ay ALLOWED 20
4 IN SUM OF
O (,,,i,o677 9
.to, p 75;244 �a579
33,s
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. hereby certify
DEPT. I ACCT #/TITLE AMOUNT
hereb certi that the attached invoices or
30/ 17,2,2_0 0 Ic0 5 S 43 3.91 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
AlIA tdi 1
i$ 2.4�
a
it
t iO r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund