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Home My WebLink About181577 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 t1�� ONE CIVIC SQUARE HINCKLEY SPRINGS /a CARMEL, INDIANA 46032 PO BOX 660579 CHECK AMOUNT: $51.90 x DALLAS TX 75266 -0579 CHECK NUMBER: 181577 CHECK DATE: 1/20/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 2677859 51.90 OTHER MISCELLANOUS HINCKLEY SPRINGS WATER 800- 444 -PURE i WATER.COM ORIGINAL CUSTOMER 1722004 TICKET 100073042017 LOCATION 2677868 PO CARMEL CITY COURT Date: 01/07/2010 Time: 10:50:38 AM 1 CIVIC SO ROUTE #3042 DAVID CARMEL, IN 46032 Last Payment Date: 12/04/2009 Last Payment tvrount: 37.38 Product Delivered QTY PRICE AMOUNT($) HS 5G DR NS 2 9.49 18.98 BOT 5.06 PLS 2 6.00 12.00 BOT 5.06 PLS -2 6.00 -12.00 5CuFIat9zHSP 4 4.49 17.96 (2 Dollies Delivered 2 Grpty Dollles Retained 0 Dollies Deposited) Subtotal Sales 36.94 Sales Tax 0.00 DELIVERY TICKET TOTAL 36.94 Previous Account Balance 62.40 Total Balance Due 99.34 Payments 0.00 ENDING BALANCE 99.34 We bill monthly by summary Invoice Retain for your records. Next Delivery Date 01/21/2010 We bill monthly by summary Invoice. Retain for your records. 1- 800 -4- WATERS (492 -8377) www.HinckleySprings.com Upcoming Delivery Dates II i January February March Springs: Bottled W Filtration •Coffee Thursday, 21 Thursday, 4 Thursday, 4 Thursday, 18 Thursday, 18 For a complete list of all future delivery dates, you can view your delivery schedule online by logging into your account at water.com today! NOW, THAT'S CONVENIENT! Customer Account 17220042677859 KIM ROTT Invoice Date: 01 -09 -10 CARMEL CITY COURT Invoice 0110 1722004 2677859 1 CIVIC SQ CARMEL, IN 46032 Purchase Order Date Transaction Details Qty. Each Amount Previous Balance 49.40 Payment 0.00 Remaining Balance 49 -40 R093492494748 WHITE HOT AND COLD COOLER RENTAL 1.0 13.00 13.00 01 -07 -10 48440106 ENERGY SURCHARGE 1.0 1.96 1.96 01 -07 -10 T100073042017 HINCKLEY SPRINGS 5G DRINK NON -SPILL 2.0 9.49 18.98 CUP COLD FLAT 9 OZ HINCKLEY SPRINGS 100 CT 4.0 4 -49 17.96 5.0 GAL BOTTLE RETURN -2.0 6.00 -12.00 5.0 GAL BOTTLE DEPOSIT 2.0 6.00 12.00 Rec'd By: Not Available or Refused Total New Charges 51.90 Managing your account is now at your fingertips. Take advantage of many time- saving options available on water.com. Save paper when you sign up for elnvoice, order additional products, check your next delivery, pay your bill and much more. Log on today! 30356 -P -0035 C Previous Balance Payment 1 �t, Total New Charges Pay This Amount $49.40 C $0.00 $51.90 $101.30 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.Hinck!eySpr_ings.com V How to Read Your Statement OOa.wA,EAS °,r, °m Important Monthly Promotions: Upcoming Delivery °ztes We Deliver! Register online for access to your Delivery Calendar: M 200' A42009 Ao9°`ry� M ^1ef """"0° 0 account. You can view and pay your bill, Your scheduled deliveries for 50 check delivery schedule and order the next three months. products all online. Customer Account Number: W''" HF, ,.rx• "...a IFi Bottle Deposits: For prompt service, please use this w y�01 e w n/ Highlights bottle deposits and returns. number when referring to your account. ^s H of 0 ,i oW 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. t�".K .un..- z, .m. -w r ,o^�, „a 0 2' 0 d Total New Charges: information provides totals for Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail L. ;;;.......z.=,...-- u using business envelope provided. Moil Remme.nce 991191 7,1 99„0 soim 12,2904 srpc20 Important Monthly Message ^E° ^„wee,,, OSw a a 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: o Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579. o The dollar amount of the suspected error. O 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 on your check gives us permission to debit your checking account electronically You do not have to pay any amount in question while we are investigating, but for the uncollected amount. Payment by check constitutes your acceptance of you are still obligated to pay the amount of your bit that is not in question. While 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 Waters 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. u 0 71-/ 79 Terms -p17 9 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 436 .9 Jt d til eQ.p, t,_ /3. va f 444. 0.11 0,4 96 Total 'i 5 90 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. L ALLOWED 20 i "`J J�° IN SUM OF L-1°- 4-6 5I -90 ON ACCOUNT OF APPROPRIATION FOR 0-[1-4‘49 Board Members Po# or I NVOICE NO. ACCT #/TITLE AMOUNT hereby certify oEP I hereb certif that the attached invoice(s), or 3-01 aG7'7 8 5 3 90 g 9 4 c$1, 9) 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 c_ 40' I, IO.�► inimpor. Cost distribution ledger classification if Title claim paid motor vehicle highway fund