HomeMy WebLinkAbout181948 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENT MGT
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CHECK AMOUNT: $100.00
100 N SENATE AVE
l CHECK NUMBER: 181948
r CARMEL, INDI 46032 MC 50 -10C
INDIANAPOLIS IN 46204 -2251
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340600 000114576 100.00 RECORDING FEES
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INVOICE
Please Remit To: Page: 1
INDIANA DEPT OF ENVIRONMENTAL MGMT Invoice No: 0001 14576
CASHIER OFFICE MAIL CODE 50 -10C Invoice Date: 01/08/2010
100 NORTH SENATE AVENUE Customer Number: CST100026885
INDIANAPOLIS IN 46204 Bill Type: 062
Payment Terms: NET 60
Due Date: 03/09/2010
Bill To:
CARMEL CLAY PARKS RECREATION
MS AUDREY KOSTRZEWA- FLOWING WELL AMOUNT DUE: 100.00 USD
1411 EAST 116TH STREET
CARMEL IN 46032
10
Amount Remitted
Note Address Changes Above
For billing questions, please call 317- 232 -8705
Line Adj Identifier Description Quantity UOM Unit Amt Net Amount
1 10- IN2290801T -0 PWS Fee GW 1.00 EA 100.00 103.00
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 /title13 /ar18 /ch20.5.htm1
Fees are based on the activity status as of December 31 of the previous year.
Fees on Transient Non- Community Water System will be based on the type of water system on record
by December 31 of the prior 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.
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 Deborah Glover in the Operations
Section, Office of Water Quality at 317 -232 -8472.
ATTENTION: The due date shown in the upper right hand corner of this invoice reflects the
standard 60 days past the invoice print date.
TOTAL AMOUNT DUE 100.00
A copy of your invoice must be included with payment.
Purchase Ann Perni.L-/ W
Description E: (A0 I1- r 1 -1/AWL wee(
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JAW 1 Z 2010 U Purchaser 111.
Approval
495 -IDEM Printed on Recycled Paper Original
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00351805 Indiana Department of Environmental Mgmt Terms
Cashier Office Mail Code 50 -10C
100 North Senate Ave
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/8110 114578 annual permit for public water flowing well 100.00
Total 100.00
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.
00351805 Indiana Department of Environmental Mgmt Allowed 20
Cashier Office Mail Code 50 -10C
100 North Senate Ave
Indianapolis, IN 46204 In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 114578 4340600 100.00 I hereby certify that the attached invoice(s), or
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
28 -Jan 2010
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund