190505 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 314125 Page 1 of 1
0 ONE CIVIC SQUARE UPS CHECK AMOUNT: $22.74
CARMEL, INDIANA 46032 LOCKBOX 577
CAROL STREAM IL 60132 -0577 CHECK NUMBER: 190505
CHECK DATE: 9/2912010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
601 5023990 76V77A370 22.74 CONT SERVICES OTHER
Delivery Service In voice
AAW Invoice date September 11, 2010
Shipped from: Invoice number 000076V77A370
CARMEL UTILITIES DISTRIBUTION Shipper number 76V77A
3450 W 1031ST ST Control ID 877X
C TM WESTFIELD. IN 46074
Page 1 of 3
#!3WNGWNG# Sign up far electronic billing today!
#0249A000076V77A9# 77401200035483 Visit ups.com /billing
AT 01 035053 63720H114 A *3DGT For questions about your invoice, call:
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Monday F day
CARMEL UTILITIES 8:00 am.- 9:00 p.m.E.T.
3450 W 131ST ST or write:
WESTFIELD, IN 46074 -8267 UPS
P.Q. Box 650580
Dallas, TX 75265 -0580
Account Status Summary Thank you for using UPS.
Weekly Payment Plan
Amount Due This Period 22.74 Summary of Charges
Amount Outstanding (prior invoices) 35.69 age Charge
Total Amount Outstanding 58.43 Outbound
Please include the Return Portion of each outstanding invoice with 3 UPS Internet Shipping 22.74
your payment. See Account Status far details. Amount due this period 22.74
Don't lug your luggage
Planning a trip? If you want to avoid airline baggage fees and UPS payment terms require payment of this invoice by September
long waits at the luggage carousel, The UPS Storeocan help. 22, 2010.
Ship your belongings directly to your destination in a specially Note: This invoice may contain a fuel surcharge as described at
designed, corrugated luggage box that acts like a suitcase, but ups.com. The published fuel surcharge is 5.5% for UPS Ground
is both lighter and trackable. If you'd rather fly with your Services and 7.0 for UPS Air Services, UPS 3 flay Select and
belongings, the boxes have a sturdy handle for carrying and International services. For more information, visit ups.com.
meet airline size restrictions. Visit theupsstore.com for more
details and to find a location near you.
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Delivery Service Invoice
Invoice date September 11, 2010
OTM Invoice number 000076V77A370
Shipper number 76V77A
Page 2 of 3
Account Status
Weekly Payment Plan
Payments Applied
Amount
Invoice Number Invoice Date Paid
000076V77A300 07/24/2010 15.44
000076V77A310 07/31/2010 17.50
000076V77A330 08/14/2010 15.37
Account Status
Weekly Payment Plan
Amount Outstanding (prior invoices):
Please include the Return Portion of each outstanding invoice
with your payment.
Balance
Invoice Number invoice Date Due
000076V77A350 08/28/2010 35.69
Total 35.69
Outstanding balances reflect any payments received as of
09/1012010. Please ignore this message if a recent payment has
been made for any outstanding invoices.
Delivery Service Invoice
Invoice date September 11, 2010
Invoice number 000076V77A370
Shipper number 76V77A
OT.
Page 3 of 3
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
08/31 1Z76V77A0392390718 Ground Commercial 46202 2 2 7.25
Fuel Surcharge 0.40
Total 7.65
1st ref Weekly Fluoride UserID CarmelWater
Sender Michelle Breedlove Receiver: Environmental Sample
Carmel Utilities Distributin Indiana State Dept of Health
3450 w 131 st 550 West 16th Street
Carmel IN 46074 INDIANAPOLIS IN 46202
09109 iZ76V77A0390023538 Ground Commercial 46202 2 2 7.25
Fuel Surcharge 0.40
Total 7.65
1st ref Fluoride UserlD CarmelWater
Sender Jaimie Foreman Receiver: Environmental Sample
Carmel Drinking Water Plant Indiana State Dept of Health
5484 E. 126th St 550 West 16th Street
CARMEL IN 46033 INDIANAPOLIS IN 46202
1 Z76V77A0393083727 Ground Commercial 46204 2 1 7.05
Fuel Surcharge 0.39
Total 7.44
let ref MRO UserlD CarmelWater
Sender Jaimie Foreman Receiver:
Carmel Drinking Water Plant IDEM/ Drinking Water B ranch
5484 E. 126th St 100 N SENATE AVE
CARMEL IN 46033 INDIANAPOLIS IN 46204
Total for Internet -ID: CarmelWater 22.74
Total UPS Internet Shipping 3 Package(s) 22.74
Total Outbound 3 Package(s) 22.74
VOUCHER 102817 WARRANT ALLOWED
314125 IN SUM OF
UPS
LOCKBOX 577
CAROL STREAM, IL 60132 0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
76V77A370 01- 6360 -03 $22.74
Voucher Total $22.74
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
314125
UPS Purchase Order No.
LOCKSOX 577 Terms
CAROL STREAM, IL 60132 Due Date 9/20/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/20/2010 76V77A370 $22.74
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
Date Offi