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Home My WebLink About190789 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CARMEL, INDIANA 46032 PO BOX 660579 CHECK AMOUNT: $516.58 DALLAS TX 75266 -0579 CHECK NUMBER: 190789 CHECK DATE: 10/13/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D ESCRIPTION 651 5023990 30839450925 516.58 MATERIALS SUPPLIES 1- 800-4- WATERS (492 -8377) www.HinckleySprings.com Upcoming Delivery Dates Hinckley® We October November December 5prings: Bottled Water •Filtration •Coffee Thursday, 7 Thursday, 4 Thursday, 2 Help us make a difference in the fight against breast Thursday, 21 Thursday, 18 Thursday, 16 cancer. From now through December 31st, 2010, for every ..Thursday, 30 referred customer who starts new service with any Komen Budget Plan, we will donate :$30 to Susan' G. Komen for the Cure. Visit Water.com /KomenReferral today! Customer Account 17209463083945 JOE ACCOUNTS PAYABLE Invoice Date: 09 -25 -10 CITY OF CARMEL UTILITIES Invoice M 3083945 092510 9609 HAZEL DELL PKWY INDIANAPOLIS, IN 46280 Purchase Order Date Transaction Details Qty. Each Amount Previous Balance 561.95 09 -24 -10 P189824 Payment Check 189824 Thank You 561.95 Remaining Balance 0.00 R102521797710 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 09 -09 -10 T102523042002 HINCKLEY SPRINGS 5G DRINK NON -SPILL 7.0 9.99 69.93 HINCKLEY 5.OG DISTILLED NON SPILL 14.0 10.49 146.86 5.0 GAL BOTTLE RETURN -21.0 6.00 126.00 5.0 GAL BOTTLE DEPOSIT 7.0 6 -00 42.00 5 -0 GAL BOTTLE DEPOSIT 14.0 6 -00 84.00 Rec'd By: Not Available or Refused 09 -23 -10 T102663042004 HINCKLEY SPRINGS 5G DRINK NON -SPILL 9.0 9.99 89.91 HINCKLEY 5.OG DISTILLED NON SPILL 12.0 10.49 125.88 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 12.0 3.29 39.48 5.0 GAL BOTTLE DEPOSIT 9.0 6.00 54.00 5.0 GAL BOTTLE RETURN -21.0 6.00 126.00 5.0 GAL BOTTLE DEPOSIT 12.0 6.00 72.00 09 -23 -10 56449315 ENERGY SURCHARGE 1.0 2.02 2.02 Total New Charges 516.58 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 einvoice, order additional products, check your next delivery, pay your bill and much more. Log on todayl 30356 -P -0035 Previous Balance Payment Total New Charges Pay This Amount J $561.95 $561.95 $516.58 $516.58 p Write the comp lete account numberon your check. Detach remittance and mail with pay ment in the enclosed envelo To pa online go to ww w.HinckleySprings.co m C7 How to Read Your Statement waTEas w Important Monthly Promotions: J,I— I D-1 we oerv FinrTwn er! Register online for access to your nuqu ly Nb9 Iu1y 3009 s,N09 Bnn,ea Wirr''co,ln Delivery Calendar: M a F15 a .',°w' account. You can view and pay your bill, Your scheduled deliveries for 1x Ma m �•..:M" check delivery schedule and order the next three months. products all online. Customer Account Number: w For prompt service, please use this v Bottle Deposits: number when referring to your account. Highlights bottle deposits and returns. e�xu Easy to Pay: Pay your invoice through the mail, online at Summar ce" www.water.com or call us to expedite your Previous balance and posted r ..a,,. remittance with automatic credit card payments payments since last bill. Wi Total New Charges: Thi s information provides totals for u,.m „o°.. „nom Mail Remittance With Payment To: various products and transactions. �<awn, Please detach remittance and mail p- using business envelope provided. II��II�� ..I�I�I.,,II�I��I��.10 aerr 0T Important Monthly Message >sersa I1.1 J.1I-IdhAb I.IdL—II.I1 11111.1 II 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' It 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: Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579. The dollar amount of the suspected error. 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 bill 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. :,VOUCHER 106290 WARRANT ALLOWED '131130 IN SUM OF HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266 -0579 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR .Board members PO INV ACCT AMOUNT Audit Trail Code 30839450925 01- 7202 -05 $516.58 1 Voucher Total $516.58 Cost distribution ledger classification if claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form fro. 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 131130 HINCKLEY SPRINGS Purchase Order No, PO BOX 660579 Terms DALLAS, TX 75266 -0579 Due Date 10/5/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or biII(s)) Amount 101512010 3083945092.` $516.58 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 Off'