191335 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA �p
CHECK AMOUNT: $2,905.04
CARMEL, INDIANA 46032 Po aoxsooloss
LOUISVILLE KY 40290 -1099 CHECK NUMBER: 191335
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
651 5023990 07610004048 2,905.04 CONT SVS —HAZ WASTE
�REPIIBLIC CARMEL U.TILITIE nvoice
S.HHW I
ZVO SERVICES Visit us at w.wwAndVwaste.com.
832 Langsdale Ave Page 1 of 3
Indianapolis, IN 46202 -1160
Current`Invoice Charges
`Date Description Reference Quanti Unit Price Amount
Account Number 3- 0761 1163292 09130 :Late Fee $48.44
Invoice Date September 30, 2010 Carmel Utilities'Hhw 901. N Range Line Rd (L1)
Invoice Number 0761 0004041853 Carmel, IN
Previous Balance $3,229.20;
Payments /Adjustments $0.00 2 Hooklift (30 Yd) Scheduled Service (S1) Recyclable
Unpaid Balance $3,229.20
Date Description Reference Q uanti t y Unit Price Amount
Current Invoice Charges $2,905.04 t
09!01 Basic Service 1.0000 $124.20 $124.20
Receipt Number 80581
09!01 ;:Basic Service 1.0000 $124.20 $124.20
Receipt Number 80581
09!03 Basic'Service 1.O
R 000 $124.20 $124.20
eceipt Number 82041
$6 3,4.4 09!03 Basic Service 1.0000 $124.20 $124.20
Receipt Nurn ber 82041
Due By: 10120110 09'10. Basic Service 1:0000 $124.20 $124.20
Receipt Number 82079
9 09109 Basic Service 1.0000 $124.20 $124.20
Customer Service (317) '83675
(317) 91.7 -7300 09109 Basic Service 1.0000 $124.20 $124.20
Receipt Number 8$676
09110 Basic Service 1.0000 $124.20 $124,20
'Receipt Number 84665
Important Information
09113 Basic'Service 1.0000 $124.20 $124.20
Receipt Number. 85328
09/13 Basic Service 1.0000 $124.20 $124.20
Receipt Number 85328
09115 `Basic service 1.0000 $124.20 $124.20
•'Receipt.Nuinber 86981
09115 Basic Service 1.0000 $124.20 $124.20
Receipt Number 86981
09117 �BasicService. 1.0000 $124.20 $124.20
Receipt Number 87773
09117 Basic Service 1.0000 $124.20 $124.20
Receipt Number 87773
09120 Basic Service 1.0000 $124.20 $124.20
;Receipt :Number 88836
To pay on -line or sign up for 2s05.04 3,2zs.zo 0.00 0.00
convenient auto pay, go to: Past Due Balance .$3,229.20
D A visit'our ,website, www.disposal:iom to rooks your tiaymenbatectrcnioa7iy r
_or to sign up for our convenient automatic oavment Dian.
CARMEL UTILITIES HHW 3-0761-1163292 Page 2 of 3
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one -time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org or call
866 474 -8275.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
000570- 000002 -001140 2065703 2240ST03 1 3
Page 3 of 3
R CARMEL UTILITIES HHW Republic Services #761
Account Number 3- 0761 1163292
REPUBLIC 832 Langsdale Ave
SERVICES Invoice Date September 30, 2010 Indianapolis, IN 46202 -1150
Invoice Number 0761 000404853
Current Invoice Charges
Date Description Reference Quanti Unit Price Amount
09/20 Basic Service 1.0000 $124.20 $124.20
Receipt Number 88836
09/22 Basic Service 1.0000 $124.20 $12420
Receipt Number 91001
09/22 Basic Service 1.0000 $124.20 $124.20
Receipt Number 91001
09124 Basic Service 1.0000 $124.20 $124.20
Receipt Number 92411
09/24 Basic Service 1.0000 $124.20 $124.20
Receipt Number 92411
09/27 Basic Service 1.0000 $124.20 $124.20
Receipt Number 92782
09127 Basic Service 1.0000 $124.20 $124.20
Receipt Number 92782
09/29 Basic Service 1.0000 $124.20 $124.20
Receipt Number 94717
Current Invoice Charges $2,905.04
VOUCHER 106396 WARRANT ALLOWED
358593 IN SUM OF
REPUBLIC WASTE SERVICES OF INDI
PO BOX 9001099
LOUISVILLE, KY 40290 -1099
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
07610004048 01- 736H -08 $2,905.04
Voucher Total $2,905.04
Cast 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
358593
REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290 -1099 Due Date 10/18/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201( 0761000404 $2,905.04
I hereby certify that the attached inyoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
f i
Date Officer