191391 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 314125 Page 1 of 1
ONE CIVIC SQUARE UPS
CARMEL, INDIANA 46032 LOCKBOX 577 CHECK AMOUNT: $23.09
CAROL STREAM IL 60132 -0577 CHECK NUMBER: 191391
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 76V77A410 23.09 CONT SERVICES OTHER
Deli very Service invoice
Invoice date October 9, 2010
Shipped from: Invoice number 000076V77A410
CARMEL UTILITIES DISTRIBUTION Shipper number 76V77A
3450 W 1031ST ST
OT. Control 0 $79R
WESTFIELD, IN 46074
Page 1 of 3
#BWNCWNG# Sign up for electronic billing today!
#0249A000076V77A94t 77401200036121 Visit ups.com /billing
AT 01 035895 777171-1116 A *3DGT For questions about your invoice, call:
1 '11 1 1 -11 1111111111111111111111111111 111114+111111 -11' (800) 811 1648
Monday Friday
CARMEL UTILITIES
8:00 am. 9:00 p.m. E.T.
3450 W 131ST ST or write:
CARMEL, IN 46074 -8267 UPS
P.O. Box 650580
Dallas, TX 75265 -0580
Account Status Summary Thank you for using UPS.
Weekly Payment Plan
Amount Due This Period 23.09 Summary of Charges
Amount Outstanding (prior invoices) 31.75 Page arge
Total Amount Outstanding 54`.84 Outbound
Please include the Return Portion of each outstanding invoice with 3 UPS Internet Shipping 23.09
your payment. See Account Status for details. Amount due this period 23.09
Take control of import shipments
UPS Import ControlsM puts you in the driver seat with UPS payment terms require payment of this invoice by October
advanced technology that ensures your inbound international 20, 2010.
packages are delivered to your exact specifications. You can Note: This invoice may contain a fuel surcharge as describedat
initiate package shipments from another country, reduce your ups.com. The published fuel surcharge is 6.0% for UPS Ground
transportation costs, minimize delays and better manage Services and 8A% for UPS Air Services, UPS 3 Day Select, and
inventories. Learn more at ups.com /importing. International services. For more information, visit ups.com.
I
Delivery Service Invoice
Invoice date October 9, 2010
Invoice number 000076V77A410
Shipper number 76V77A
n
Page 2 of 3
Account Status
Weekly Payment Plan
Payments Applied
Amount
Invoice Number Invoice Date Paid
000076V77A370 09/11/2010 22.74
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
000076V77A380 09/18/2010 15.09
000076V77A390 09/25/2010 16.66
Total 31.75
Outstanding balances reflect any payments received as of
10/08/2010. Please ignore this message if a recent payment has
been made for any outstanding invoices.
1
Delivery Service Invoice
Invoice date October 9, 2010
elm Invoice number 000076V77A410
Shipper number 76V77A
Page 3 of 3
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
09/30 1Z76V77A0397809276 Ground Commercial 46202 2 4 7.52
Fuel Surcharge 0.41
Total 7.93
1st ref Weekly Fluoride Samples UserlD 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
10/05 1Z76V77A0391034140 Ground Commercial 46202 2 2 7.25
Fuel Surcharge 0.44
Total 7.69
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
iZ76V77A0394259554 Ground Commercial 46204 2 1 7.05
Fuel Surcharge 0.42
Total 7.47
1st ref wbell @carmel.in.gov UserlD CarmelWater
Sender Jai mie 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 23.09
Total UPS Internet Shipping 3 Package(s) 23.09
Total Outbound 3 Package(s) 23.09
VOUCHER 103066 WARRANT ALLOWED
314125 IN SUM OF
UIDS
LOCKBOX 577
CAROL STREAM, !L 60132
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
76V77A410 01- 6360 -03 $23.09
Voucher Total $23.09
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.
LOCKBOX 577 Terms
CAROL STREAM, IL 60132 Due Date 10/18/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201( 76V77A410 $23.09
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 Officer