192224 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
0 j• ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA CHECK AMOUNT: $3,272.78
CARMEL, INDIANA 46032 PO BOX 9001099
LOUISVILLE KY 40290 -1099 CHECK NUMBER: 192224
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 076100004428 3,272.78 CONT SVS -HAZ WASTE
A REPUBLIC CARMEL UTILITIES HHW Invoice
W SERVICES Visit us at www.indywaste.com. Page 1 of 3
832 Langsdale Ave
Indianapolis, IN 46202 -1150
PaymentstAdj ustments
A Date Description Reference Amount
Account Number 3- 0761 1163292 1A /09 Payment Thank You 190444 $3,229.20
Invoice Date October 31, 2010
Invoice Number 0761- 000442843 Current Invoice Charges
Previous Balance $6,134.24 Date Description Reference Quantity Unit Price Amount
Payments /Adjustments $3,229.20 90!31 Late Fee $43.58
Unpaid Balance $2,905.04
Current Invoice Charges $3,272.78 Carmel Utilities Hhw 901 N.Range tine Rd (1-1)
Carmel, IN
2 Hooklift (30 Yd) Scheduled Service (S1) Recyclable
PayThis A m o unt Date Description Reference Quanti Unit Price Amount
10/01 Basic Service 1.0000 $124.20 $124.20
$6,177.82 Receipt Number 96210
10/01 Basic Service 1.0000 $124.20 $12420
Due By: 11/20110 Receipt Number 96210
1 10104 :Basic Service 1.0000 $124.20 $124.20
Contact In'f ormation Receipt Number 96997
10104 Basic Service 1.0000 $124.20 $124.20
Customer Service (317) 917 -7300 Receipt Number 96997
10/06 Basic Service 1.0000 $124.20 $124.20
Receipt Number 98624
10/06 Basic Service 1 .0000 $124.20 $124.20
Receipt Number 98624
10!08 Basic Service 1.0000 $124.20 $124.20
Your next Invoice may reflect a rate adjustment, if Receipt Number 41
you have any questions after receiving your next 10 08 Basic Service 1.0000 $12410 $124.20
invoice please contact us. Receipt Number 41
Your next invoice may reflect an increase in your 10/11 Basic Service 1.0000 $124.20 $124.20
rate. Please contact our office with any questions. Receipt Number 848
10/11. Basic Service 1.0000 $124.20 $124.20
Receipt Number 848
10113 Basic Service 1.0000 $124.20 $124.20
Receipt Number 2249
10/14 Basic Service Bill 1.0000 $124.20 $124.20
Receipt Number 3575
10114 Basic Service Driver 1.0000 $124.20 $124.20
-CURR,ENT' €3t1 DAYS a w X60 D;4YS 90 (3A
To pay on -line or sign up for 3,272.78 2,905.04 0.00 0.00
convenient auto pay, go to: Past Due Balance $2,905.04
D A Visit our website, www.disposal.com to make your payment electronically
or to sign up for our convenient automatic payment plan.
Visit us at www.disposal.com Please see reverse side for terms and conditions_
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.
000837 000002 -001674 2067910 2240ST03 1 3
Page 3 of 3
CARMEL UTILITIES HHW Republic Services #761
R, Account Number 3 -0761- 1163292
REPUBLIC Invoice Date October 31, 2010 832 Langsdale Ave
+3►2 SERVICES Invoice Number 0761 000442843 Indianapolis, IN 46202 -1150
Current Invoice Charges
Date Description Reference Quanti Unit Price Amount
Receipt Number 3866
10/15 Basic Service 1.0000 $124.20 $124.20
Receipt Number 3452
10/18 Basic Service 1.0000 $124.20 $124.20
Receipt Number 4243
10/18 Basic Service 1.0000 $124.20 $124.20
Receipt Number 4243
10/20 Basic Service 1.0000 $124.20 $124.20
Receipt Number 5969
10/20 Basic Service 1.0000 $124.20 $124.20
Receipt Number 5969
10122 Basic Service 1.0000 $124.20 $124.20
Receipt Number 8176
10/22 Basic Service 1.0000 $124.20 $124.20
Receipt Number 8176
10/25 Basic Service 1.0000 $124.20 $124.20
Receipt Number 8819
10125 Basic Service 1.0000 $124.20 $124.20
Receipt Number 8819
10127 Basic Service 1.0000 $124.20 $124.20
Receipt Number 10331
10/27 Basic Service 1.0000 $124.20 $124.20
Receipt Number 10331
10129 Basic Service 1.0000 $124.20 $124.20
Receipt Number 11841
10/29 Basic Service 1.0000 $124.20 $124.20
Receipt Number 11841
Current Invoice Charges $3,272.78
VOUCHER 106543 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
07610004428 01- 736H -08 $3,272.78
Voucher Total $3,272.78
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
358593
REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290 -1099 Due Date 11/15/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/15/201( 0761000442f $3,272.78
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