192551 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIAIRIECK AMOUNT: $476.50
CARMEL, INDIANA 46032 PO BOX 9001099
i on `p LOUISVILLE KY 40290 -1099 CHECK NUMBER: 192551
CHECK DATE: 121712 010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350101 761000473773 476.50 TRASH COLLECTION
IC CARMEL CLAY PARK'S Invoice
ZW SERVICES Visit us at www.indVwaste Page 1 of 2
832 Langsdale Ave
Indianapolis, IN 46202 -1'150
Payments/Adjustments
Date Description Reference Amount
Account Number 3- 0761 1410948 11/22 Payment Thank You 191814 $474.15
Invoice Date November 25, 2010
Invoice Number 0761 000473773 Current Invoice Charges
Previous Balance $474.15 Carmel Clay Park's 1411 E 116th St (L1)
Payments/Adjustments $474.15 Carmel, IN
Unpaid Balance $0.00
Current Invoice Charges $476.50 2 Front Load (8 Yd) Scheduled Service (S1)
Date Description Reference Quanti Unit Price Amount
11125 Basic Service 12/01/10- 12/31/10 $399.04 $399.04
Total Fuel /Environmental Recovery Fee $77.46
Current Invoice Charges $476.50
$476.50
Due By: 12/15/10
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Customer Service (317) 917 -7300
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To pay on -line or sign up for 476.50 0.00 0.00 0.00
convenient auto pay, go to:
A A visit our website, www.disposal.com to make your payment electronically
or to sign up'foe our convenient automatic payment plan.
visit us at www.disposal.com Please see reverse side for terms and conditions
CARMEL CLAY PARK'S 3- 0761- 1410948 Page 2 of 2
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transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not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.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show, kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
358593 Republic Waste Services of Indiana Terms
P.O. Box 9001099
Louisville, KY 40290 -1099
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/25/10 761000473773 Dumpster A. 0. Dec'10 476.50
Total 476.50
1 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
20_
Clerk- Treasurer
Voucher No. Warrant No,
358593 Republic Waste Services of Indiana Allowed 20
P.O. Box 9001099
Louisville, KY 40290 -1099
In Sum of
476.50
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #rFITLE AMOUNT Board Members
Dept
1 125 761000473773 4350101 476.50 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
2 -Dec 2010
Signature
476.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund