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192907 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1 ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA �p 0 CHECK AMOUNT: $277.67 CARMEL, INDIANA 46032 PO BOX 9001099 LOUISVILLE KY 40290 -1099 CHECK NUMBER: 192907 CHECK DATE: 12/15/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 471813 141.71 CONT SERVICES OTHER 601 5023990 473775 135.96 CONT SERVICES OTHER REPUBLIC CARMEL UTILITIES Invoice 1j►� SERVICES Visit us at www.indywaste.com. Pag 1 of 2 832 Langsdale Ave g Indianapolis, IN 46202 -1150 Payments /Adjustments Date Description Reference Amount Account Number 3- 0761 1410952 11!22 Payment Thank You 191814 $135.29 Invoice Date November 25, 2010 Invoice Number 0761 000473775 Current invoice Charges Previous Balance $135.29 Carmel Utilities 5484 E 126th St (1-1) Payments /Adjustments $135.29 Carmel, IN Unpaid Balance $0.00 Current Invoice Charges $135.96 1 Front Load (6 Yd) Scheduled Service (Si) Date Description Reference Quantity Unit Price Amount 11/25 Basic Service 12/01/10 12/31/10 $113.86 $113.86 Total Fuel /Environmental Recovery Fee $22.10 Current Invoice Charges $135.96 $135.96 Due By: 12115/10 Customer Service (317) 917 -7300 o e o 0 IEEE RIM NEW, R �stAY3' To pay on -line or sign up for 135.96 0.00 0.00 0.00 convenient auto pay, go to: A division of REPUBLIC SERVICES A A Visit o u r webs Ile, www.dlsposal.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 3- 0761 1410952 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 When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not receive your check back from your financial institution.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. 114 14 CARMEL UTILITIES Invoice ItO SERVICES Visit us at www.indywaste.com. Page 1 of 2 832 Langsdale Ave Indianapolis, IN 46202-1150 Payments /Adjustments Date Description Reference Amount Account Number 3- 0761 1157550 11/22 Payment- Thank You 191814 $141.01 Invoice Date November 25, 2010 Invoice Number 0761- 000471813 Current Invoice Charges Previous Balance $141.01 Carmel Utilities 3450 W 131st St (1-1) Payments /Adjustments $141.01 Westfield, IN Unpaid Balance $0.00 Current Invoice Charges $141.71 1 Front Load (6 Yd) Scheduled Service (S1) Date Description Reference Quantity Unit Price Amount 11/25 Basic Service 12/01/10- 12/31/10 $118.67 $118.67 Total Fuel /Environmental Recovery Fee $23.04 .o o Current Invoice Charges $141.71 $141.71 Due By: 12/15/10 0 0 0 Customer Service (317) 917 -7300 00 0 L -V To pay on -line or sign up for 141.71 0.00 0.00 0.00 convenient auto pay, go to: A A Visit our website, www.disposal.com to make your paymeni 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 3- 0761 1157550 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. electron icpayments.orq 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. VOUCHER 103538 WARRANT ALLOWED 358593 IN SUM OF REPUBLIC SERVICES #761 PO BOX 9001099 WA TER OP ERAVONS LOUISVILLE, KY 40290 -1099 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 471813 01- 6360 -06 $141.7 Voucher Total -(y7 71 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 SERVICES #761 Purchase Order No. PO BOX 9001099 Terms LOUISVILLE, KY 40290 -1099 Due Date 12/7/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/7/2010 471813 $141.71 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 p Date Officer