192934 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 314125 Page 1 of 1
ONE CIVIC SQUARE UPS CHECK AMOUNT: $15.42
CARMEL, INDIANA 46032 LOCKBOX 577
CAROL STREAM IL 60132 -0577 CHECK NUMBER: 192934
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 76V77A480 15.42 CONT SERVICES OTHER
Delivery Service Invoice
Invoice date November 27, 2010
Shipped from: Invoice number 000076V77A480
CARMEL UTILITIES DISTRIBUTION Shipper number 76V77A
C�Tm 3450 W 1031ST ST Control ID J769
WESTFIELD, IN 46074
Page 1 of 3
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AT 01 031006 99655HI04 D *3DGT For questions about your invoice, call:
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CARMEL UTILITIES
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 Summary f Charges
Amount Due This Period 15.42 Y 9
Amount Outstanding (prior invoices) 20.55 age Charge
Total Amount Outstanding 35.97 Outbound
Please include the Return Portion of each outstanding invoice with 3 UPS Internet Shipping 15.42
your payment. See Account Status for details. Amount due this period 15.42
2011 Rates Information
Effective Jan. 3, 2011, UPS Rates will increase as follows: UPS payment terms require payment of this invoice by December
UPS Ground Services will increase a net 4.9% and UPS Air 8, 2010.
and International Services will increase a net 4.9 Also, the Note: This invoice may contain a fuel surcharge as described at
dimensional weight divisor will change from 194 to 166 for ups.com. The published fuel surcharge is 5.5% for UPS Ground
domestic U.S. services, and from 166 to 139 for U.S. export Services and 8.5% for UPS Air Services, UPS 3 Day Select, and
shipments. Learn more at ups.com /rates International services. For more information, visit ups.com.
Delivery Service Invoice
Invoice date November 27, 2010
Invoice number 000076V77A480
Shipper number 76V77A
n
Page 2 of 3
Account Status
Weekly Payment Plan
Payments Applied
Amount
Invoice Number Invoice Date Paid
000076V77A410 10/09/2010 23.09
000076V77A430 10/23/2010 15.38
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
000076V77A440 10/30/2010 20.55
Total 20.55
Outstanding balances reflect any payments received as of
11/26/2010. Please ignore this message if a recent payment has
been made for any outstanding invoices.
Delivery Service Invoice
Invoice date November 2 1 7, 2010
Invoice number 000076V77A480
Shipper number 76V77A
n
Page 3 of 3
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
11/10 1Z76V77A0392989199 Ground Commercial 46202 2 3 7.31
Fuel Surcharge 0.40
Total 7.71
1st ref 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
11/23 1Z76V77A0395578690 Ground Commercial 46202 2 3 7.31
Fuel Surcharge 0.40
Total 7.71
1st ref 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
Total for Internet -ID: CarmelWater 15.42
Total UPS Internet Shipping 2 Package(s) 15.42
Total Outbound 2 Package(s) 15.42
VOUCHER 103523 WARRANT ALLOWED
314125 IN SUM OF
UPS WATER
LOCKBOX 577
CAROL STREAM, IL 60132
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
76V77A480 01- 6360 -03 $15.42
Voucher Total $15.42
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 12/6/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/6/2010 76V77A480 $15.42
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have a udited same in accordance with IC 5- 11- 10 -1.6
Date Officer