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Home My WebLink About165800 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $733.85 CARMEL, INDIANA 46032 PO BOX 660579 DALLAS TX 75266 -0579 CHECK NUMBER: 165800 CHECK DATE: 11/1212008 DEPARTMENT AC PO NUMBER INVOICE NUMBER AMO UNT DESCRIPTION 651 5023990 10081720946 689.84 OTHER EXPENSES 1301 4239099 11081722004 44.01 OTHER MISCELLANOUS ®a Hinckley brand of Springs For Customer Service and Account Inquiries, H. i nC k- Springs DS Waters of America Inc. Call 1- 80044 -PURE (7873) or visit PO Box 660579 www.hinckleysprings.com Dallas, TX 75266 -0579 Customer Account 17220042677859 IM ROTT Invoice Date: 11 -01 -08 ARMEL CITY COURT Invoice 1108 1722004 2677859 CIVIC SQ Purchase Order ARMEL, IN 46032 Date Details Qty. Each Amount Previous Balance 44.01 10 -27 -08 Payment Check 164748 Thank You -44.01 Remaining Balance 0.00 TRANSACTION 082902494748 HOT AND COLD COOLER RENTAL 1.0 13.00 13.00 10 -30 -08 TRANSACTION T083043042007 HINCKLEY 5.OG DRINK NON -SPILL 3.0 9.49 28.47 5.0 GAL BOTTLE DEPOSIT 3.0 6.00 18.00 5.0 GAL BOTTLE RETURN -3.0 6.00 -18.00 Rec'd By: 10 -30 -08 TRANSACTION 35345679 ENERGY SURCHARGE 1.0 2.54 2.54 Total New Charges 44.01 Finding your next scheduled delivery day just got easier! Go to My Account at www.water.com. Login or register for Self Service today. Click on Printable Calendar to view print your 2009 Delivery Calendar online. 30356 -P -0023 Previous Balance Payment Total New Charges Pay This Amount $44.01 C $44.01 $44.01 $44.01 -Write the comlete account numberomyour- check. Detach remittance and mail with payment in the enclosed envelope. To pay online go to www.hicnkleysprings.com How to Read Your Statement visit Our Website: Register online for access to your °.m.• p' °m v w•^• account. You can view and pay your bill, check delivery schedule and order Customer Account Number: For prompt service, please use this products all on'Tne, number when referring to your account. k �f Bottle Deposits: Summary: Highlights bottle deposits and returns. Balance from previous bill (previous balance minus payments). Easy to Pay: You can pay through the mail, online, or call us Easy to Read: I M to expedite your remittance with automatic credit All charges and credits are easy card payments. to understand. P 5 9 r L4�a�w Total New Charges: This information rovides totals for p "4�* Mail Remittance With Payment To: various products and transactions. Please Please detach remittance and mail �f fTICTTt using business envelope provided. Important Monthly Message JFIIb.O ?00413 :SV 22 ]fl33t L.L L�3 [If I -.CII 3 C'JO:IC] L J Billing Rights Summary Electronic Funds Transfer Notice In case of Errors or Questions About Your Bill: If you pay by check, it will be converted into an "Electronic Funds Transfer If you think your bill is incorrect, or if you need more information about a (EFT), a process in which your financial institution is electronically instructed to transaction on your bill, write us as soon as possible on a separate sheet, at transfer funds from your account to ours in lieu of processing the check. By P.O. Box 660579, Dallas,TX 75266 -0579. We must hear from you no later sending your completed check to us, you authorize us to use the account than 60 days after we sent you the first bill on which the error or problem information therein to create an EFT for the amount indicated on the check. If appeared. Your bill shall be deemed correct unless disputed within 60 days the EFT cannot be processed for technical or other reasons, you authorize us from receipt. You can telephone us, but doing so will not preserve your rights. to process an image replacement document, draft, or copy of your check. In your letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion program, please write to us on a separate sheet at: Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579. The dollar amount of the suspected error. Describe the error and explain why you believe there is an error. If you need Insufficient Funds Notice more information, describe the item you are unsure about. If your check is returned for insufficient or uncollected funds (NSF), your signature You do not have to pay any amount in question while we are investigating, but on your check gives us permission to debit your checking account electronically you are still obligated to pay the amount of your bill that is not in question. While for the uncollected amount. Payment by check constitutes your acceptance of we investigate your questions, we cannot report you as delinquent or take any these terms. action to collect the amount you question. We appreciate your business. As a food product, bottled water is subject to rules and regulations promulgated by the federal Food and Drug Administration (FDA). For further information, please write DS Waters of America, Inc. at P.O. Box 660579, Dallas, TX 75266 -0579. Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER t. CITY OF CARMEL An invoice or biw'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. D, 6665`7 Terms 7V6 10' y Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) aiLd, �tLd= LCL2, �=4 �111 1,5, 0 C) Total 44. J 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. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF o 5`7 el' 71 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 3 0 I g/ 7- 2 d D. 0) 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 20 Signature Ti Cost distribution ledger classification if claim paid motor vehicle highway fund Hj Hinckley Spri For Customer Service and Account Inquiries, Call 1- 800 -444 -PURE (7873) or visit p E"AllgS:. DS Waters of America, Inc. PO Box 660579 www.hinckleysprings.com Dallas, TX 75266 -0579 Customer Account 17209463083945 ACCOUNTS PAYABLE Your Next Deliveries: Invoice Date: 10 -25 -08 CITY OF CARMEL UTILITIES 11 -06 -08 Invoice 1008 1720946 3083945 9609 HAZEL DELL PKWY 11 -20 INDIANAPOLIS, IN 46280 Purchase Order Date Details Qty. Each Amount Previous Balance 1,231.45 10 -01 -08 Payment Check 163773 Thank You 636.43 Remaining Balance 595.02 TRANSACTION 082831797710 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 10 -09 -08 TRANSACTION T082833042003 HINCKLEY 5.OG DRINK NON -SPILL 7.0 9.49 66.43 HINCKLEY 5.OG DISTILLED NON SPILL 24.0 9.99 239.76 CUP COLD FLAT 9 OZ HINCKLEY SPRINGS 100 CT 10.0 4.49 44.90 5.0 GAL BOTTLE RETURN -29.0 6.00 174.00 5.0 GAL BOTTLE DEPOSIT 7.0 6.00 42.00 5.0 GAL BOTTLE DEPOSIT 24.0 6.00 144.00 Rec'd By: 10 -23 -08 TRANSACTION T082973042014 HINCKLEY 5.OG DRINK NON -SPILL 6.0 9.49 56.94 HINCKLEY 5.OG DISTILLED NON SPILL 23.0 9.99 229.77 5.0 GAL BOTTLE DEPOSIT 23.0 6.00 138.00 5.0 GAL BOTTLE RETURN -28.0 6.00 168.00 5.0 GAL BOTTLE DEPOSIT 6.0 6.00 36.00 Rec'd By: 10 -23 -08 TRANSACTION 35170754 ENERGY SURCHARGE 1.0 2.54 2.54 Keeping your dispenser in top performance throughout the year is important, especially during winter months. For detailed information on proper maintenance of your water dispenser, visit us online at www.water.com /cooler cleaning 30356 0023 Previous Balance Payment Total New Charges Pay This Amount sea a.n ,e $1.28_4...8.6 How to Read Your Statement Visit Our Website•- Id. Register online for access to your °y ry w•a account. You can view and pay your bill, check delivery schedule and order Customer Account Number: products all online. For prompt service, please use this number when referring to your account. Bottle Deposits: Summary: Highlights bottle deposits and returns. Balance from previous bill (previous balance minus payments). Easy to Pay: You can pay through the mail, online, or call us Easy to Read: d to expedite your remittance with automatic credit All charges and credits are easy card payments. to understand. o Total New Charges: 6 This information provides totals for w Mail Remittance With Payment To: various products and transactions. dam. a Please detach remittance and mail [mil using business envelope provided. Important Monthly Message izue:o zoo u3 aoznezzsie nnv,ro [o[x Billing Rights Summary Electronic Funds Transfer Notice In case of Errors or Questions About Your Bill: If you pay by check, it will be converted into an "Electronic Funds Transfer" If you think your bill is incorrect, or if you need more information about a (EFT), a process in which your financial institution is electronically instructed to transaction on your bill, write us as soon as possible on a separate sheet, at transfer funds from your account to ours in lieu of processing the check. By P.O. Box 660579, Dallas,TX 75266 -0579. We must hear from you no later sending your completed check to us, you authorize us to use the account than 60 days after we sent you the first bill on which the error or problem information therein to create an EFT for the amount indicated on the check. If appeared. Your bill shall be deemed correct unless disputed within 60 days the EFT cannot be processed for technical or other reasons, you authorize us from receipt. You can telephone us, but doing so will not preserve your rights. to process an image replacement document, draft, or copy of your check. In our letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion y g g program, please write to us on a separate sheet at: Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579. The dollar amount of the suspected error. Describe the error and explain why you believe there is an error. If you need Insufficient Funds Notice more information, describe the item you are unsure about. If your check is returned for insufficient or uncollected funds (NSF), your signature You do not have to pay any amount in question while we are investigating, but on your check gives us permission to debit your checking account electronically you are still obligated to pay the amount of your bill that is not in question. While for the uncollected amount. Payment by check constitutes your acceptance of these terms. we investigate your questions, we cannot report you as delinquent or take any action to collect the amount you question. We appreciate your business. As a food product, bottled water is subject to rules and regulations promulgated by the federal Food and Drug Administration (FDA). Fnr furfhar infnrmafinn Man wrifc nC %Alnfnrc -f Ameri— I-- n n n..., Customer Account 17209463083945 Invoice 1008 1720946 3083945 Date Details Qty. Each Amount Total New Charges 689.84 612749 M1081025_SM10- 10367 000001686 Page 2 of 2 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 131130 HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms r DALLAS, TX 75266 -0579 Due Date 1113!2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/3/2008 1008172094E $689.84 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and ;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 M 1s/ Date Officer VOUCHER 086599 WARRANT ALLOWED 131`130 IN SUM OF HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266 -0579 F� Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 10081720946 01- 7202 -05 $689.84 t: r Voucher Total $689.84 `;t distribution ledger classification if .,m paid under vehicle highway fund