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Home My WebLink About161394 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 j ONE CIVIC SQUARE HINCKLEY SPRINGS PO BOX 660579 CHECK AMOUNT: $40.fi6 CARMEL. INDIANA 46032 DALLAS TX 75266 -0579 CHECK NUMBER: 161394 CHECK DATE: 7111/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 081643042014 40.66 OTHER MISCELLANOUS i HINCKLEY SPRINGS WATI_H 800-444-PML WAIER.COM I ORIGINAL CUSTOMER #11722004 TICKER p: 081643042014 Location 2677868 POa: CARMEL CI COURT Date: 06112108 Time. 10:23:43 am I L'IVIC SQ ROUTE# 3042 GARY CARMEL, IN 5032 Last PeyioeuDale: 6/512008 Last Payinait Aimunt: 40.66 Product Deli red QIY PRICE AMOUNT HS 5G DR NS- 3 $8.45 $25.47 HS 5G Deposit 3 $6.00 $18.00 BOI 5.OG PLS -3 $6.00 -18.00 (3 Ilk' tlleS De G,ply Dollba R,Yluiuwi 0 Bullle D,:;�sitSj 1 Subtotal Sales 25.47 Sales Tax 0.00 DELIVERY TII:KEI IOTAL 25.47 Previous Account Da lance 13.00 Total Balance Due 38.47 Payments: ENDING BALANCE 38.47 Next Delivery Date: 711012008 We bill muntbiy by s;uvuriiy invuice Rtilain 6 y(n.0 [VC01IIS. Hinckley Springs L �LLnC� 1 1� a brand of For Customer Service and Account Inquiries, 1 1 L DS Waters of America, Inc. Springs PO Box 660579 Call 1- 800 -444 -PURE (7873) or visit Dallas, TX 75266 -0579 www.hinckleysprings.com C ustomer Account 7220042677859 KIM ROTT Your Next Deliveries: Invoice Date: 06 -14 -08 CARMEL CITY COURT 07 -10 -08 Invoice 0608 1722004 2677859 1 CIVIC SQ 08 -07 -08 Purchase Order CARMEL, IN 46032 Date Details Qty. Each Amount revious Balance 40.66 06 -09 -08 Payment Check 159912 Thank You -40.66 Remaining Balance 0.00 TRANSACTION 081502494748 HOT AND COLD COOLER RENTAL 1.0 13.00 13.00 06 -12 -08 TRANSACTION 30723405 ENERGY SURCHARGE 1.0 2.19 2.19 06 -12 -08 TRANSACTION T081643042014 HINCKLEY 5.OG DRINK NON -SPILL 3.0 8.49 25.47 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: DD-k6 Total New Charges 40.66 When the weather starts heating up, stay cool on the go with our single -serve bottles conveniently delivered right to your door! Available in 24 pack cases, they're an easy way to keep plenty of crisp, refreshing water on hand all day. 30356 -P -0015 Previous Balance Payment I Total New Charges Pay This Amount $40.66 0 $40.66 1 -1,,- $40.66 0 $40.66 v Write the com plete account number on y our check. Detach remittance and mail with pay ment in the enclosed envelope. To pay online g o to www.hinckle ysprings.com v How to Read Your Statement Visit Our Website• Register online for access to your ,K �NZ �•k w•�•�• account. You can view and pay your bill C I check delivery schedule and order Customer Account Humber: products all online. For prompt service, please use this number when referring to your account. P 7 "1 Summary: Bottle Deposits: Y: 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: to expedite your remittance with automatic credit All charges and credits are easy b card payments. to understand. Total New Charges: M. This information provides totals for Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail using business envelope provided. c..u...n....•..u.dua. .,..i.,,ma.u...,.i.d,a 6n.u•.•ni•.+.,i,,..o.. .•d,.d••,vaddda Important Monthly Message J2116:0 3D01Y] 5422) 623E L 4113 OL IiLI E C302II 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 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 for the uncollected amount. Payment by check constitutes your acceptance of you are still obligated to pay the amount of your bill that is not in question. While 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). 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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or 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. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7 XL 01 d �9 l l'3 Total yd, �p o 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 D� 6 ®3 7q -Is -ju 0s 7 ON ACCOUNT OF APPROPRIATION FOR Board Members Fo# or INVOICE NO. ACCT #/TITLE AMOUNT EPT. I hereby certify that the attached invoice(s), or D J 3 0 1 0$J 6 A 3 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 200 Si a e Tit Cost distribution ledger classification if claim paid motor vehicle highway fund