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Home My WebLink About160902 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 131130 Pegg 4 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CARMEL, INDIANA 46032 PO BOX 660579 CHECK AMOUNT: $541.58 DALLAS TX 75266 -0579 CHECK NUMBER: 1609D2 CHECK DATE: 6/25/2008 DEPARTMENT ACCOUNT P O NUMB I NVOIC E NUMBER AMOUNT DESCRIP 651 5023990 s 06081720946 541.58 O'T'HER EXPENSES E LH I Hlnbft �"r&1t,�Engs For Customer Service and Account Inquiries, �Lncl D a brarWaafd of k l e DS MWa tetAofetimria, Inc. Call 1- 800 444 -PURE (7873) or visit PO X690579 Dall i 19 206 9579 www.hinckleysprings.com Z Customer Account 17209463083945 ACCOUNTS PAYABLE Your Next Deliveries: Invoice Date: 06 -07 -08 CITY OF CARMEL UTILITIES 06 -19 -08 Invoice 0608 1720946 3083945 9609 HAZEL DELL PKWY 07 -03 INDIANAPOLIS, IN 46280 Purchase Order Date Details Qty. Each Amount Previous Balance 1,058.1 05 -12 -08 Payment Check 158925 Thank You -509.1 Remaining Balance 549.0 TRANSACTION 081431797710 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.511 10.5 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.5 10.5 ROOM TEMP AND COLD COOLER RENTAL 1.0 10.5 10.5 05 -22 -08 TRANSACTION T081433042038 HINCKLEY 5.OG DRINK NON -SPILL 7.0 8.49 59.4 HINCKLEY 5.OG DISTILLED NON SPILL 18.0 8.49 152.8 5.0 GAL BOTTLE RETURN -25.0 6.0 -150.0 5.0 GAL BOTTLE DEPOSIT 18.0 6.0 108.0 5.0 GAL BOTTLE DEPOSIT 7.0 6.0 42.0 Rec'd By: 06 -05 -08 TRANSACTION 30559350 ENERGY SURCHARGE 1.0 2.1 2.1 06 -05 -08 TRANSACTION T081 57 304 1 043 HINCKLEY 5.OG DRINK NON -SPILL 9.0 8.4 76.4 HINCKLEY 5.OG DISTILLED NON SPILL 23.0 8.4 195.2 CUP COLD FLAT 9 OZ HINCKLEY SPRINGS 100 CT 4.0 4.4 17.9 5.0 GAL BOTTLE DEPOSIT 23.0 6.0 138.0 5.0 GAL BOTTLE RETURN -31.0 6.0 -186.0 5.0 GAL BOTTLE DEPOSIT 9.0 6.0 54.0 Rec'd By: 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, 6 52742 A they're an easy way to keep plenty of crisp, refreshing water on hand all day. Previous Balance Payment Total New charges Pay This Amount $1,058.13 $509.10 $541.58 1 0 $1,090.61 y Please detach and return the bottom portion with your payment in the enclosed envelope. Do not send cash. Please write in black or blue ink. y How to Read Your Statement www.hinckleysprings.com Visit our website and re ster online for access n" """s i •I �m rPo,�w�>a• Fer CU. C°II PIIPE TB9l ar g� to your account. You can view and pay your bill, Customer Account Number: check delivery schedule and order products all For prompt service, please use this online. F number when referring to your account. d- 1 Bottle Deposits: Summary: Highlights bottle deposits and returns Balance from previous bill (previous balance minus payments). m Easy to Pay: You can pay through the mail, online, or call us Easy to Read: to expedite your remittance with automatic credit Your new bill is streamlined- All charges card payments. and credits are easy to understand. Z m0 Total New Charges: This information provides totals for Remit To: various products and transactions. Please detach and mail to this address with o=-,-= 1-5 your payment. 0 Important Monthly Message from Hinckley Springs. 141LIIL. 1111111. 111111. 1. 1. .IIIIIA1..11.IIIL.IIILIIIIJ ILILIIILILILLIIL6. IILLIIJIJL .IILLIIL.NIJIILIII 020610 200113 L S a22?A23661193 0003600 a 0002000 6 0 Billing Rights Summary Electronic Funds Transfer Notice In case of Errors or Questions About Your Bill: It 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 on a separate sheet, at P.O. Box 660579, Dallas, transfer funds from your account to ours in lieu of processing the check. By TX 75266 -0579 as soon as possible. We must hear from you no later than 60 sending your completed check to us, you authorize us to use the account days after we sent you the first bill on which the error or problem appeared. Your information therein to create an EFT for the amount indicated on the check. If bill shall be deemed correct unless disputed within 60 days from receipt. the EFT cannot be processed for technical or other reasons, you authorize us You can telephone us, but doing so will not preserve your rights. to process an image replacement document, draft, or copy of your check. OPT OUT NOTICE: If you do not wish to participate in this check conversion program, In your letter, give us the following information: please write to us on a separate sheet at: P.O- Box 660579, Dallas, TX 75266- Your name and customer account number, or invoice number. 0579. The dollar amount of the suspected error. Insufficient Funds Notice Describe the error and explain why you believe there is an error. If you need more information, describe the item you are unsure about. If your check is returned for insufficient or uncollected funds (NSF), your signature on your check gives us permission to debit your checking account electronically You do not have to pay any amount in question while we are investigating, but 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 thank you for your business. DS Waters of America, LP P.O. Box 660579, Dallas, TX 75266 -0579 As a food product, bottled water is subject to rules and regulations promulgated by the federal Food and Drug Administrations (FDA). L For further information, please contact DS Waters of America, LP at 1 -800- 444 -PURE (1- 800 444 -7873) Customer Account 17209463083945 invoice M. 0608 1720946 3083945 e a s c moun hL Total New Charges 541.58 M1080607 M10- 10771 0000017 9 612 av Page 2 0i 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 t f 131130 HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms DALLAS, TX 75266 -0579 Due Date 6/16/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount. 6/16/2008 0608172094( $541.58 r 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 9li2 CLIL- Date Officer VOUCHER 085721 WARRANT ALLOWED 131130 IN SUM OF HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266 -0579 AA t`. Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code r' 06081720946 01- 7202 -05 $541.58 5� Voucher Total $541.58 Cost distribution ledger classification if claim paid under vehicle highway fund