156644 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL MGT
CARMEL, INDIANA 46032 CASHIER'S OFFICE -MAIL CODE 50 -10C CHECK AMOUNT: $14,500.00
100 N SENATE AVE
o CHECK NUMBER: 156644
INDIANAPOLIS IN 46207 -7060
CHECK DATE: 2/2112008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 85442 14,500.00 PERMIT
I
n
r
INVOICE
Please Remit To: Page: 1
INDIANA DEPT OF ENVIRONMENTAL MGMT Invoice No: 000085442
CASHIER OFFICE MAIL CODE 50 -10C Invoice Date: 01/07/2008
100 NORTH SENATE AVENUE Customer Number: CST100010357
INDIANAPOLIS IN 46204 Bill Type: 021
Payment Terms: NET 60
Due Date: 03/07/2008
Bill To:
CITY OF CARMEL
MS CINDY SHEEKS AMOUNT DUE: 14,500.00 USD
ONE CIVIC SQUARE
CARMEL IN 46032
Amount Remitted
Note Address Changes Above
-For-bMing questions, !ease Call 3 17 2 33 -0604
Line Adi Identifier Description Quantity UOM Unit Amt Net Amount
PLEASE NOTE NEW REMIT TO ADDRRSS ABOVE.
Annual Fee Billing is required for active NPDES permits under Indiana Code: IC 13- 18 -20. To view
via the Internet visit! http: /www.IN.gov /legislative /ic /code /titlel3 /arl8 /ch2O,html
Facilities with no discharge are still required to pay any applicable base fee as long as the
permit is active. A permit is active until a written request for termination is submitted to IDEM
and must be received prior to Jan 1 of the year.
NPDES permit fees are based on the activity status as of January 1 of the current year. Fees are
not pro rated. If a facility is sold or the permit terminated during the billing year, the entire
amount of the assessed fee remains due and payable_
If payment of the full assessed fee amount imposes an undue burden upon the permit holder, the
facility may notify this agency no later than February 15th to pay instead four equal, installments,,,,_,_„
spread evenly over the year.
J
Payments not received or received after the DUE date are subject to a delinquency charge equal to
10% of the'assessed fee. Either the complete fee payment or the 1st installment is due March 15 (60
days after the assessment date),
If several permits or invoices are to be paid by one check, you MUST INCLUDE A COPY OF EACH
BILLING INVOICE in order to ensure proper credit for each fee assessment.
For questions regarding flow values and invoice amounts contact the Office of Water quality at
317 -232- 04.72. Flow based fees are based on reported flow values for a twelve month period ending in
June of the previous year.
I 1 08- IN0022497 -0 Base fee Municipal Major i.00 1,500.00 1,500 -00
1 2 09- IN0022497 -0 Flow Fee for 10.0 MOD 1.00 13,-000 -0o 13,000.00
TOTAL AMOUNT DUE 14,500.00
A copy of your invoice must be included with payment.
495 -11)EM Printed Recycled Paper Original
VOUCHER 077316 WARRANT ALLOWED
x146900 IN SUM OF
IDEM
,100 N. Senate Avenue
Indianapolis, IN 46207 -7060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
pa# 85442 0_17750 -9& $14,500.00
Voucher Total $14,500.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) t•
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where F
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
146900
IDEM Purchase Order No.
100 N. Senate Avenue Terms
Indianapolis, IN 46207 -7060 Due Date 2/12/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/12/2008 85442 $14,500.00
yi
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
I
Date Officer