205303 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 314125 Page 1 of 1
ONE CIVIC SQUARE UPS CHECK AMOUNT: $16.82
CARMEL, INDIANA 46032 LOCKBOX 577
CAROL STREAM IL 60132 -0577 CHECK NUMBER: 205303
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 76V77A511 16.82 CONT SERVICES OTHER
Delivery Service Invoice
Invoice date December 17, 2011
Shipped from: Invoice number 000076V77A511
CARMEL UTILITIES DISTRIBUTION Shipper number 76V77A
3450 W 1031ST ST Control ID 4Y48
WESTFIELD, IN 46074
Page 1 of 3
Sign up for electronic billing today!
0249A000076V77A9 77401300026402 Visit ups.com /billing
AT 01 023894 05275H 75 D *3DGT For questions about your invoice, call:
(800) 811 -1648
Monday Friday
CARMEL UTILITIES 8:00 a.m.- 9:00 p.m.E.T.
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
Amount Due This Period $16.82 Summary O f Charges
Amount Outstanding (prior invoices) $122.10 age C h arge
Total Amount Outstanding $138.92 Outbound
Please include the Return Portion of each outstanding invoice with 3 UPS Internet Shipping 16.82
your payment. See Account Status for details. Amount due this period 782
New Rates Information
Effective January 2, 2012, UPS Rates will change as follows: UPS payment terms require payment of this invoice by December
UPS Ground, Air, and International services will increase a net 28, 2011'
4.9 To view these new rates, as well as changes to Note: This invoice may contain a fuel surcharge as described at
accessorial rates, visit ups.com /rates. ups.com. The published fuel surcharge is 8.51yo for UPS Ground
Services and 14.0% for UPS Air Services, UPS 3 Day Select, and
International services. For more information, visit ups.com.
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Delivery Service Invoice
Invoice date December 17, 2011
UCTM Invoice number 000076V77A511
Shipper number 76V77A
Page 2 of 3
Account Status
Weekly Payment Plan
Payments Applied
Amount
Invoice Number Invoice Date Paid
000076V77A441 10/29/2011 16.82
000076V77A451 11/05/2011 24.20
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
000076V77A481 11/26/2011 25.23
000076V77A491 12/03/2011 96.87
Total $122.10
Outstanding balances reflect any payments received as of
12/16/2011. Please ignore this message if a recent payment has
been made for any outstanding invoices.
Delivery Service Invoice
Invoice date December 17, 2011
Invoice number 000076V77A511
Shipper number 76V77A
n
Page 3 of 3
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
12/07 1Z76V77A0398850755 Ground Commercial 46202 2 2 7.75
Fuel Surcharge 0.66
Total 8.41
1st ref Weekly Fluoride 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
12/13 1Z76V77AP292034545 Ground Commercial 46202 2 2 7.75
Fuel Surcharge 0.66
Total 8.41
1st ref Weekly 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 16.82
Total UPS Internet Shipping 2 Package(s) 16.82
Total Outbound 2 Package(s) 16.82
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 12/29/2011
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
12/29/201' 76V77A511 $16.82
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
Date Officer
VOUCHER 113370 WARRANT ALLOWED
314125 IN SUM OF
UPS
LOCKBOX 577 0P WATER S
CAROL STREAM, IL 60132
Carmel Water Utility
ON ACCOUNT OF ROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
76V77A511 01- 6360 -03 $16.82
Voucher Total $16.82
Cost distribution ledger classification if
claim paid under vehicle highway fund