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Home My WebLink About178193 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS ii CHECK AMOUNT: $645.26 CARMEL, INDIANA 46032 ao sox 660579 DALLAS TX 75266.0579 CHECK NUMBER: 178193 CHECK DATE: 10114/2009 DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 09091720946 645.26 MATERIALS SUPPLIES 1- 800 4_WATE RS_ (492,8377) www.Hinckle S resin s.com Upcoming Delivery Dates `1 "r! Hinckley October November December Springsf Bottled Water Filtration Coffee Thursday, 8 Thursday, 5 Thursday, 3 We are proud to announce our new partnership with Thursday, 22 Thursday, 19 Thursday, 17 Susan G. Komen for the Cure! To celebrate this endeavor, Thursday, 31 during the months of September and October you may notice we've changed our 5- gallon bottles to a new pink cap to show our commitment. Visit water.com for more information? Customer Account 17209463083945 JOE ACCOUNTS PAYABLE Invoice Date: 09 -26 -09 CITY OF CARMEL UTILITIES Invoice 0909 1720946 3083945 9609 HAZEL DELL PKWY INDIANAPOLIS, IN 46280 Purchase Order Date Transaction Details Qty. Each Amount Previous Balance 1,260.31 08 -31 -09 P176267 Payment Check 176267 Thank You 654.03 09 -25 -09 P177239 Payment Check 177239 Thank You 606.28 Remaining Balance 0.00 R092531797710 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50 09 -10 -09 T092533042003 HINCKLEY SPRINGS 5G DRINK NON -SPILL 6.0 9.49 56.94 HINCKLEY 5.OG DISTILLED NON SPILL 28.0 9.99 279.72 5.0 GAL BOTTLE RETURN -34.0 6.00 204.00 5.0 GAL BOTTLE DEPOSIT 6.0 6.00 36.00 5.0 GAL BOTTLE DEPOSIT 28.0 6.00 168.00 Rec'd By: 09 -24 -09 T092673042005 HINCKLEY SPRINGS 5G DRINK NON -SPILL 8.0 9.49 75.92 HINCKLEY 5.OG DISTILLED NON SPILL 19.0 9.99 189.81 5.0 GAL BOTTLE RETURN -27.0 6.00 -162.00 5.0 GAL BOTTLE DEPOSIT 8.0 6.00 48.00 5.0 GAL BOTTLE DEPOSIT 19.0 6.00 114.00 Recd By: 09 -24 -09 45345327 ENERGY SURCHARGE 1.0 1.87 1.87 Managing your account is now at your fingertips. Take advantage of many time saving options available on water.com. Save paper when you sign up for elnvoice, order additional I, C products check y our next delive pay your bill and much more. Log on todayl 30356 -P -0035 :Previous Balance Payment Total New Charges r= Pay Zs Amount $1,260.31 $645.26 45.26 0 Write.the.eomplete,account numberon_ your check. Detach remittance and.mail with.paymentin the.enclosed envelope To. pay- online.go to www HmckleySpnngs.com v How to Read Your Statement low I wITERs Important Monthly Promotions: We De river! Register online for access to your —1,r account. You can view and pay your bill, Delivery Calendar: Your scheduled deliveries for check delivery schedule and order the next three months. products all online. Customer Account Number: For prompt service, please use this Bottle Deposits: number when ghlights bottle deposits and returns. n referring to your account. 4M 1.1i�F -Ira 7777�1 M—TR I— -1, Easy to Pay: Pay your invoice through the mail, online at Summary: www.water.com or call us to expedite your Previous balance and posted remittance with automatic credit card payments payments since last bill- Total New Charges: P= This information provides totals for m.. o Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail 0 using business envelope provided. Important Monthly Message 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 560579, 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 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 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. nvoice 0909 1720946 3083945 Cus Account "17209463083945 w T Date Details Eac Amount Total New Charges 645.26 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 l HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms DALLAS, TX 75266 -0579 Due Date 10/5/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/5/2009 0909172094E $645.26 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 Date Officer VOUCHER 096520 WARRANT ALLOWED 131130 IN SUM OF HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266 -0579 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 09091720946 01- 7202 -05 $64526 'a s Voucher Total $645.26 Cost distribution ledger classification if claim paid under vehicle highway fund