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Home My WebLink About206795 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1 ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA GHECK AMOUNT: $3,607.45 CARMEL, INDIANA 46032 PO BOX 9001099 LOUISVILLE KY 40290 -1099 CHECK NUMBER: 206795 CHECK DATE: 2/28/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 07610010553 3,607.45 CONT SVS -HAZ WASTE FIndlanapolis, UBLIC CARMEL UTILITIES HHW Invoic e AVlCES Ave Page 1 of 3 N 46202 -1150 Payments /Adjustments A division of REPUBL SERVICES Date Description Reference Amount 01/27 Payment -Thank You 205584 $4,135.05 Acco Account Number Summ 3-0761-1163292 Current Invoice Charges Invoice Date January 31, 2012 Carmel Utilities Hhw 901 N Range Line Rd (L1) CSA 3292121010 Invoice Number 0761- 001055354 Carmel, IN Previous Balance $4,135.05 Payments /Adjustments $4,135.05 1 Hooklift (30 Yd) Scheduled Service (S1) Comingled Unpaid Balance $0.00 Date Description Reference Quanti Unit Price Amount Current Invoice Charges $3,607.45 01/03 Basic Service 1.00 $153.15 $153.15 Receipt Number 76426 01/03 Basic Service Schedule 1.0000 $153.15 $153.15 Receipt Number 76635 01104 Basic Service 1.0000 $153.15 $153.15 Am ount Pay This Receipt Number 76598 3,607.45 01/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 79218 Due By: 02/20/12 01/09 Basic Service 1.0000 $153.15 $153.15 Receipt Number 79993 01/11 Basic Service 1.0000 $153.15 $153.15 C ontact Receipt Number 82293 Customer Service (317) 917 -7300 01/13 Basic Service 1.0000 $153.15 $153.15 01/17 Basic Service 1.0000 $153.15 $153.15 01/20 Basic Service 1.0000 $153.15 $153.15 Receipt Number 88590 01/23 Basic Service 1.0000 $153.15 $153.15 Im portant Information Receipt Number 89594 01/27 Basic Service 1.0000 $153.15 $153.15 Receipt Number 93693 01/30 Basic Service 1.0000 $153.15 $153.15 Receipt Number 94390 1 Rolloff (30 Yd) Scheduled Service (S3) Comingled Date Description Reference Quanti Unit Price Amount 01/04 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 x„ CIJRitENT� A.=30 DAYS;, 60 „DAYS'° X90 ±..DAYS 3,607.45 0.00 0.00 0.00 Lconven�ient p for o to: D A Visit our website, www.dispo sal.com to make your payment electronically or to sign up for our convenient automatic payment plan. Please see reverse side for terms and conditions CARMEL UTILITIES HHW 3- 0761 1163292 Page 2 of 3 Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you authorize us to use information from your check to make a one -time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click on the Check Conversion tab. If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise prohibited by law. The Company reserves the right to require that payment for services be made only by check, credit card or money order, unless otherwise required by contract or applicable law. 001562 000002 000002 003124 2301031 2240ST03 1 3 Page 3 of 3 CARMEL UTILITIES HHW Republic Services #761 Account Number 3- 0761 1163292 WREPUBLIC Invoice Date January 31, 2012 832 Langsdale Ave SERVICES Invoice Number 0761 001055354 Indianapolis, IN 46202 -1150 Current Invoice Charges Date Description Reference Quanti Unit Price Amount 01/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/09 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/11 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/13 Basic Service 1.0000 $153.15 $153.15 01/16 Dry Run 1.0000 $85.00 $85.00 Receipt Number 37829 01/18 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/20 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/23 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/25 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/27 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 01/30 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 Current Invoice Charges $3,607.45 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 358593 REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No. PO BOX 9001099 Terms LOUISVILLE, KY 40290 -1099 Due Date 2/20/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/20/2012 0761001055: $3,607.45 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 116813 WARRANT ALLOWED 358593 IN SUM OF REPUBLIC WASTE SERVICES OF INDI PO BOX 9001099 LOUISVILLE, KY 40290 -1099 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 07610010553 01- 736H -08 $3,607.45 Voucher Total $3,607.45 Cost distribution ledger classification if claim paid under vehicle highway fund