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178435 10/14/2009 ,a CITY OF CARMEL, INDIANA VENDOR: 314125 Page 1 of 1 ONE CIVIC SQUARE UPS i CHECK AMOUNT: $30.10 CARMEN, INDIANA 46032 LOCKBOX577 CAROL STREAM IL 60132 -0577 CHECK NUMBER: 178435 CHECK DATE: 10/1412009 DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER A MOUNT DESC 601 5023990 76V77A399 11.18 OTHER EXPENSES 601 5023990 76V77A409 18.92 OTHER EXPENSES i Delivery Service Invoice Invoice date September 26, 2009 Invoice number 000076V77A399 Shipper number 76V77A Page 3 of 3 Outbound UPS Internet Shipping Pickup ZIP Billed Date Tracking Number Service Code Zone Weight Charge 09/22 1 Z76V77A0397540154 Ground Commercial Same 46202 2 2 10.78 Day Pickup- Web Request Fuel Surcharge 0.40 Total 11.18 1st ref Weekly Fluoride Samples UserlD CarmelWater Sender Jaimie Foreman Receiver: Environmental Sample Carmel Drinking Water Plant Indiana State Dept of Health 5484 E. 126th St 550 West 16th Street CARMEL IN 46033 INDIANAPOLIS IN 46202 Total for Internet -ID: CarmelWater 11.18 Total UPS Internet Shipping 1 Package(s) 11.18 Total Outbound 1 Package(s) 11.18 Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYA13LE 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 10/5/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/5/2009 76V77A399 $11.18 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 I 1V Date O fe r VOUCHER 093164 WARRANT ALLOWED —z 314125 *�i*- IN SUM OF UPS LOCKBOX 577 N CAROL STREAM, IL 60132 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 76V77A399 01- 6360 -03 $11.18 Voucher Total $11.18 II host distribution ledger classification if claim paid under vehicle highway fund 007M Delivery Service Invoice Invoice date October 3, 2009 Shipped from: Invoice number 000076V77A409 CARMEL UTILITIES DISTRIBUTION Shipper number 76V77A 3450 W 1031ST ST Control ID 52L7 WESTFIELD, IN 46074 Page 1 of 3 For questions about your invoice, call: #BWNCWNG# (800) 811 -1648 #0249A000076V77A9# 77401100020369 Monday Friday AT 01 028479 38579H 85 A *3DGT 8:00 a.m. 9:00 p.m. E.T. IIII' 1111111" I' ll' llllllll 'll'lllllllllll'llllll'lllll "111'1111 or visit ups.com CARMEL UTILITIES or write: UPS 3450 W 131ST ST P.O. Box 650580 WESTFIELD, IN 46074 -8267 Dallas, TX 75265 -0580 Account Status Summary Thank you for using UPS. Weekly Payment Plan Amount Due This Period $18.92 Summary of Charges Amount Outstanding (prior invoices) $112.06 age Charge Total Amount Outstanding $130.98 Outbound Please include the Return Portion of each outstanding invoice with 3 UPS Internet Shipping 11.90 your payment. See Account Status for details. 3 Adjustments Other Charges 7.02 .Online printing from The UPS Store® Amount due this period 18.92 Add convenience to your busy day with new online printing from The UPS Store. Whether you need to print a flyer, a UPS payment terms require payment of this invoice by October presentation or something in between, you can easily upload, 14, 2009. customize, preview and submit your project right from your Note: This invoice may contain a fuel surcharge as described at desktop. Then, simply stop by to pick the materials up. Get ups.com. The published fuel surcharge is 3.75% for UPS Ground ME started today at theupsstore.com /print Services and 5.591. for UPS Air Services, UPS 3 Day Select, and International services. For more information, visit ups.com. Delivery Service Invoice Invoice date October 3, 2009 Invoice number 000076V77A409 Shipper number 76V77A n Page 2 of 3 Account Status Weekly Payment Plan Payments Applied Amount Invoice Number Invoice Date Paid 000076V77A359 08/29/2009 30.53 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 000076V77A239 06/06/2009 1.26 000076V77A369 09/05/2009 11.43 000076V77A379 09/12/2009 77.01 000076V77A389 09/19/2009 11.18 000076V77A399 09/26/2009 11.18 Total $112.06 Outstanding balances reflect any payments received as of 10/02/2009. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice Invoice date October 3, 2009 Invoice number 000076V77A409 Shipper number 76V77A n Page 3 of 3 Outbound UPS Internet Shipping Pickup ZIP Billed Date Tracking Number Service Code Zone Weight Charge 09/29 1 Z76V77A4397427363 Ground Commercial Future 46202 2 2 9.78 Date Pickup Web Request Delivery Confirmation Response 1.75 Fuel Surcharge 0.37 Total 11.90 1st ref Weekly Fluoride Samples UserlD CarmelWater Sender :Michelle Breedlove Receiver: Environmental Sample Carmel Drinking Water Plant Indiana State Dept of Health 5484 E. 126th St 550 West 16th Street CARMEL IN 46033 INDIANAPOLIS IN 46202 Total for Internet -ID: CarmelWater 11.90 Total UPS Internet Shipping 1 Package(s) 11.90 Total Outbound 1 Package(s) 11.90 Adjustments Other Charges Packages Delivered but not Previously Billed Delivery Billed Date Tracking Number Service Zone Weight Charge 08125 1Z76V77A0392683269 Ground Commercial 2 2 6.78 Fuel Surcharge 0.24 Total 7.02 Receiver: Sender CARMEL UTILITIES DISTRIBUTION 7615 S STATE ROAD 267 3450 W 1031 ST ST BROWNSBURG IN 46112 WESTFIELD IN 46074 Message Codes m Total Packages Delivered but not Previously Billed 1 Package(s) 7.02 Total Adjustments Other Charges 7.02 Invoice Messaging Code Message M Median weight for service based on last six weeks 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 J 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 10/8/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/8/2009 76V77A409 $18.92 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 fficer VOUCHER 093221 WARRANT ALLOWED 314125 IN SUM OF UPS LOCKBOX 577 CAROL STREAM, IL 60132 1p t• Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 76V77A409 01- 6360 -03 $18.92 1 Voucher Total $18.92 Cost distribution ledger classification if claim paid under vehicle highway fund