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209322 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1 ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA GHECK AMOUNT: $3,501.30 CARMEL, INDIANA 46032 PO BOX 9001099 LOUISVILLE KY 40290 -1099 CHECK NUMBER: 209322 CHECK DATE: 5/22/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 07610011762 3,369.30 OTHER EXPENSES 1207 4350101 20711 07611174479 132.00 TRASH SERVICE qf CITY OF CARMEL BROOKSHIRE GOLF Invoice X04 SERVICES Page 1 of 2 832 Langsdale Ave Indianapolis, IN 46202 -1150 Payments /Adjustments Date Description Reference Amount 05/01 Payment Thank You 208019 $218.79 4 Account Number 3- 0761 -0035460 w Current Invoice Charges Invoice Date April 30, 2012 Brookshire Golf Course 12120 Brookshire Pkwy (1-1) CSA 002765 Invoice Number 0761 001174479 Carmel, IN Previous Balance $218.79 Payments /Adjustments $218.79 1 Front Load (8 Yd) Scheduled Service (S1) Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount Current Invoice Charges $132.00 04/30 Basic Service 05101/12- 05/31/12 $132.00 $132.00 Current Invoice Charges $132.00 $132.00 Due By: 05/20/12 Customer Service (317) 917 -7300 0 Effective 4/1612012: SERVICE INTERRUPTION POLICY CHANGE All accounts with a balance over 60 days will experience a service interruption unless prior arrangements are made. ,..a- CItREtC;2 .9 +A1lS 132. 0.00 0. 00 0. To pay on -line or sign-up -for. convenient auto pay, go to: D A Visit our website, www.disposal.com to make your payment electronically www.disposal.com or to sign up for our convenient automatic payment plan. Please see reverse side for terms and conditions CITY OF CARMEL BROOKSHIRE GOLF 3- 0761 0035460 Page 2 of 2 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 When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not receive your check back from your financial institution.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. VOUCHER NO. WARRANT NO. ALLOWED 20 Republic Services #761 IN SUM OF P. O. Box 9001099 Louisville, KY 40290 -1099 $132.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE I AMOUNT Board Members 20711 1 0761 0011744791 43- 501.01 1 $132.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, May 09, 2012 Director, Brookshi e Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 04/30/12 1 0761 0011744791 Trash Removal 1 $132.00 1 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 20 Clerk- Treasurer eFREP'UBL /C CARMEL UTILITIES HHW Invoice SERYtCES Page 1 of 3 832 Langsdale Ave Indianapolis, IN 46202 -1150 Current Invoice Charges Date Description Reference Quanti Unit Price Amount 04/30 Late Fee $4 Carmel Utilities Hhw 901 N Range Line Rd (L1) CSA 3292121010 Account Number 3- 0761- 1163292 Carmel, IN Invoice Date April 30, 2012 Invoice Number 0761 001176216 1 Hooklift (30 Yd) Scheduled Service (S1) Comingled Previous Balance $3,275.26 Date Description Reference Quanti ty Unit Price Amount Payments /Adjustments $0.00 04/02 Basic Service 1.0000 $153.15 $153.15 Unpaid Balance $3,275.26 Receipt Number 27977 Current Invoice Charges $3,418.43 04/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 29775 04/11 Basic Service 1.0000 $153.15 $153.15 Receipt Number 32969 04/13 Basic Service 1.0000 $153.15 $153.15 Pay Receipt Number 34182 04116 Basic Service 1 -0000 $153.15 $15- Receipt Number 34790 Due By: 05/20/12 04/18 Basic Service 1.0000 $153.15 $153.15 Receipt Number 36245 04/23 Basic Service 1.0000 $153.15 $153.15 Receipt Number 38580 Customer Service (317) 917 -7300 04/27 Basic Service 1.0000 $153.15 $153.15 Receipt Number 43056 04130 Basic Service 1.0000 $153.15 $153.15 Receipt Number 43627 1 Rolloff (30 Yd) Scheduled Service (S3) Comingled Effective 4/16/2012: SERVICE INTERRUPTION Date Description Reference Quanti Unit Price Amount POLICY CHANGE All accounts with a balance over 04102 Basic Service 1.0000 $153.15 $153.15 60 days will experience a service interruption unless Receipt Number 37829 prior arrangements are made. 04/04 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/09 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 y 4 DAYS s ,CURRENT0 DAYS6E1;i?AYS,.,, 90 3 3,221.15 54.11 0.00 To pay on -line or sign up for Past Due Balance $3,275.26 convenient auto pay go to: D A Visit our website, www.disposal.com to make your payment electronically www.disposal 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. 000753 000002 000002 001506 2303503 2240ST03 1 23 Page 3 of 3 R CARMEL UTILITIES HHW Republic Services #761 Account Number 3- 0761 1163292 REPUBLIC Invoice Date April 30 2012 832 Langsdale Ave 110-4 SERVICES Invoice Number 0761 001176216 Indianapolis, IN 46202 -1150 Current Invoice Charges Date Description Reference Quanti Unit Price Amount 04/11 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/13 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/16 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/18- Basic-Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/20 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/23 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/25 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/27 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 04/30 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 Current Invoice Charges $3,418.43 VOUCHER 117306 WARRANT ALLOWED 358593 IN SUM OF REPUBLIC WASTE SERVICES OF INDI PO BOX 9001099 LOUISVILLE, KY 40290 -1099 Caravel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 07610011762 01- 736H -08 $3,369.30 Voucher Total $3,369.30 Cost distribution ledger classification if claim paid under vehicle highway fund 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 5/14/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/14/2012 0761001176: $3,369.30 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