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Home My WebLink About210025 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CARMEL, INDIANA 46032 PO BOX 660579 CHECK AMOUNT: $267.18 DALLAS TX 75266 -0579 CHECK NUMBER: 210025 CHECK DATE: 6/2012012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 267785905261 55.93 OTHER MISCELLANOUS 651 5023990 308394506021 211.25 MATERIALS SUPPLIES 1-800-4-WATERS 492 -8377 www.HinckleySprings.com Upcoming Delivery Dates 'I Hinckley® ►e Deli June July August Bottled Water Filtration Coffee Thursday, 7 Thursday, 5 Thursday, 2 Enjoy premium coffee and tea brands at your home or office. Thursday, 21 Thursday, 19 Thursday, 16 With the addition of Standard Coffee to our service options, Thursday, 30 customers can benefit from a complete beverage program from one delivery source. Learn more at water.com Customer Account 17220042677859 KIM ROTT Invoice Date: 05 -26 -12 CARMEL CITY COURT Invoice 2677859 052612 1 CIVIC SQ CARMEL, IN 46032 Purchase Order Date Transaction Details Qty. Each Amount Previous Balance 121.67 04 -30 -12 P207897 Payment Check 207897 Thank You Remaining Balance R121222494748 WHITE HOT AND COLD COOLER RENTAL 1.0 13.50 13.50 05 -10 -12 T121313042004 HINCKLEY SPRINGS 5G DRINKING WATER 2.0 9.99 19.98 5.0 GALLON BOTTLE DEPOSIT 2.0 6.00 12.00 5.0 GALLON BOTTLE RETURN -2.0 6.00 -12.00 Rec'd By: Not Available or Refused 05 -24 -12 T121453042042 HINCKLEY SPRINGS 5G DRINKING WATER 2.0 9.99 19.98 5.0 GALLON BOTTLE RETURN -2.0 6.00 -12.00 5.0 GALLON BOTTLE DEPOSIT 2.0 6.00 12.00 Rec'd By: Not Available or Refused 05 -24 -12 74828024 ENERGY SURCHARGE 1.0 2.47 2.47 Total New Charges 55.93 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 products, check your next delivery, pay our bill and much more. Log on today! -L 30356 -P -0034 Previous Balance Payment Total New Charges Pay This Amount $121.67 $55.81 $55.93 $121.79 Write the complete account number on your check. Detach remittance and mail with payment in the enclosed envelope. To pay online go to www.HinckleySphngs.comv How to Read Your Statement -WB- Important Monthly Promotions: Upcoming Delivery Dares We Deliver! Register online for access to your duty 3009 N� 1009 Botl W Delivery Calendar: M�a;,° asp g B.d „F ,F. a "A; account. You can view and pay your bill, FUw Your scheduled deliveries for M me„ �^^ssa• check delivery schedule and order the next three months.T� products all online. nM Customer Account Number: For prompt service, please use this Bottle Deposits: number when referring to your account. T° Highlights bottle deposits and returns. 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.: BM m ®p „o�0 Total New Charges: This information rovides totals for p n° Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail using business envelope provided. ,M.,B.m,,.a.w,” ",.a, 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 660579, 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 our letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion y g g 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. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 C 4 i/V /Qi�IG Purchase Order No. Po 8 d x 0 s Terms f L ft 7�( 7 SQ 6 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) S 02260 _.7 -6 k EI /4910 6,,L6& r217 W 5Y Total 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. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF PC) �ox ID��S7 -DA- ,LLr'+ S rX 7S a (a (a ON ACCOUNT OF APPROPRIATION FOR C t Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 93 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 20 Cost distribution ledger classification if Title claim paid motor vehicle highway fund 1- 800-4- WATERS (1- 800 492 -8377) www.HinckleySprings.com Upcoming Delivery Dates Hinckiey. 6UMAlb Springs We Deliver! June July I�1U USt B ott l ed Water F Coffee Thursday, 14 Thursday, 12 Thursday, 9 Enjoy premium coffee and tea brands at your home or office. Thursday, 28 Thursday, 26 Thursday, 23 With the addition of Standard Coffee to our service options, customers can benefit from a complete beverage program from one delivery source. Learn more at water.com. Customer Account 17209463083945 JOE ACCOUNTS PAYABLE Invoice Date: 06 -02 -12 CITY OF CARMEL UTILITIES 9609 HAZEL DELL PKWY Invoice 3083945 060212 INDIANAPOLIS, IN 46280 Purchase Order Date Transaction Details Qty. Each Amount Previous Balance 409.05 05 -11 -12 P208320 Payment Check 208320 Thank You 234.71 Remaining Balance 174.34 R121381797710 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.00 11.00 05 -17 -12 T121383042003 HINCKLEY SPRINGS 5G DRINKING WATER 5.0 9.99 49.95 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 3.0 3.69 11.07 5.0 GALLON BOTTLE RETURN -5.0 6.00 -30.00 5.0 GALLON BOTTLE DEPOSIT 5.0 6.00 30.00 Recd By: Not Available or Refused 05 -31 -12 T121523042006 HINCKLEY SPRINGS 5G DRINKING WATER 7.0 9.99 69.93 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 7.0 3.69 25.83 5.0 GALLON BOTTLE RETURN -7.0 6.00 -42.00 5.0 GALLON BOTTLE DEPOSIT 7.0 6.00 42.00 Rec'd By: Not Available or Refused 05 -31 -12 75095486 ENERGY SURCHARGE 1.0 2.47 2.47 Total New Charges 211.25 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 products, check your next delivery, pay your bill and much more. Log on today! 30356 -P -0034 Previous Balance Payment C !!lNew Charges Pay This Amount $409.05 $234.71 7t 211.25 $385.59 O Write the complete account number on your check. Detach remittance and mail with payment in the enclosed envelope. To pay online go to wwwAinckleySprings.com 0 How to Read Your Statement Important Monthly Promotions: We Deliver! Register online for access to your -.:aw i+y zro9 Auqus.l009 eww ww.rm.a� caw Delivery Calendar. account. You can view and pay your bill, Your scheduled deliveries for m;; check delivery schedule and order the next three months. products all online. Customer Account Number: Bottle Deposits: For prompt service, please use this Highlights bottle deposits and returns. number when referring to your account. 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: This information provides totals for G m Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail A 92 B S 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 660579, 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 our letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion Y 9 9 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. F Prescrd by orm counts ACCOUNTS PAYABLE VOUCHE Form No. 301 -S (Rev. 19951 TO L.L,4, P2tvvs l o ADDRESS Invoice Date Invoice Number Item Amount I 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 19 Signature Title 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. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS SANITATION DEPARTMENT ACCT. CARMEL, INDIANA NO Favor Of I 13 oD Total Amount of Voucher Deductions Amount of Warrant Month of 19 VOUCHER RECORD No Collection System Operation Plant Commercial General Undistributed Construction Depreciation Reserve Stock Accounts Merchandise Total Allowed Board Members Filed BOYCE FORMS SYSTEMS 1- 800 -382 -8702 325