210525 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA MECK AMOUNT: $26.40
CARMEL, INDIANA 46032 PO BOX 9001099
LOUISVILLE KY 40290 -1099 CHECK NUMBER: 210525
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350900 07611235356 26.40 OTHER CONT SERVICES
eW REPUBLIC CITY OF CARMEL Invoice
tl•21 SERVICES
Page 1 of 2
832 Langsdale Ave
Indianapolis, IN 46202 -1150
Payments /Adjustments
G1 Date Description Reference Amount
06/25 Payment Thank You 210113 $52.80
0 06/06 Inv# 001200564 Dated 05/25/12 $119.01
Account Number •3- 0761- 0034749 For Site 00001 Service Group 01
Re: Basic Service
Invoice Date June 25, 2012
Invoice Number 0761- 001235356 Current Invoice Charges
Previous Balance $171.81
Payments /Adjustments 171.81 Communications Department 31 1st Ave NW (L1) CSA 002772
Unpaid Balance $0.00 Carmel, IN
Current Invoice Charges $26.40
1 Front Load (4 Yd) Scheduled Service (S4)
Date Description Reference Quanti Unit Price Amount
06/25 Basic Service 07101/12- 07/31/12 $26.40 $26.40
o Current Invoice Charges $26.40
$26.40
Due By: 07/15/12
0 0 0
0
Customer Service (317) 917 -7300
00 0 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.
26.40 0.00 0.00 0.00
To pay on -line or sign up for
convenient auto pay, go to: A 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 3- 0761 0034749 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transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not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. WARRA NO.
ALLOWED 20
Republic Services
IN SUM OF
P.O. Box 9001099
Louisville, KY 40290 -1099
$26.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT
Board Members
1115 1 0761 0012353561 43- 509.00 1 $26.40 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
Monday, July 02, 2012
Director
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))
06/25/12 0761 001235356 $26.40
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