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Home My WebLink About211115 07/18/2012 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $377.23 CARMEL, INDIANA 46032 PO Box 660579 o� DALLAS TX 75266-0579 CHECK NUMBER: 211115 CHECK DATE: 7/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 30839450630 377 . 23 MATERIALS & SUPPLIES 1-800-4-WATERS 1-800-492-8377 www.HinckleySorincis.com Upcoming Delivery Dates Hinckiey 6UMA%Springs We Deliver! July August September Bottled Water• Filtration • Coffee Thursday, 12 Thursday, 9 Thursday, 6 Enjoy premium coffee and tea brands at your home or office. Thursday, 26 Thursday, 23 Thursday, 20 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: 06-30-12 CITY OF CARMEL UTILITIES Invoice#: 3083945 063012 9609 HAZEL DELL PKWY INDIANAPOLIS, IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 385.59 06-07-12 P209183 Payment-Check-209183-Thank You -178.34 06-28-12 P210025 Payment-Check-210025-Thank You -211.25 Remaining Balance -4.00 06-14-12 T121663042003 HINCKLEY SPRINGS 5G DRINKING WATER 9.0 9.99 89.91 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 11.0 3.69 40.59 CUP DISPENSER TRANSPARENT BLUE 4-10 OZ CUPS 1.0 7.99 7.99 5.0 GALLON BOTTLE RETURN -9.0 6.00 -54.00 5.0 GALLON BOTTLE DEPOSIT 9.0 6.00 54.00 WHITE ROOM TEMP AND COLD COOLER Installed Serial 1.0 0.00 0.00 Rec'd By: Not Available or Refused R121661797710 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 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 R1216617977101 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 06-28-12 T121803042006 HINCKLEY SPRINGS 5G DRINKING WATER 13.0 9.99 129.87 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 10.0 3.69 36.90 5.0 GALLON BOTTLE RETURN -11.0 6.00 -66.00 5.0 GALLON BOTTLE DEPOSIT 13.0 6.00 78.00 Rec'd By: Not Available or Refused 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 Total New Charges o Pay This Amount $385.59 $389.59 $381.23 $377.23 0 Write.the.complete account number_on.yourcheck.Detach.remittance.and.mail with,payment in the.enclosed envelope.To.pay_online.go.to_www.HinckleySpdngs.com 0 How to Read Your Statement WATBBfl . ' Important Monthly Promotions: °''"e Wh°"r°.- We Deliver! Register online for access to your � Mae 3009 1Wy 3009 gust 3009 °Nae BW twn Coffee Delivery Calendar: M . �ey3 �, .N account.You can view and pay your bill, Your scheduled deliveries for "° """° M ,3; ` 1Leom° „m " check delivery schedule and order the next three months. products all online. Customer Account Number: ""e m W For prompt service,please use this - Bottle Deposits: number when referring to your account. 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. Total New Charges: a° This information provides totals for < �, M .°; o.°""°"" W o Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail ❑ a�a ❑ �w ra 5 using business envelope provided. IL..LW„J,"--LAI Idd Men Bemiuence Wim reYmem*° Important Monthly Message M,wmeve us i.vss,ee IIILE„ILII„��L�L�� L�,u�� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 your letter,give us the following information: OPT OUT NOTICE:If you do not wish to participate in this check conversion 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. Customer Account.#: 17209463083945 Invoice#: 3083945.-063012 Date Details Qty. Each Amount 06-28-12 75948000 ENERGY SURCHARGE 1.0 2.47 2.47 Total New Charges 381.23 ILI'E.", 23 -" --- - -- - -- -MI120630 BM10-75-000000354 Page 2 of 2 VOUCHER # 125269 WARRANT # ALLOWED 131130 IN SUM OF $ HINCKLEY SPRINGS PO BOX 660579 DALLAS, TX 75266-0579 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 30839450630 01-7202-05 3 .23 371 Voucher Total 381.23 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 131130 HINCKLEY SPRINGS Purchase Order No. PO BOX 660579 Terms DALLAS, TX 75266-0579 Due Date 7/9/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/9/2012 3083945063( $381.23 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