212356 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA MECK AMOUNT: $3,216.15
,\ ?o CARMEL, INDIANA 46032 PO BOX 9001099
�+ o� LOUISVILLE KY 40290-1099 CHECK NUMBER: 212356
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 07610012832 3 , 216 . 15 OTHER EXPENSES
e REPUBLIC CARMEL UTILITIES HHW Invoice SERVICES
832 Langsdale Ave Page 1 of 3
Indianapolis,IN 46202-1150
Current Invoice Charges
x Carmel Utilities Hhw 901 N Range Line Rd (1-7) CSA 32921 21 01 0
Carmel,IN
1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled
Account Number 3-0761-1163292
Invoice Date July 31,2012 Date Description Reference Quantity Unit Price Amount
Invoice Number 0761-001283212 07/02 Basic Service 1.0000 $153.15 $153.15
Previous Balance $3,369.30 Receipt Number 79084
Payments/Adjustments $0.00 07/06 Basic Service 1.0000 $153.15 $153.15
Unpaid Balance $3,369.30 Receipt Number 81389
Current Invoice Charges $3,216.15 07/09 Basic Service 1.0000 $153.15 $153.15
Receipt Number 82017
07/13 Basic Service 1.0000 $153.15 $153.15
Receipt Number 85079
07/18 Basic Service 1.0000 $153.15 $153.15
Receipt Number 87287
0 07/23 Basic Service 1.0000 $153.15 $153.15
6,585.45 Receipt Number 89851
07/27 Basic Service 1.0000 $153.15 $153.15
Due By: 08/20/12 Receipt Number 93109
07/30 Basic Service 1.0000 $153.15 $153.15
® o o Receipt Number 93715
Customer Service (317)917-7300 1 -Rolloff(30 Yd) Scheduled Service (S3) Comingled
Date Description Reference Quantity Unit Price Amount
07/02 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
0 0 0 0 07/05 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
Effective 4/16/2012:SERVICE INTERRUPTION 07/06 Basic Service 1.0000 $153.15 $153.15
POLICY CHANGE All accounts with a balance over Receipt Number 37829
60 days will experience a service interruption unless
prior arrangements are made. 07/09 BBSIC Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/11 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/13 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/16 Basic Service 1.0000 $153.15 $153.15
' RRENT,,' ��30 QAY5 €- 60 DAYS, 0§0 DAYS
3,216.15 3,369.30 0.00 0.00
Y T.n.r,�.._nn..1: s. . ^" ^•tiU.for -P_.act.tlr:iP,R.-a 12
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.
001442-000002-000002-002884 2306528 2240ST03 1 3
Page 3 of 3
CARMEL UTILITIES HHW Republic Services #761
Account Number 3-0761-1163292
5; REPUBLIC Invoice Date — July 31,2012 832 Langsdale Ave
SERVICES Invoice Number 0761-001283212 Indianapolis, IN 46202-1150
Current Invoice Charges
Date Description Reference Quantity Unit Price Amount
Receipt Number 37829
07/18 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/20 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/23 Basic Service 1.0000 $153.15 $153.15 _
Receipt Number 37829
07/25 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/27 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
07/30 Basic Service 1.0000 $153.15 $153.15
Receipt Number 37829
Current Invoice Charges $3,216.15
1 J,-
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 8/20/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/20/2012 0761001283: $3,216.15
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
VOUCHER # 125575 WARRANT # ALLOWED
358593 IN SUM OF $
REPUBLIC WASTE SERVICES OF INDI
PO BOX 9001099
LOUISVILLE, KY 40290-1099
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
07610012832 01-736H-08 $3,216.15
Voucher Total $3,216.15
Cost distribution ledger classification if
claim paid under vehicle highway fund