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Home My WebLink About213157 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1 ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIANA CARMEL, INDIANA 46032 PO BOX 9001099 CHECK AMOUNT: $2,735.55 ?� LOUISVILLE KY 40290-1099 CHECK NUMBER: 213157 CHECK DATE: 9/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4350101 20711 132 . 00 TRASH SERVICE 651 5023990 07610013167 2, 603 . 55 OTHER EXPENSES ��f REPUBLIC CITY OF CARMEL BROOKSHIRE GOLF Invoice SERVICES Page 1 of 2 832 Langsdale Ave Indianapolis,IN 46202-1150 Payments/Adjustments ' Date Description Reference Amount 08/25 Payment-Thank You 211925 -$132.00 Account Number 3-0761-0035460 Current Invoice Charges Invoice Date August 31,2012 Brookshire Golf Course 12120 Brookshire Pkwy (Li) CSA 002765 Invoice Number 0761-001314983 Carmel,IN Previous Balance $132.00 Payments/Adjustments -$132.00 1 -Front Load(8 Yd) Scheduled Service (S1) Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount Current Invoice Charges $132.00 08/31 Basic Service 09/01/12-09/30/12 $132.00 $132.00 Current Invoice Charges $132.00 o o. g . . $132.00 Due By: 09/20/12 . . ® Customer Service ,(317)917-7300 n ; 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. DAYS 132.00 0.00 0.00 0.00 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 When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not receive your check back from your financial institution.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.electron icpayments.orq 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. 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)) 08/31/12 0761-001314983 Trash $132.00 I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Republic Services#761 IN SUM OF$ P. O. Box 9001099 Louisville, KY 40290-1099 $132.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 20711 1 0761-0013149831 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 Tuesday, September 11, 2012 7::� Director, Ir Brooks Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund ewREPUBLIC CARMEL UTILITIES HHW Invoice 44 SERVICES 832 Langsdale Ave Page 1 of 3 Indianapolis,IN 46202-1150 Payments/Adjustments QtUI Date Description Reference Amount 08/10 Payment-Thank You 211440 -$3,369.30 o Account Number 3-0761-1163292 Current Invoice Charges Invoice Date August 31,2012 Carmel Utilities Hhw 901 N Range Line Rd (1-1) CSA 3292121010 Invoice Number 0761-001316770 Carmel,IN Previous Balance $6,585.45 Payments/Adjustments -$3,369.30 1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled Unpaid Balance $3,216.15 Date Description Reference QUantl Unit Price Amount Current Invoice Charges $2,603.55 08/03 Basic Service 1.0000 $153.15 $153.15 Receipt Number 96839 08/08 Basic Service 1.0000 $153.15 $153.15 Receipt Number 98878 08/15 Basic Service 1.0000 $153.15 $153.15 Lpg,yvm o Receipt Number 2120 $5,81 99.70 08/17 Basic Service Bill Kellam 1.0000 $153.15 $153.15 Receipt Number 4290 Due By: 09/20112 08/17 Basic Service Bill Kellam 1.0000 $153.15 $153.15 Receipt Number 4522 0 0 0 08/21 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 Customer Service (317)917-7300 08/28 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 1 -Rolloff(30 Yd) Scheduled Service (S3) Comingled 0 0 0 o Date Description Reference Quanti Unit Price Amount 08/01 Basic Service 1.0000 $153.15 $153.15 Effective 4/16/2012:SERVICE INTERRUPTION Receipt Number 37829 POLICY CHANGE All accounts with a balance over 08/03 Basic Service 1.0000 $153.15 $153.15 60 days vAll experience a service interruption unless Receipt Number 37829 prior arrangements are made. 08/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 08/08 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 08/10 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 100MURREAT,FM,. ,, 3b DAYxS '" ;60,;DAYSNSG.' m;L 90+DAYS,-.,V 2,603.55 _ �3 216..1 0.00 0.00 ,J---To pay 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. 001012-000002-000002-002024 2307547 2240ST03 1 3 Page 3 of 3 CARMEL UTILITIES HHW Republic Services #761 Account Number 3-0761-1163292 5 ttW SERVICES REPUBLIC 832 Langsdale Ave 14A SERVICES Date August 31,2012 Invoice Number 0761-001316770 Indianapolis, IN 46202-1150 Current Invoice Charges Date Description Reference Quantity Unit Price Amount 08/15 Basic Service 1.0000 $153.15 $153.15 Receipt Number 37829 08/21 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 08/23 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 08/28 Basic Service 1.0000 $153.15 $153.15 _ Receipt Number 5831 08/30 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 Current Invoice Charges $2,603.55 Fs:� 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 9/18/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/18/2012 0761001316 $2,603.55 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 # 125754 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 07610013167 01-736H-08 $2,603.55 Voucher Total $2,603.55 Cost distribution ledger classification if claim paid under vehicle highway fund