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Home My WebLink About214058 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1 40 ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA CHECK AMOUNT: $2,429.25 ,+a CARMEL, INDIANA 46032 PO Box 9001099 LOUISVILLE KY 40290-1099 CHECK NUMBER: 214058 CHECK DATE: 10/23/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4350101 20711 132 . 00 0761-001351371 651 5023990 1352994 2, 297 .25 OTHER EXPENSES 4R"AREPUBLIC CITY OF CARMEL BROOKSHIRE GOLF Invoice Zk*4 SERVICES Page 1 of 2 832 Langsdale Ave Indianapolis,IN 46202-1150 Current Invoice Charges Q' m Brookshire Golf Course 12120 Brookshire Pkwy (1-1) CSA 002765 Carmel,IN o 1 -Front Load(8 Yd) Scheduled Service (S1) Account Number 3-0761-0035460 Invoice Date September 30,2012 Date Description Reference Quantity Unit Price Amount Invoice Number 0761-001351371 09/30 Basic Service 10/01/12-10/31/12 $132.00 $132.00 Previous Balance $132.00 Current Invoice Charges $132.00 Payments/Adjustments $0.00 Unpaid Balance $132.00 Current Invoice Charges $132.00 o � 6 $264.00 Due By: 10/20/12 0 0 0 Customer Service (317)917-7300 00 0 Effective 4/16/2012:SERVICE INTERRUPTION POLICY CHANGE All accounts with a balance over 60 days will experience a service interruption unless prior arrangements are made. CUR�2Ef�i O LiAYSi: 8t1.17AY.S,,,, .0 9t!w f�AX" ,. 132.00 132.00 0.00 0.00 To pay on-line or sign up for Past Due Balance $132.00 convenient auto pay, go to: DA • 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 When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not receive your check back from your financial institution.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.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. 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)) 09/30/12 1 0761-0013513711 Trash 1 $132.00 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 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. ACCT#!TITLE I AMOUNT Board Members 20711 1 0761-001351371 I 43-501.01 I $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 Wednesday, October 10, 2012 t� Director, Brook , ire Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund I.N. REPUBLIC CARMEL UTILITIES HHW Invoice SERVICES Page 1 of 3 832 Langsdale Ave Indianapolis,IN 46202-1150 Payments/Adjustments Date Description Reference Amount 09/04 Payment-Thank You 212356 -$3,216.15 Account Number 3-0761-1163292 Current Invoice Charges Invoice Date September 30,2012 Carmel Utilities Hhw 901 N Range Line Rd (1-1) CSA 3292121010 Invoice Number 0761-001352994 Carmel,IN Previous Balance $5,819.70 Payments/Adjustments -$3,216.15 1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled Unpaid Balance $2,603.55 Date Description Reference Quanti Unit Price Amount Current Invoice Charges $2,297.25 09/04 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 09/06 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 09/11 Basic Service 1.0000 $153.15 $153.15 mulu Receipt Number 3853 $4,900'80 09113 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 Due By: 10/20/12 09/18 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 09/25 Basic Service 1.0000 $153.15 $153.15 0 0 o Receipt Number 3853 Customer Service (317)917-7300 09/27 Basic Service 1.0000 $153.15 $153.15 Receipt Number 3853 1 -Rolloff(30 Yd) Scheduled Service (S3) Comingled o © o o Date Description Reference Quantity Unit Price Amount • 09/04 Basic Service 1.0000 $153.15 $153.15 Your next Invoice may reflect a rate adjustment,if Receipt Number 5831 you have any questions after receiving your next 09/06 Basic Service 1.0000 $153.15 $153.15 invoice please contact us. Receipt Number 5831 Effective 4/16/2012:SERVICE INTERRUPTION 09/11 Basic Service 1.0000 $153.15 $153.15 POLICY CHANGE All accounts with a balance over Receipt Number 5831 60 days will experience a service interruption unless 09/13 Basic Service 1.0000 $153.15 $153.15 prior arrangements are made. Receipt Number 5831 09/18 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 Gl1RREN C.. JUZ, DAY I= 60,'DAYS 2 X90--MAYS 0.00 0.00 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. 001008-000002-000002-002016 2308503 2240ST03 1 3 Page 3 of 3 CARMEL UTILITIES HHW Republic Services #761 R Account Number 3-0761-1163292 9w REPUBLIC Invoice Date September 30, 2012 832 Langsdale Ave SERVICES Invoice Number 0761-001352994 Indianapolis, IN 46202-1150 Current Invoice Charges Date Description Reference Quantity Unit Price Amount 09/20 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 09/25 Basic Service 1.0000 $153.15 $153.15 Receipt Number 5831 09/27 Basic Service 1 A000 $153.15 $153.15 Receipt Number 5831 Current Invoice Charges $2,297.25 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 10/15/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/15/201; 07610013524 $2,297.25 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 # 125969 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 07610013529 01-736H-08 $2,297.25 Voucher Total $2,297.25 Cost distribution ledger classification if claim paid under vehicle highway fund