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Home My WebLink About214676 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 `�. ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $303.65 CARMEL, INDIANA 46032 PO BOX 660579 9yON�+ DALLAS TX 75266-0579 CHECK NUMBER: 214676 CHECK DATE: 11/20/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 3083945 303 . 65 OTHER EXPENSES wwwMinckleySprings.com Upcoming Delivery Dates Hinckiey 8TIMA% Springs We Deliver! November December Janua Bottled Water• Filtration • Coffee Thursday, 1 Thursday, 13 Thursday, 10 We are doubling our commitment to the cause! Athena Thursday, 15 Thursday, 27 Thursday, 24 announces a minimum contribution of$2 million to support Thursday,29 breast cancer care, awareness, research and education by 2014. Support the cause by adding a case of Athena to your order today! Customer Account#: 17209463083945 JOE ACCOUNTS PAYABLE Invoice Date: 10-2:;-12 CITY OF CARMEL UTILITIES Invoice#: 3083945 102012 9609 HAZEL DELL PKWY INDIANAPOLIS, IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 314.86 Payment 0.00 Remaining Balance 314.86 R122781797710 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.99 9.99 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 1'.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.`0 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 10-04-12 T122783042007 HINCKLEY SPRINGS 5G DRINKING WATER 12.0 9.99 1i Q' CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 2.0 3.69 5.0 GALLON BOTTLE RETURN -12.0 6.00 5.0 GALLON BOTTLE DEPOSIT 12.0 6.00 ENERGY SURCHARGE 1.0 3.14 Recd By: Not Available or Refused 10-18-12 T122923042010 HINCKLEY SPRINGS 5G DRINKING WATER 8.0 9.99 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 2.0 3.69 .38 HINCKLEY SPRINGS 5G DISTILLED WATER 1.0 10.49 V149 5.0 GALLON BOTTLE DEPOSIT 8.0 6.00 46.00 5.0 GALLON BOTTLE DEPOSIT 1.0 6.00 6.00 5.0 GALLON BOTTLE RETURN -7.0 6.00 -42.00 Recd By: Not Available or Refused Managing your account is now at your fingertips. Take advantage of many time-saving options C. check available on water.com. Save paper when you sign up for einvoice order additional products, r next delivery,pay our bill and- uch Lo n today! 30356-P-0037 Previous Balance C::=:D Total New Charges ° Pay This Amount $314.86 $303.65 $618.51 Write the complete account number on your check.betach remittance and mail.with.pay ent in the.enclosed,eme op ._7o pay-online go.to__www_HinckleySprirs� - How to Read Your Statement Important Monthly Promotions: we D.1-0 �^� Register online for access to your ,uty account.You can view and pay your bill, Delivery Calendar: "°°°'"" check delivery schedule and order Your scheduled deliveries for the next three months. products all online. Customer Account Number: "°" Bottle Deposits: For prompt service,please use this Highlights bottle deposits and returns. number when referring to your account. :� ,,,, " Easy to Pay: ° Pay your invoice through the mail,online at Summary: w www.water.com or call us to expedite your Previous balance and posted remittance with automatic credit card payments payments since last bill. ®o,�o tea • _ - C t Total New Charges: This information provides totals for Mail Remittance With Payment To: various products and transactions. °-- c:.r.:m: Please detach remittance and mail U= : using business envelope provided. Important Monthly-Message-- X.°.,aE°=„NU.•. o..,,..f... kk;ra........:...:.:..... — — — - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 our letter,give us the following information: OPT OUT NOTICE:If you do not wish to participate in this check conversion Y 9 9 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. VOUCHER # 126062 WARRANT # ALLOWED i 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 3083945 102( 01-7202-06 $303.65 i i Voucher Total $303.65 ' Cost distribution ledger classification if ' claim paid under vehicle highway fund i 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 11/8/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/8/2012 3083945102 $303.65 hereby certify that the attached invoice(s), or bill(s) is (are) true and ,orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer