215140 12/04/2012 a CITY OF CARMEL, INDIANA VENDOR: 366730 Page 1 of 1
ONE CIVIC SQUARE JOSEPH AND RHEA PERRIN CHECK AMOUNT: $771.25
CARMEL, INDIANA 46032 10580 GREENTREE DRIVE
CARMEL IN 46032 CHECK NUMBER: 215140
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
604 5023990 771 .25 REIMBURSEMENT AGREE
December 3, 2012, 2012
Memo To: Cindy Sheeks
From:John Duffy
RE: Reimbursement to Joseph and Rhea Perrin—10580 Greentree Drive
Cindy,
When Carmel Utilities acquired the then Indianapolis Water Customers in Carmel/Clay Township,
Carmel Utilities was given responsibility for existing Water Reimbursement Agreements. One of these
Agreements was Main Extension Agreement NO. D-02-163 between Joseph and Rhea Perrin and
Indianapolis Water.
Crystal Bush (Downey) resides at 10580 Greentree Drive . In order to receive water service at this
address they paid Indianapolis Water their allotted portion to extend a 8" water main water main 667
ft. on Greentree Drive. As part of this Agreement she is to receive a reimbursement for a "subsequent
connector" in the amount of$771.25.This connection has occurred at 10575 Greentree Drive. Per the
reimbursement Agreement the Perrins are owed a reimbursement of$771.25.
Submitted By,
?//)(/Y
John Duffy
Indianapolis �, MAIN EXTENSION AGREEMENT NO. D-02-163 ,r
HATER Contract Author: ?LC
Serving Ce,hmi Indiana PROJECT NAME AND LOCATION Greentree Dr., 10550-10585
TH'S AGREEMENT,entered into on the (date)of Fe U 4 z y (month)20 03 by and between
c
j2 b R.='J k'hC:Lt 1,-2 i 1,) ("Depositor")and U.S.Filter Operating Services,Inc.("USFilter")and the Consolidated City of �
Indianapolis,Department of Waterworks(the"Department"),
WITNESSES THAT:
WHEREAS,Department owns the water system serving the greater Indianapolis area and certain areas in the surrounding vicinity(the"Waterworks");and
WHEREAS, USFOS operates and maintains the Waterworks under a long-term contract with the Department;and
WHEREAS,the Depositor and other prospective customers have requested the Department to extend its main so as to make water utility service
available to their parcels,and USFilter and the Department are willing to do so upon the following terms and conditions,
NOW THEREFORE,in consideration of the covenants,agreements and undertakings hereinafter provided,and each act to be performed pursuant
hereto,the parties agree that:
1. Standard Conditions. This agreement is subject to the Department's Standard Conditions for Main Extensions,a copy of which may be obtained
upon request.
2. Main Extension and Cost. The Department will install,own,operate and maintain the main extension,which will consist of:
667 feet of water main pipe in Greentree Drive from Greentree Drive to a point South of 106th Street
fire hydrants located as determined by policies of the Department and public fire protection
agencies;and related appurtenances.
The total cost of the main extension is$18,220.00
3. Amount of Immediate Revenue Allowance. In determining the total required deposit,the Department has allowed an immediate three-year
revenue allowance in the amount of$735.00 per depositor for full cash payment contracts.
4. Total Number of Depositors. The number of depositors required prior to the Department commencing construction of the main extension is 4.
5. Cash Deposit Contract. Concurrently with the execution of this agreement,the Depositor has paid to the Department the sum of$4,021.00,which
amount represents the Depositor's share of the total required deposit. This amount includes a$201.00 connection fee.
6. If Deposits Collected Are Less Than Total Required Deposit. Counterparts of this Agreement are being provided to each Depositor. If the
Department does not receive from each Depositor an executed counterpart of this Agreement,together with the cash deposit required to be made by
such Depositor,so that the Department has received the number of deposits required in paragraph 4 above,the Department may either(1)cancel
the main extension and return the deposits collected in which event this Agreement shall be void and of no effect,or(2)proceed with the main
extension,in which event the amount by which the total required deposit exceeds the deposits collected shall be identified as the Department's
'.repayable investment,"and no refunds will be made to the Depositors until the Department has recovered all of its repayable investment,with
interest at the annual rate of 8.5%.
7, Subsequent Connector's Fee. Each subsequent connector shall be required to pay to the Department the amount of$4,021.00 for each parcel to
be connected to,and receive service from,the main extension.. This amount includes a$201.00 connection fee. This subsequent connector's fee is
collected for ten years from the in-service date of this main extension.
8. Refunds. Any refunds to the Depositorwitti respect to his deposit will be determined and made in accordance with the refund provisions of the
Department's Standard Conditions for Main Extensions.
9. Connection and Use. The Department will notify the Depositor of the in service date of the main extension,and the Depositor shall connect to the
main extension and commence water service from the Department within nine months after said in-service date. Water service from the Department
shall be used by the premises so connected to the main extension for a period not less than five(5)years. Depositor acknowledges that the cost of
the service pipe from the main extension to the premises shall be paid by the Depositor as a separate expense. In accordance with 3271AC 8-
10-5,a private well,or water lines connected to a private well,shall not be connected in any manner to water lines supplying water from
the public water supply system to the premises served.
10. Unforeseen Circumstances. The Department reserves the right to terminate this agreement,without prejudice to the Department,in the event
contaminated soil is encountered. In such an event,the Department shall notify Depositor of the termination in writing and may then propose(but is
not required to)an alternative route and the use of substitute pipe materials and appurtenances as the situation,in Department's sole discretion
requires. All such additional costs of the excavation and disposal of contaminated soil,environmental testing,substitute pipe and appurtenances
used for installing the water main in such site shall be borne by the Depositor.
11. Grant of Easement. If required,Depositor will grant an easement at no cost to the Department for the water main installation.
DEPOSITOR
G3o Gl'eelo 7Tet
Corporati n,Depart I.or Individual's NAME Mailing Address
B ONCE. 4GO:5
Signature Address of Property td be Served Water by IWC
Taxpayer ID or Soc.Sec.No. Phone Number(Daytime): L5/'7 2 Yid—14:89
trvErrlO ,.,OF�RAnJitr3T_ {ChecKOne)_,,.., ...0 . ..4< .. :.;,,;• ..:>':::<»: _ �.�
Method 1 -Cash Deposit with Revenue Allowance
_Full Cash Payment: $4,021.00
INDIANAPOLIS WATER CONSOLIDATED el ��F IND Af�APOLIS
J Department of WAt o}Ks /
Milton L".Keys,Dir, -tor
Asset Management Printed Name: Carlton Curry,,
Title: Director-of Contracts and Operations
Date Signed:_ ��a
Prescribed by State Board of Accounts
Form No.301 (Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I 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
' 19
Signature Title
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.
19
O er Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
I
CARMEL, INDIANA NO.
Favor Of
cRuhed �603�L
Total Amount of Voucher $
Deductions
z
,o z5
Amount of Warrant $
Month of 19
Acct.
VOUCHER RECORD No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
i
Total
Allowed
Board of Control
Filed
i
Official Title
BOYCE FORMS.SYSTEMS 1-800-382-8702 325