215220 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 00352479 Page 1 of 1
ONE CIVIC SQUARE WASTE MANAGEMENT
CARMEL, INDIANA 46032 BILL PAYMENT CENTER CHECK AMOUNT: $80.89
PO Box 4648 CHECK NUMBER: 215220
CAROL STREAM IL 60197-4648
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350101 176538424795 80 . 89 TRASH COLLECTION
Page 1 of 3
" ��� Customer: BROOKSHIRE GOLF CLUB
!� !/O Account Number: 600-0001510-2479-1
WASTE MANAGEMENT® �At Invoice Date: 12/01/2012
Waste Management Invoice Number: 1765384-2479-5
Attn: Port-O_Let Billing Due Date: Due Upon Receipt
1411 Opus Place,Suite 400 WM ezPay Account ID: 00001-29232-93008
Downers Grove,IL 60515
(800)443-5646 Customer Service
(866)863-4834 FAX Total Current Charges Total Amount Due
:YAccount Su`mmarY
Please pay total amount due.Thank you for your
Description _ _ _ business.
Previous Balance 228.14
Total Credits and Adjustments 0.00
Total Payments Received 228.14-
Total Current Charges 8_0.89
Total Amount Due 80.89
Total Amount Past Due 0.00
-
_r.—. ,., WASTE MANAGEMENT APPRECIATES THE OPPORTUNITY
CFsEinif^2 Perroci :nfov so,12-SE IC - .s A ._:.� F
r r<,, r "a :. : ?.. Y ra,-,'b ,- TO SERVE YOU.TO INSURE PROPER APPLICATION OF YOUR
Description Amount PAYMENT,PLEASE USE THE ENCLOSED REMITTANCE STUB
Commercial 80.89 AN-1-1 URN ENVELOPE.THANK YOU
Total Current Charges $� 89 Customers carrying a balance due of 60 days or greater are
subject to service cutoff and an automatic resume fee.
If full payment of the invoiced amount is not received within 30 days of the invoice date, you
will be charged a monthly late fee of 1.5% of the unpaid amount, with a minimum monthly
charge of$5.00, or such lesser late fee allowed under applicable law, regulation or contract.
Additionally, if your service is suspended for non-payment,you may be charged a resume fee
to restart your service. For each returned check, a fee will be assessed on your next billing
equal to the maximum amount permitted by applicable state law.
Want to pay this bill on-line?Visit www.wm.com and click on
My Account to make a convenient,secure payment.
;;Current Due,. ,Over:,30,, a Over<60�:x: " Over,90
xy
., r.Ch..lit r.t..-. .. L�Y l:Yn. ., 4 tn.,£..�;. ;!2vitr'.:..
80.89 0.00 0.00 0.00 0.00 80.89
Page 3 of 3
Customer: BROOKSHIRE GOLF CLUB
Account Number: 600-0001510-2479-1
WASTE MANAGEMENT Invoice Date: 12/01/2012
Waste Management Invoice Number: 1765384-2479-5
Attn: Port-O_Let Billing Due Date: Due Upon Receipt
1411 Opus Place,Suite 400 WM ezPay Account ID: 00001-29232-93008
Downers Grove,IL 60515
Servlce;Locatiori 1600°1510 Brookshire Golf:„Club 42120nBrooksliire"Fkw : Carmel,'�In 46033;3314 sroti', :
Date Ticket Description Quantity U/M Rate Amount
11/15/12 Prorate auto pol on vac status 1.00 80.89
I
Total Current Charges 80.89
Y,7!
.gym+,,,c�,��+:. �I,I ,aa:w-��3�'s��.*r✓,. .� "�,� ..t'�r...;„ :ih_5
Payment-thank you 228.14-
Total Payments Received 228.14-
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FOR CHANGE OF ADDRESS OR ANY SERVICE ISSUES CONTACT NUMBER ON PAGE 1
VOUCHER NO. WARRANT NO.
Waste Management ALLOWED 20
IN SUM OF $
P.O. Box 4648
Carol Stream, IL 60197-4648
$80.89
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
_ Board Members
1207 1 1765384-2479-5I 43-501.01 1 $80.89 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
Friday, November 30, 2012
14 ,
Director, BrookshirgVGolf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/01/12 I 1765384-2479-5 I Trash I $80.89
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