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Home My WebLink About216069 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CARMEL, INDIANA 46032 PO Box 660576 CHECK AMOUNT: $234.42 DALLAS TX 75266-0579 CHECK NUMBER: 216069 CHECK DATE: 1/9/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 30839451215 234 .42 MATERIALS & SUPPLIES 1-800-4-WATERS (1-800-492-8377) www.HinckleySprings.com Upcoming Delivery Dates Hinckley 8TAIIDA% Springs We Deliver! December January nuary February Bottled Water• Filtration • Coffee Thursday, 27 Thursday, 10 Thursday, 7 Thursday, 24 Thursday, 21 guy any available flavor of Arnold Palmer Sticks(30ct) or AriZona Tea Sticks(30ct)at$13.99 and get a case of.5 liter water bottles for FREE (24 bottles/case) Ask your RSR or call 800.4.WATERS to order today! Offer Expires 12/28/12 Customer Account#: 17209463083945 JOE ACCOUNTS PAYABLE Invoice Date: 12-15-12 CITY OF CARMEL UTILITIES 9609 HAZEL DELL PKWY Invoice#: 3083945 121512 INDIANAPOLIS, IN 46280 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 560.79 12-10-12 P214676 Payment-Check-214676-Thank You -303.65 Remaining Balance 257.14 11-29-12 T123343042009 HINCKLEY SPRINGS 5G DRINKING WATER 6.0 9.99 59.94 HINCKLEY SPRINGS 5G DISTILLED WATER 1.0 10.49 10.49 5.0 GALLON BOTTLE DEPOSIT 6.0 6.00 36.00 5.0 GALLON BOTTLE DEPOSIT 1.0 6.00 6.00 5.0 GALLON BOTTLE RETURN -7.0 6.00 -42.00 ENERGY SURCHARGE 1.0 3.24 3.24 R123341797710 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.99 9.99 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 9.50 9.50 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 WHITE ROOM TEMP AND COLD COOLER RENTAL 1.0 11.49 11.49 12-13-12 T123483042008 HINCKLEY SPRINGS 5G DRINKING WATER 9.0 9.99 89.91 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 2.0 3.69 7.38 5.0 GALLON BOTTLE DEPOSIT 9.0 6.00 54.00 5.0 GALLON BOTTLE RETURN -9.0 6.00 -54.00 Rec'd By: Not Available or Refused Total New Charges 234.42 Managing your account is now at your fingertips. Take advantage of many time-saving options available on water.com. Save paper when you sign up for einvoice,order additional products, check your next delivery,pay your bill and much more. Log on today! 30356-P-0037 Previous Balance Payment Total New Charges ° Pay This Amount $560.79 $303.65 $234.42r 34.42 V Write the complete account number on your check.Detach remittance and mail with payment in the en I sed ±C. •; How to Read Your Statement 14001-WATERS °'°" ..,.,Wm Important Monthly Promotions: up<°'^'^9°e'Ne'YDdOPf 1�4 we oelrveri ^�, Register online for access to your Delivery Calendar: � 3 W" " :a o a g.ga�m account.You can view and pay your bill, a m�w.arps New e�N Ftii� Your scheduled deliveries for M° ,, n;w„"•°eom�..�. check delivery schedule and order 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. .�s,. °„ P.„""°"=P" Easy to Pay: Pay your invoice through the mail,online at Summary.. www.water.com or call us to expedite your Previous balance and posted remittance with automatic credit card payments payments since last bill. .u,„eaNanimn mn°n Cryxb/,M�.'..°FU„:,r„kv NP�IMf�d iad/,w ,*.5,,_n sP.nxm�o."F, Total New Charges: This information provides totals for ail Remittance With Payment To: various products and transactions. �;Kw Please detach remittance and mail „;,... ❑�u a :�- a using business envelope provided. ,N.II R-11 c.Wlt"Pl,—1 T"t Important Monthly Message - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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). Fn•' ^f^~^^°•^^.Tease write DS Waters of America,Inc.at P.O.Box 660579,Dallas,TX 75266-0579. VOUCHER # 126382 WARRANT # ALLOWED 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 30839451215 01-7202-05 $234.42 Voucher Total $234.42 Cost distribution ledger classification if claim paid under vehicle highway fund ?—v m �)�- 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 12/31/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/31/201; 3083945121! $234.42 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