HomeMy WebLinkAbout216739 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1
ONE CIVIC SQUARE HINCKLEY SPRINGS
CHECK AMOUNT: $218.43
CARMEL, INDIANA 46032 PO BOX 660579
DALLAS TX 75266-0579 CHECK NUMBER: 216739
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1301 4239099 010513 34 .44 OTHER MISCELLANOUS
651 5023990 3083945 183 . 99 OTHER EXPENSES
1-800-4-WATERS 1-800-492-8377 www.HinckleySprings.com
Upcoming Delivery Dates Hlnckiey .C�TAHDARD,
January February March Springs We Deliver!
Bottled Water• Filtration • Coffee
Wednesday, 16 Wednesday, 13 Wednesday, 13 We are doubling our commitment to the cause!. Athena
announces a minimum contribution of$2 million to support
breast cancer care, awareness, research and education by
2014. Support the cause by adding a case of Athena to your
order today!
Customer Account#: 17220042677859
KIM ROTT Invoice Date: 01-05-13
CARMEL CITY COURT Invoice#: 2677859 010513
1 CIVIC SO
CARMEL, IN 46032 Purchase Order#:
Date Transaction# Details Qty. Each Amount
Previous Balance 119.87
12-24-12 P215043 Payment-Check-215043-Thank You -65.42
12-24-12 P215660 Payment-Check-215660-Thank You -54.45
Remaining Balance 0.00
R123462494748 EVEREST BLACK HOT AND COLD COOLER W ITH CUP 1.0 11.25 11.25
12-19-12 T123543042040 HINCKLEY SPRINGS 5G DRINKING WATER 2.0 9.99 19.98
5.0 GALLON BOTTLE DEPOSIT 2.0 6.00 12.00
5.0 GALLON BOTTLE RETURN -2.0 6.00 -12.00
ENERGY SURCHARGE 1.0 3.21 3.21
Rec'd By: Not Available or Refused
Total New Charges 34.44
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 elnvoice,order additional products,
check your next delivery,pay your bill and much more. Log on today!
30356-P-0037
Previous Balance Payment To�Ch Pay This Amo unt$119.87 $119.8n $34.44
Write the complete account number on your check.Detach Femittance and mail with payment in the enclosed erivelope.To pay online gc to www.HinckleySprings.com
How to Read Your Statement 1 8111 i .'e° me.�m Important Monthly Promotions:
u°a mgDo—Dares ., WeDe11Vef, 6D,,.m„q� Register online for access to your
M";`,a°' "„'°6' 09;';°°9 °�"`°"" account.You can view and pay your bill,
Delivery Calendar: ; 'm Fe.a�w„�
Your scheduled deliveries for "° y M° 'a:�° P check delivery schedule and order
”"°"'
the next three months. .",.0 P roducts all online.
Customer Account Number: Bottle Deposits
For prompt service,please use this Highlights bottle deposits and returns.
number when referring to your account.
m, r mq.rv°eA„ re 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 ." °".e.. remittance with automatic credit card payments
payments since last bill. m
Total New Charges:
This information provides totals for Mail Remittance With Payment To:
various products and transactions. Please detach remittance and mail
amo-:,r ❑°uq;:,;; €, using business envelope provided.
IIIII„IIIIII11111.II.II,IIII„.II 1 u.n gemivance witn Payment i°:1
o„ry enur”
Important Monthly Message ""”""Eae,"s""S°zf° IIJIIIIIIILII,„IILIIJIIIIIII
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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 your letter,give us the following information: OPT OUT NOTICE:If you do not wish to participate in this check conversion
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.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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
Lg�// < � ' " C-s Purchase Order No.
(o &C �7- ! Terms
� � S -F Date Due
Invoice Invoice Description Amount
Pat 7 Number (or note attached invoice(s) or bill(s))
S 3 ,779106 0513 2IA-1 Kim 6 A-1 K
Total
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
-{ IJIICKLc � S,%'� i �/ GS IN SUM OF $
Iry
ON ACCOUNT OF APPROPRIATION FOR
3v/f�
Board Members
PO#or D PT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or
r O s 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
20
Sig re
Tit
Cost distribution ledger classification if
claim paid motor vehicle highway fund
1-800-4-WATERS 1-800-492-8377 www.HinckleySprings.com
Upcoming Delivery Dates Himkiey �TAI�DARD;
`J
January February March Springs We Deliver!
Bottled Water• Filtration • Coffee
Thursday, 24 Thursday, 7 Thursday, 7 We are doubling our commitment to the cause! Athena
Thursday, 21 Thursday, 21 announces a minimum contribution of$2 million to support
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: 01-12-13
CITY OF CARMEL UTILITIES Invoice#: 3083945 011213
9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280 Purchase Order#:
Date Transaction# Details Qty. Each Amount
Previous Balance 491.56
12-24-12 P215043 Payment-Check-215043-Thank You -257.14
Remaining Balance 234.42
R123621797710 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 9.50 9.50
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 11.49 11.49
12-28-12 T123636561004 HINCKLEY SPRINGS 5G DRINKING WATER 4.0 9.99 39.96
HINCKLEY SPRINGS 5G DISTILLED WATER 1.0 10.49 10.49
CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 3.0 3.69 11.07
5.0 GALLON BOTTLE DEPOSIT 1.0 6.00 6.00
5.0 GALLON BOTTLE DEPOSIT 4.0 6.00 24.00
5.0 GALLON BOTTLE RETURN -4.0 6.00 -24.00
ENERGY SURCHARGE 1.0 3.21 3.21
Rec'd By:Not Available or Refused
01-10-13 T130103042014 HINCKLEY SPRINGS 5G DRINKING WATER 3.0 9.99 29.97
CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 7.0 3.69 25.83
5.0 GALLON BOTTLE DEPOSIT 3.0 6.00 18.00
5.0 GALLON BOTTLE RETURN -4.0 6.00 -24.00
Total New Charges 183.99
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 elnvoice,order additional products,
check your next delivery,pay your bill and much more. Log on today!
30356-P-0037
Previous Balance Payment �t Total New Charges o Pay This Amount
$491.56 ° $257.14 $183.99 $418.41
0 Write the complete account numtrer on your check.Detach remittance and mail with payment in the enclosed envelope.To pay online go to www.HinckleySprings.com
How to Read Your Statement ..w.=Eas Important Monthly Promotions:
Upcoming Delivery Dates ..-- We Deliver! Register online for access to your
` °
Delivery Calendar: account.You can view and pay your bill,
°,a �e �.�p�.a.p•w,.�rM,D..a.,w..
ter, p
Your scheduled deliveries for , a °,; ;� ;"k•q„ check delivery schedule and order
the next three months. products all online.
Customer Account Number:
For prompt service,please use this - Bottle Deposits:
Highlights bottle deposits and returns.
number when referring to your account. s
Nw
p p Easy to Pay:
p" 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. :-
nnii.Zvi,C7,4, ..q k I(&IIMOd.4,1.,.__,
Total New Charges:
This information provides totals for Mail Remittance With Payment To:
various products and transactions. Please detach remittance and mail
using business envelope provided.
IIIJLLIIIIIII .IIAIILIJIIIII 1 x.n eemm°nce wn"p.y—nt*.:,
Important Monthly Message m.wew°.°51PS6'"* III.IIIJdIIJLJLdJI.III.IIIJI.II
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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 g g 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.