HomeMy WebLinkAbout217685 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL M&ECK AMOUNT: $27,911.95
i, CARMEL, INDIANA 46032 CASHIER OFFICE-MAIL CODE 50-10C H
100 N SENATE AVE CHECK NUMBER: 217685
INDIANAPOLIS IN 46204
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 164503 26, 535 .40 OTHER EXPENSES
601 5023990 164794 1, 376 . 55 OTHER EXPENSES
INVOICE
Please Remit To: Page: 1
INDIANA DEPT OF ENVIRONMENTAL MGMT Invoice No: 000164794
CASHIER OFFICE-MAIL CODE 50-10C Invoice Date: 01/09/2013
100 NORTH SENATE AVENUE Customer Number: CST100026471
INDIANAPOLIS IN 46204 Bill Type: 060
Payment Terms: NET 60
Due Date: 03/10/2013
Bill To:
CARMEL WATER&WASTEWATER
MR JOHN DUFFY AMOUNT DUE: 1,376.55 USD
760 3RD AVENUE SOUTHWEST
SUITE 110
CARMEL IN 46032-2584 7�
Amount Remitted
Note Address Changes Above
6 questions; iedse`caii s'i 7-232-8705
-For-billin
Line Ad' Identifier Description Quantity UOM Unit Amt Net Amount
1 13-IN5229024C-0 PWS Fee - SVC:1449 1.00 EA 1,376.55 1,376.55
- IDEM's Cashier office is now accepting payment by Master Card or Visa between the hours of 9 am to
3 pm Monday through Friday. You may come to the office or call (317) 232-8705. A processing fee of
$1 plus 2% will be charged of the total transaction.
- This annual fee billing is required for active Public Water Systems (to defray the costs of
administering activities of the federal Safe Drinking Water Act) under Indiana Code: IC 13-18-20.5.
9 To view via the internet, visit:
http://www.IN.gov/legislative/ic/code/titlel3/arl8/ch2O.5.html
Fees are based on the activity status as of December 31 of the previous year.
Fees on Community Water Systems will be based on the number of service connections on record for
the month of December of the prior year.
- Fees are not pro-rated. If a system is sold or inactivated during the billing _year, the amount of
the assessed fee remains due and payable.
- If payment of the assessed fee amount imposes an undue burden on the public water system, the
facility may notify this Agency within forty-five (45) days of this invoice date to pay in four
equal installments within a year.
- Payments not received or received after the DUE date are subject to a delinquency charge equal to
10% of the assessed fee.
- If several invoices are to be paid by one check, you MUST INCLUDE A COPY OF EACH BILLING INVOICE
in order to ensure proper credit for each fee assessment.
For questions regarding your assessed fee amount, please contact Deborah Glover in the Operations
Section, Office of Water Quality at 317/232-8472 or e-mail dglover @idem.in.gov.
- ATTENTION: The due date shown in the upper right hand corner of this invoice reflects the
standard 60 days past the invoice print date.
TOTAL AMOUNT DUE: 1,376.55
A copy of your invoice must be included with payment.
495-IDEM Printed on Recycled Paper Original
VOUCHER # 123637 WARRANT # ALLOWED
TIDEM IN SUM OF $
IDEM
100 N SENATE AVENUE
INDIANAPOLIS, IN 46204-2251
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
164794 01-6750-08 $1,376.55
Voucher Total $1,376.55
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
TIDEM
IDEM Purchase Order No.
100 N SENATE AVENUE Terms
INDIANAPOLIS, IN 46204-2251 Due Date 2/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/18/2013 164794 $1,376.55
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
</2Z/3 Cam`�.�,•,,� -
Date Officer
INVOICE
Please Remit To: Page: 1
INDIANA DEPT OF ENVIRONMENTAL MGMT Invoice No: 000164503
CASHIER OFFICE-MAIL CODE 50-10C Invoice Date: 01/09/2013
100 NORTH SENATE AVENUE Customer Number: CST100010357
INDIANAPOLIS IN 46204 Bill Type: 060
Payment Terms: NET 60
Due Date: 03/10/2013
Bill To:
CITY OF CARMEL
MR JOHN DUFFY-WATER DEPT AMOUNT DUE: 26,535.40 USD
760 3RD AVENUE SOUTHWEST
SUITE 110 G '-'U(1
CARMEL IN 46032-2584
Amount Remitted
❑ Note Address Changes Above
For billing uestions; lease call 317-232-8705
Line Adj Identifier Description Quantity UOM Unit Amt Net Amount
1 13-IN5229004C-0 PWS Fee - SVC:27932 1.00 EA 26,535.40 26,535.40
- IDEM's Cashier office is now accepting payment by Master Card or Visa between the hours of 9 am to
3 pm Monday through Friday. You may come to the office or call (317) 232-8705. A processing fee of
$1 plus 2% will be charged of the total transaction.
- This annual fee billing is required for active Public Water Systems (to defray the costs of
administering activities of the federal Safe Drinking Water Act) under Indiana Code: IC 13-18-20.5.
_ To view via the internet, visit:
http://www.IN.gov/legislative/ic/code/titlel3/arl8/ch2O.5.html
- Fees are based on the activity status as of December 31 of the previous year.
Fees on Community Water Systems will be based on the number of service connections on record for
the month of December of the prior year.
- Fees are not pro-rated. If a system is sold or inactivated during the billing year, the amount of
the assessed fee remains due and payable.
- If payment of the assessed fee amount imposes an undue burden on the public water system, the
facility may notify this Agency within forty-five (45) days of this invoice date to pay in four
equal installments within a year.
- Payments not received or received after the DUE date are subject to a delinquency charge equal to
10% of the assessed fee.
- If several invoices are to be paid by one check, you MUST INCLUDE A COPY OF EACH BILLING INVOICE
in order to ensure proper credit for each fee assessment.
For questions regarding your assessed fee amount, please contact Deborah Glover in the Operations
Section, Office of Water Quality at 317/232-8472 or e-mail dglover @idem.in.gov. ~
- ATTENTION: The due date shown in the upper right hand corner of this invoice reflects the
standard 60 days past the invoice print date.
TOTAL AMOUNT DUE: 26,535.40
A copy of your invoice must be included,with payment.
495-IDEM Printed on Recycled Paper Original
VOUCHER # 123636 WARRANT # ALLOWED
TIDEM IN SUM OF $
IDEM
100 N SENATE AVENUE
INDIANAPOLIS, IN 46204-2251
Carmel Water Utility
r
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
164503 01-6750-08 $26,535.40
Voucher Total $26,535.40
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
TIDEM
IDEM Purchase Order No.
100 N SENATE AVENUE Terms
INDIANAPOLIS, IN 46204-2251 Due Date 2/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/18/2013 164503 $26,535.40
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