217799 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA IRIECK AMOUNT: $2,977.35
CARMEL, INDIANA 46032 PO BOX 9001099
LOUISVILLE KY 40290-1099 CHECK NUMBER: 217799
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 14938 2 , 908 .35 OTHER EXPENSES
1207 4350101 20020 35460 69 . 00 TRASH SERVICE
REPUBLIC CARMEL UTILITIES HHW Invoice
SERVICES
832 Langsdale Ave Page 1 of 3
Indianapolis,IN 46202-1150
Current Invoice Charges
m Carmel Utilities Hhw 901 N Range Line Rd (1_1) CSA 3292121010
Carmel,IN
1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled
Account Number 3-0761-1163292
Invoice Date January 31,2013 Date Description Reference Quantity Unit Price Amount
Invoice Number 0761-001493879 01/03 Basic Service Bradley 1.0000 $153.15 $153.15
Previous Balance $2,738.35 Receipt Number 62372
Payments/Adjustments $0.00 01/04 Basic Service Bradley 1.0000 $153.15 $153.15
Unpaid Balance $2,738.35 Receipt Number 62374
Current Invoice Charges $2,908.35 01/08 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
01/15 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
01/17 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
o .;q 01122 Basic Service 1.0000 $153.15 $153.15
$5,646.70 Receipt Number 48391
01/24 Basic Service 1.0000 $153.15 $153.15
Due By: 02/20/13 Receipt Number 48391
01/29 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
01/31 Basic Service 1.0000 $153.15 $153.15
Customer Service (317)917-7300 Receipt Number 48391
1 -Rolloff(30 Yd) Scheduled Service (S3) Comingled
Date Description Reference Quantity Unit Price Amount
0 0 0 0 01/02 Basic Service 1.0000 $170.00 $170.00
Receipt Number 48393
Effective 4/16/2012:SERVICE INTERRUPTION 01/03 Basic Service Bradley 1.0000 $170.00 $170.00
POLICY CHANGE All accounts with a balance over Receipt Number 62373
60 days will experience a service interruption unless 01/04 Basic Service Bradley 1.0000 $170,00 $170.00
prior arrangements are made. y
Receipt Number 62375
01/08 Basic Service 1.0000 $170.00 $170.00
Receipt Number 48393
01/11 Basic Service 1.0000 $170.00 $170.00
Receipt Number 73432
01/15 Basic Service 1.0000 $170.00 $170.00
'` f 30?DAYS_'? 60 C34XS r � a90+D"A,YS .
,CURRENT'S �. "
f 2,908.35 2,738.35 0.00 0.00
To pay on-line or sign up for Past Due Balance $2,738.35
convenient auto pay, go to: D A • Visit our website,www.disposal.com to make your payment electronically
www.disposal.com or to sign up for our convenient automatic payment plan.
ore......toA...„o.�.,s;.rp�,,..,...,,�,...a...... .......
CARMEL UTILITIES HHW 3-0761-1163292 Page 2 of 3
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
000935-000002-000002-001870 2312832 2240ST03 1 3
Page 3 of 3
CARMEL UTILITIES HHW Republic Services #761
�REPUBL►C Account Number 3-0761-1163292 g32 Langsdale Ave
SERVICES Invoice Date January 31, 2013
Invoice Number 0761-001493879 Indianapolis, IN 46202-1150
Current Invoice Charges
Date Description Reference Quantity Unit Price Amount
Receipt Number 48393
01/17 Basic Service 1.0000 $170.00 $170.00
Receipt Number 48393
01/22 Basic Service 1.0000 $170.00 $170.00
Receipt Number 48393
01/29 Basic Service 1.0000 $170.00 $170.00
-- - -- Rereipt_Number_—_4$393 -- - - - -- - - --
Current Invoice Charges $2,908.35
r
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
358593
REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290-1099 Due Date 2/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/18/2013 0761001493f $2,908.35
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
L(2v(��
Date Officer
VOUCHER # 126738 WARRANT # ALLOWED
358593 IN SUM OF $
REPUBLIC WASTE SERVICES OF INDI
PO BOX 9001099
LOUISVILLE, KY 40290-1099
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
07610014938 01-736H-08 $2,908.35
Voucher Total $2,908.35
Cost distribution ledger classification if
claim paid under vehicle highway fund
N
R
g "A REPUBLIC CITY OF CARMEL BROOKSHIRE GOLF Invoice
6-4 SERVICES Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Qd1G Date Description Reference Amount
01/30 Payment-Thank You 216483 -$344.00
Account Number 3-0761-0035460 Current Invoice Charges
Invoice Date January 31,2013 Brookshire Golf Course 12120 Brookshire Pkwy (L1) CSA 002765
Invoice Number 0761-001492018 Carmel,IN
Previous Balance $344.00
Payments/Adjustments -$344.00 1 -Front Load(8 Yd) Scheduled Service (S1)
Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $69.00 01/31 Basic Service 02/01/13-02/28/13 $69.00 $69.00
Current Invoice Charges $69.00
° ` o
$69.00
Due By: 02/20/13
0 0 0
Customer Service (317)917-7300
00 0 0
Your next Invoice may reflect a rate adjustment,if
you have any questions after receiving your next
invoice please contact us.
Effective 4/16/2012:SERVICE INTERRUPTION
POLICY CHANGE All accounts with a balance over
60 days will experience a service interruption unless
prior arrangements are made.
u` ,GtIRRENT„r;;�� � 3ofVAYS '60 DAYS r. 90f.t7AYS
69.00 0.00 0.00 0.00
To pay on-line or sign up for
convenient auto pay, go to: D A • Visit our website,www.disposal.com to make your payment electronically
vvww.disposal.com or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
CITY OF CARMEL BROOKSHIRE GOLF 3-0761-0035460 Page 2of2
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
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))
01/31/13 0761-001492018 Trash Removal $69.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Republic Services #761
IN SUM OF $
P. O. Box 9001099
Louisville, KY 40290-1099
$69.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
20020 1 0761-0014920181 43-501.01 ( $69.00 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
Tuesday, February 19, 2013
)2'(., d 4'�
Director, Brookshl Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund