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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