217920 03/12/2013 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL M T
CARMEL, INDIANA 46032 CASHIER OFFICE-MAIL CODE 50-10C HECK AMOUNT: $11,500.00
100 N SENATE AVE CHECK NUMBER: 217920
INDIANAPOLIS IN 46204
CHECK DATE: 3/12/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 165744 11, 500 . 00 MISCELLANEOUS EXPENSE
MAR. 8. 2013 2:51 PM NO. 0907 P. 2
INVOICE
Please Remit To: Page: 1
INDIANA DEPT OF ENVIRONMENTAL MGMT invoice No: 000165744
CASHIER OFFICE-MAIL CODE 50-10C Invoice DatO: 01/09/2013
100 NORTH SENATE AVENUE Customer Number: OST100010357
INDIANAPOLIS IN 46204 Bill Type: 021
Payment Terms: NET 60
Due Date: 03/10/2013
Bill To:
CITY OF CARMEL
MS CINDYSHEFKS AMOUNT DUE: 11,500.00 USD
ONE CIVIC SQUARE C (O [Ply CARMEL IN 48032 //1500 Od
Amount Remitted
Note Address Changes Above
For billinq qUeslJon_s please call 317232-8705
Line Ad' Idengfier Descri tlan Quan6ty UOM Unit Amt NetAmount
1 13-IN0022491-0 Base fee -Municipal Major 1.00 EA 1,500.00 11500.00.
2 13-IN0022497-0 Flow FBC far 8.90 MGD 1.00 EA 10,000.00 10,000.00
- IDEK'a Cashier office is now accepting payment by Mastcr card or visa between the hours of 9 am to
3 pm Menday through Friday. You may came to the office c= call (317) 232-970S. A processing fee of
S1 pluo 2t will be charged of the total trA"action.
Annual Fee Billing is required for active NPDES Permits under Indiana Code: IC 13-18-20. To view
via the Internet visit: http!//www.IN.gov/legislative/ic/code/titlel3/arl8/ch2O.htMI
- Facilities with no discharge are still required to pay any applicable base foe as long as the
permit is active. A permit is active until it i6 officially terminated by IDSM. Fees are not
pxo-rated,
- The entire amount of the assessed fee is due and payable by the permit holder unlea: IDEM receivcS
and approves a permit termination request by December 31st of the previous year.
- if paymeac of the full d9seased fee amount imposes an undue burden upon the permit holder, the
facility may notify this agency within 45 days of the date of this invoice to pay four equal
in:tallmentx spread evenly Over the year.
- Payments not reccived or received after the DUE date are subject to a delinquency charge equal to
10t of the assessed fee. The complete fee payment or the lct installment i6 due within 60 days of
the date of this invoice.
- If several permits or invoices are to be paid by one cherk, you MUST INCLUDE A COPY OF EACH
BILLING XMIC5 in order to ensure proper credit for each fee acsessmcnt.
- Flow fees arc based on reported flow values for a twelve month period ending in June of the
previous year. If you have any questions regarding flow fees please contact Nancy Coker, Office of
water quality, 317/234-6690 or e-mail ncoker®idem.in,gov.
C TOTAL AMOUNT DUE: _ 11 50d.dQ
A copy of your invoice must be included with payment
Q95-IDLH Printed an Recycled raper original
VOUCHER # 135109 WARRANT # ALLOWED
146900 IN SUM OF $
IDEM
100 N. Senate Avenue
Indianapolis, IN 46207-7060
Carmel.-Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
i
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
000165744 01-7750-08 $11,500.00
Ct
-� � �) 6
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
146900
IDEM Purchase Order No.
100 N. Senate Avenue Terms
Indianapolis, IN 46207-7060 Due Date 3/8/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/8/2013 000165744 $11,500.00
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
Date Officer