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Home My WebLink About218883 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS h CHECK AMOUNT: $51.71 i•.�+, CARMEL, INDIANA 46032 Po sox 660579 «o� DALLAS TX 75266-0579 CHECK NUMBER: 218883 CHECK DATE: 4/9/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 267785903013 51 . 71 OTHER MISCELLANOUS 1-800-4-WATERS (1-800-492-8377) www.HinckleySprings.com Upcoming Delivery Dates Hinckley 8TANDAlb Springs We Deliver! April May June Bottled Water Filtration • Coffee Wednesday, 10 Wednesday, 8 Wednesday, 5 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: 03-30-13 CARMEL CITY COURT 1 CIVIC SQ Invoice#: 2677859 033013 CARMEL, IN 46032 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 97,22 03-08-13 P217670 Payment-Check-217670-Thank You -41.79 03-22-13 P218084 Payment-Check-218084-Thank You -55.43 Remaining Balance 0.00 R130642494748 EVEREST BLACK HOT AND COLD COOLER W ITH CUP 1.0 11.25 11.25 03-13-13 T130723042026 HINCKLEY SPRINGS 5G DRINKING WATER 3.0 9.99 29.97 CUP PLASTIC FLAT 9 OZ HINCKLEY SPRINGS 50 CT 2.0 3.69 7.38 5.0 GALLON BOTTLE RETURN -3.0 6.00 -18.00 5.0 GALLON BOTTLE DEPOSIT 3.0 6.00 18.00 ENERGY SURCHARGE 1.0 3.11 3.11 Rec'd By: Not Available or Refused Total New Charges 51.71 It's now easier than ever to manage your account online.A new&improved website has been created with enhanced features.Please visit water.comlmywater to take advantage of the many time-saving options available.Your username&password will remain the same or you can create a new one. 30356-P-0037 Previous Balance Payment Total New Charges ° Pay This Amount $97.22 0 $97.22 $51.71 $51.71 0 Write the complete account number on your check.Detach remittance and mail with payment in the enclosed envelope.To pay online gp to L mm Uinckley$prings.com 0 How to Read Your Statement Important Monthly Promotions: °�°m'^9°°'"•.r°°`� WeDea 8°°�^"C Register online for access to your '°°' „°°' ApgvS 009 ~a°""w"" account.You can view and pay your bill, Delivery Calendar: M°""' " ° -r.�°we Your scheduled deliveries�for ;;""° b � P check delivery schedule and order the next three months. '- products all online. Customer Account Number: , For prompt service,please use this - Bottle Deposits: number when referring to your account. by^ 1. Highlights bottle deposits and returns. mm .� ,•„ ° " 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 remittance with automatic credit card payments payments since last bill. ..u„„s,Nxm"mrom Cr7�..�7;�;;kv Nepla9i..-Fh„-,..•...,.5,�.,=,s�ww,�.,ap, Total New Charges: Wm• This information provides totals for ""m°.",o'"""°' •"• Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail using business envelope provided. II...IIII,I,ihlllllll,ll,l„1,,.11,1.,1,.II .Mali n•m�n.nc•wun r mr•:, Important Monthly Message - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 You do not have to pay any amount in question while we are investigating,but on your check gives us permission to debit your checking account electronically you are still obligated to pay the amount of your bill that is not in question.While for the uncollected amount. Payment by check constitutes your acceptance of we investigate your questions,we cannot report you as delinquent or take any these terms. 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 C W 0 S 5f 0 3 5 D3 3 T r Co J l 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 IN SUM OF $ �b i34 a S 7 DAB LLA-s T)l 75x-6 65;1 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 13 06-MSS D 3 /3 bill(s) is (are) true and correct and that the a 0,9 9 materials or services itemized thereon for which charge is made were ordered and received except 20 natu E1. 7 ' Cost distribution ledger classification if le claim paid motor vehicle highway fund