219468 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
`i ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA
CHECK AMOUNT: $2,213.10
CARMEL, INDIANA 46032 Po sox sooloss
4 0:�o•� LOUISVILLE KY 40290-1099 CHECK NUMBER: 219468
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350101 20020 69 . 00 0761-001560776
651 5023990 07610015624 2, 144 . 10 OTHER EXPENSES
5; WREPUBLIC CITY OF CARMEL BROOKSHIRE GOLF Invoice
443 SERVICES
Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
03/09 Payment-Thank You 217799 -$69.00
0 :,_;j`,i.; 03/30 Payment-Thank You 218604 -$344.00
Account Number 3-0761-0035460
Invoice Date March 31,2013 Current Invoice Charges
Invoice Number 0761-001560776 Brookshire Golf Course Ro/FI 12120 Brookshire Pkwy (1-1) CSA 002765
Previous Balance $413.00 Carmel,IN
Payments/Adjustments -$41100
Unpaid Balance $0.00 1 -Front Load(8 Yd) Scheduled Service (S1)
Current Invoice Charges $69.00
Date Description Reference Quantity Unit Price Amount
03/31 Basic Service 04/01/13-04/30/13 $69.00 $69.00
Current Invoice Charges $69.00
$69.00
Due By: 04120141^0
�¢ a a o `Z' OA a i
Customer Service (317)917-7300
a o o" o
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.
CURRENT-,;; �.; �,: 30 LAYS. SO.DAY.S.: 90+".DAYS
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
www.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 2 of 2
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transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not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.
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 0761-0015607761 43-501.01 1 $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, April 09, 2013
Director, Brooks re Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
03/31/13 0761-001560776 Trash I $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
e7WPUBLIC CARMEL UTILITIES HHW Invoice
4-0 SERVICES
Page 1 of 3
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
03/09 Payment-Thank You 217799 -$2,908.35
' • 03/30 Payment-Thank You 218604 -$1,990.95
Account Number 3-0761-1163292
Invoice Date March 31,2013 Current Invoice Charges
Invoice Number 0761-001562406 Carmel Utilities Hhw 901 N Range Line Rd (L1) CSA 3292121010
Previous Balance $4,899.30 Carmel,IN
Payments/Adjustments -$4,899.30
Unpaid Balance $0.00 1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled
Current Invoice Charges $2,144.10 ,
Date Description Reference Quanti Unit Price Amount
03/05 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
03/07 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
LEI ° 03/12 Basic Service 1.0000 $153.15 $153.15
$2,144.1 Receipt Number 48391
03/14 Basic Service 1.0000 $153.15 $153.15
Due By: 04/20/13 Receipt Number 48391
03/19 Basic Service 1.0000 $153.15 $153.15
• e e Receipt Number 48391
03121 Basic Service 1.0000 $153.15 $153.15
Customer Service (317)917-7300 Receipt Number 48391
03/26 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
03/28 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48391
oe e •
1 -Recycle Rolloff(30yd) Scheduled Service (S3) Comingled
Effective 4/16/2012:SERVICE INTERRUPTION
POLICY CHANGE All accounts with a balance over Date Description Reference Quantity Unit Price Amount
60 days will experience a service interruption unless 03/05 Basic Service 1.0000 $153.15 $153.15
prior arrangements are made. Receipt Number 48393
03/12 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48393
03/19 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48393
03/21 Basic Service 1.0000 $153.15 $153.15
CURRENT "'• 30 DAYS, 60.DAYS ". 90*DAYS:; ".
2,144.10 0.00 0.00 0.00
Lonpvenient on-line or sign up for
auto pay, g0 t0: DA Visit our website,vvww.disposal.com to make your payment electroriically'
ww.disposal.com or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
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.
000991-000002-000002-001982 2314890 2240ST03 1 3 0
Page 3 of 3
CARMEL UTILITIES HHW Republic Services #761
R, Account Number 3-0761-1163292
m "REPUBLIC Invoice Date March 31, 2013 832 Langsdale Ave
+1►� SERVICES Invoice Number 0761-001562406 Indianapolis, IN 46202-1150
Current Invoice Charges
Date Description Reference Quantity Unit Price Amount
Receipt Number 48393
03/26 Basic Service 1.0000 $15115 $153.15
Receipt Number 48393
03/28 Basic Service 1.0000 $153.15 $153.15
Receipt Number 48393
Current Invoice Charges $2,144.10
I
VOUCHER # 135373 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
07610015624 01-736H-08 $2,144.10
Voucher Total $2,144.10
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 4/16/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/2013 0761001562, $2,144.10
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
I/X 7-113 c --' -
Date Officer