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219879 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 366093 Page 1 of 1 ONE CIVIC SQUARE REPUBLIC WASTE SERVICE-TRASH COMCK AMOUNT: $84,196.22 CARMEL, INDIANA 46032 ATTN:NANCY COLLINS y o� 832 LANGSDALE AVE CHECK NUMBER: 219879 INDIANAPOLIS IN 46202-1150 CHECK DATE: 517/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 4/22-5/5 84, 196 .22 OTHER EXPENSES Republic Services 832 Langsdale Ave Indianapolis, IN 46202-1150 ATTN: Nancy Collins Account# 3-0761-9761020 $$$$ Collected By Carmel Utilities Apr 22 to May 5 $ 86,579.97 2013 Rate Less Administrative Fee 2013 $ (2,383.75) 9,535 Payments Payment to Republic $ 84,196.22 Prescribed by State Board of Accounts Form No.301(Rev.1995) ACCOUNTS PAYA AtEen VOUCHER `44 TC1�ZJ( �I -- 5bbbi7 ADDRESS y /,� L4W G-5ogLL A,,4. ^JA.O`( Invoice Date Invoice Number Item Amount I 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 Mo. Day Yr. Signature Title I hereby certify that the attached invoice(s), or bill(s), is (are)tr orrect and I have audited same in accordance with IC 5-11-10-1.6. Mo. Day Yr. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. "NO NO.. CARMEL, INDIANA rh r Of �3� Lpa�sDa�c A.�E ��•Ac/Y'AJ��u� �� �(CQ�D�+ 14AW-LY Coy. Total Amount of Voucher $ Deductions k4- to Amount of Warrant $ Month of VOUCHER RECORD Acct. No. Source of Supply Water Treatment Transmission and Dist. Customer Accounts Administrative and General Operation-Maintenance Utility Plant in Service Constr.Work in Progress Materials and Supplies Customers De osits Total Allowed. Board of Control Filed Official Title ROYCE FORMS•SYSTEMS 1-800-382-8702 325