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Home My WebLink About220191 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL M9ECK AMOUNT: $100.00 CARMEL, INDIANA 46032 CASHIER OFFICE-MAIL CODE 50-10C 100 N SENATE AVE CHECK NUMBER: 220191 INDIANAPOLIS IN 46204 CHECK DATE: 5/2112013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4358300 163632RB 100 . 00 OTHER FEES & LICENSES INVOICE Please Remit To: Page: 1 INDIANA DEPT OF ENVIRONMENTAL MGMT Invoice No: 000163632RB CASHIER OFFICE-MAIL CODE 50-10C Invoice Date: 04/17/2013 100 NORTH SENATE AVENUE Customer Number: CST100026885 INDIANAPOLIS IN 46204 Bill Type: 062 Payment Terms: NET 60 Due Date: 06/1612013 Bill To: CARMEL CLAY PARKS&RECREATION ACCOUNTS PAYABLE AMOUNT DUE: 100.00 USD 1411 EAST 116TH STREET CARMEL IN 46032 Amount Remitted FINote Address Changes Above Y Y For billing questions,}please call 317-232-8705 Original Invoice: 000163632 01/09/2013 Prior Adjustment: 000163632CR 04/12/2013 Line Adj Identifier Description Quantity UOM Unit Amt Net Amount 1 13-IN2290801T-0 PWS Fee - GW 1.00 EA 100.00 100.00 - IDEM's Cashier office is now accepting payment by Master Card or Visa between the hours of 9 am to 3 pm Monday through Friday. You may come to the office or call (317) 232-8705. A processing fee of $1 plus 2% will be charged of the total transaction. - This annual fee billing is required for active Public Water Systems (to defray the costs of ° administering activities of the federal Safe Drinking Water Act) under Indiana Code: IC 13-18-20.5. To view via the internet, visit: http://www.IN.gov/legislative/ic/code/titlel3/arl8/ch2O.5.html - Fees are based on the activity status as of December 31 of the previous year. - Fees on Transient Non-Community Water System will be based on the type of water system on record by December 31 of the prior year. - Fees are not pro-rated. If a system is sold or inactivated during the billing year, the amount of the assessed fee remains due and payable. - If payment of the assessed fee amount imposes an undue burden on the public water system, the facility may notify this Agency within forty-five (45) days of this invoice date to pay in four equal installments within a year. - Payments not received or received after the DUE date are subject to a delinquency charge equal to 10% of the assessed fee. - If several invoices are to be paid by one check, you MUST INCLUDE A COPY OF EACH BILLING INVOICE in order to ensure proper credit for each fee assessment. - For questions regarding your assessed fee amount, please contact Deborah Glover in the Operations Section, Office of Water Quality at 317/232-8472 or e-mail dglover @idem.in.gov. - ATTENTION: The due date shown in the upper right hand corner of this invoice reflects the standard 60 days past the invoice print date. - IDEM assessed your Public Water Supply 2013 annual fees on 01-09-13. Due to circumstances beyond our control, invoices were not mailed at that time. - This is the current 2013 annual drinking water fee invoice for your facility. You will still have the standard 60 days to pay the amount shown on the invoice. 495-IDEM Printed on Recfcled Paper Original INVOICE Bill To: Page: 2 CARMEL CLAY PARKS & RECREATION Invoice No: 000163632RB ACCOUNTS PAYABLE Invoice Date: 04/17/2013 Line Adj Identifier Description Quantity UOM Unit Amt Net Amount TOTAL AMOUNT DUE : 100.00 A copy of your invoice must be included with payment. ;,.... ,. t on r/cui.'� _( C C� �1� fzc t ] 7ED L O. PorF 30Q APR 18 2913 rurchaser Date Approval /` Date ! 495-IDEM Printed on Recycled Paper Original ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 146900 Indiana Department of Environmental Mgmt Terms Cashier Office - Mail Code 50-10C 100 North Senate Ave Indianapolis, IN 46204-2251 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 4/17/13 163632RB Flowing Well annual fee $ 100.00 — I Total $ 100.00 I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance with I C 5-11-10-1.6 , 20_ Clerk-Treasurer Voucher No. Warrant No. 146900 Indiana Department of Environmental Mwt Allowed 20 Cashier Office - Mail Code 50-10C 100 North Senate Ave Indianapolis, IN 46204-2251 In Sum of$ $ 100.00 ON ACCOUNT OF APPROPRIATION FOR 101 - General Fund PO#or Board Members INVOICE NO. ACCT#/TITLE AMOUNT Dept# 1125 163632RB 4358300 $ 100.00 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 16-May 2013 Signature $ 100.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund