HomeMy WebLinkAbout220191 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.
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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