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Home My WebLink About221544 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS CHECK AMOUNT: $36.32 CARMEL, INDIANA 46032 PO BOX 660579 «per DALLAS TX 75266-0579 CHECK NUMBER: 221544 CHECK DATE: 7/212013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 267785906221 36 . 32 OTHER MISCELLANOUS 1-800-4-WATERS (1-800-492-8377) www.HinckleySprings.com Upcoming Delivery Dates Hinckley ��HpARD= June J uly Au ust Springs We Deliver! v Bottled Water• Filtration • Coffee Thursday, 27 Wednesday, 3 Thursday, 22 The heat is here to stay, stay hydrated! It's easy with our Thursday, 25 24-pack .51L bottles that offer convenient refreshment for all your indoor &outdoor plans. Individual bottles are perfect for the gym, a walk to the park, or just around the home or office when you're feeling thirsty. Customer Account#: 17220042677859 PAM BAKER Invoice Date: 06-22-13 CARMEL CITY COURT Invoice#: 2677859 062213 1 CIVIC SQ CARMEL, IN 46032 Purchase Order#: Date, Transaction# Details Qty. Each Amount Previous Balance 116.88 05-24-13 P219761 Payment-Check-219761 -Thank You -54.45 Remaining Balance 62.43 R1314810140050 EVEREST BLACK HOT AND COLD COOLER W ITH CUP 1.0 11.25 11.25 06-05-13 T131563042005 HINCKLEY SPRINGS 5G DRINKING WATER 4.0 9.99 39.96 5.0 GALLON BOTTLE RETURN -7.0 6.00 -42.00 5.0 GALLON BOTTLE DEPOSIT 4.0 6.00 24.00 ENERGY SURCHARGE 1.0 3.11 3.11 Rec'd By: Not Available or Refused Total New Charges 36.32 Mel It's now easier than ever to manage your account online.A new&im �ny as been created with enhanced features.Please visit water.com►mywater to adva time-saving options available.Your username&password will rem the same te a new one. 30356-P-0037 Previous Balance Payment Total New Charges L� Pay This Amount $116.88 $54.45 1 $36.32 $98.75 v Write the complete account number on your check.Detach remittance and mail with payment in c osed envelope.To pay online go to www.HinckleySprings.com 17 How to Read Your Statement Important Monthly Promotions: Del-0 +� Register online for access to your Delivery Calendar: M "'� 9a:"^" B Fw° account.You can view and pay your bill, M,. a°9 s Fes.°� check delivery schedule and order Your scheduled deliveries for the next three months. products all online. Customer Account Number: w For prompt service,please use this Bottle Deposits: number when referring to your account. Highlights bottle deposits and returns. 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. Or _ O = : Total New Charges: `ow oe'�"%"° K"RM91 ......V This information provides totals for ,""" Mail Remittance With Payment To: various products and transactions. Please detach remittance and mail a-- $ using business envelope provided. 6M.11 w11"P.—M r.. Important Monthly Message Ill.T - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 on your check gives us permission to debit your checking account electronically You do not have to pay any amount in question while we are investigating,but for the uncollected amount. Payment by check constitutes your acceptance of you are still obligated to pay the amount of your bill that is not in question.While these terms. we investigate your questions,we cannot report you as delinquent or take any , 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. pof�� /J Terms VALLAS T / SP6 (P Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) �- i Total 6. 3 -D 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 14-IAJCKlel' IN SUM OF $ PO /5v\� 6 6 emu- 5 T� 7, $ 5� .3 ON ACCOUNT OF APPROPRIATION FOR &7,t� Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or /3v l G T X90 13 �a�90 '.3.2-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 l 20 ig Cost distribution ledger classification if � le claim paid motor vehicle highway fund