227585 12/27/2013 °SAF CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA MECK AMOUNT: $113.00
` a CARMEL, INDIANA 46032 PO BOX 9001099
LOUISVILLE KY 40290-1099 CHECK NUMBER: 227585
CHECK DATE: 12/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1827176 113 . 00 OTHER EXPENSES
ft
q REPUBLIC CARMEL UTILITIES Invoice
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SERVICES Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
10/28 Payment-Thank You 225642 -$160.21
•
Account Number 3-0761-0062694 Current Invoice Charges
Invoice Date November 25,2013 Water Plant 1 4915 E 106th St (1-1) CSA 5387
Invoice Number 0761-001827176 Carmel,IN
Previous Balance $273.21
Payments/Adjustments -$160.21 1 -Front Load(8 Yd) Scheduled Service (S3)
Unpaid Balance $113.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $113.00 11/25 Basic Service 12/01/13-12/31/13 $113.00 $113.00
Current Invoice Charges $113.00
Due By: 12/15/13
o • •
Customer Service (317)917-7300
ee • •
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. /J
W
l Gt1RR"VAN ; � �,.3.O DAY,S, .��K,- F �60 SAYS�x"� �<���K�fi90+�DiAYS � s.....
113.00 113.00 0.00 0.00
To pay on-line or sign up for Past Due Balance $113.00
convenient auto pay, go to: A A • Visit our website,www.disposal.com to make your payment electronically
_ www.disp-osal.com � _ or to sign up for our convenient automatic payment plan.
Please see reverse side-for.te ns and.conditions _
CARMEL UTILITIES 3-0761-0062694 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transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not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.electronicpaVments.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 # 133653 WARRANT # ALLOWED
358593 IN SUM OF $
REPUBLIC SERVICES #761
PO BOX 9001099
LOUISVILLE, KY 40290-1099
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1827176 01-6360-03 $113.00
Voucher Total $113.00
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 SERVICES#761 Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290-1099 Due Date 12/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/18/201: 1827176 $113.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date Officer