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Home My WebLink About228024 1 /14/2014 CITY OF CARMEL, INDIANA VENDOR: 131130 Page 1 of 1 ONE CIVIC SQUARE HINCKLEY SPRINGS � CARMEL, INDIANA 46032 PO BOX 660579 CHECK AMOUNT: $44.36 DALLAS TX 75266-0579 CHECK NUMBER: 228024 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1301 4239099 44 . 36 2677859120713 1-800-4-WATERS (1-800-492-8377) www.HinckloySprings.com Upcoming Delivery Dates HInCkiey. 69MA% Springs We Deliver! December JanuaryFebruary Bottled Water• Filtration • Coffee Thursday, 12 Thursday, 9 Thursday, 6 Sparkling Water! We now offer Italy's#1 sparkling water, Ferrarelle, for delivery! Order convenient 12-pack(750ml-) glass bottles or 24-pack(330ml- glass bottles of Ferrarelle and put a little sparkle in your day. Ask your Route Sales Representative to add a case to your next order. Customer Account#: 17220042677859 PAM BAKER Invoice Date: 12-07-13 CARMEL CITY COURT Invoice#: 2677859 120713 1 CIVIC SQ CARMEL, IN 46032 Purchase Order#: Date Transaction# Details Qty. Each Amount Previous Balance 110.29 11-22-13 P225842 Payment-Check-225842-Thank You -54.29 12-05-13 P226336 Payment-Check-226336-Thank You -56.00 Remaining Balance 0.00 R1331610140050 EVEREST BLACK HOT AND COLD COOLER WITH CUP 1.0 11.25 11.25 11-14-13 T133183042034 HINCKLEY SPRINGS 5G DRINKING WATER 3.0 9.99 29.97 5.0 GALLON BOTTLE DEPOSIT 3.0 6.00 18.00 5.0 GALLON BOTTLE RETURN -3.0 6.00 -18.00 ENERGY SURCHARGE 1.0 3.14 3.14 Rec'd By:Not Available or Refused Total New Charges 44.36 Ready to streamline your life? View your delivery schedule and account history,manage your payment options,pay your bill and much more with your own online account at water.comlmyaccount. 30356-P-0037 Previous Balance Payment Total New Charges o Pay This Amount $110.29 $110.29 $44.36 0 $44.36 7 Write the complete account number on your check.Detach remittance and mail with paymerd in the enclosed envelope.To pay online gcto www.HinckleySprings com 0 How to Read Your Statement m Important Monthly Promotions: °a°'^'19°e1°efyDd1Pf we Deliver' Register online for access to your M� M; �e� account.You can view and pay your bill, Delivery Calendar: �� ee^�°=�a,�ry�u�=°w=�=� Your scheduled deliveries for "-^°�;_�;;;q�� check delivery schedule and order the next three months. "ten products all online. SMITH Customer Account Number: Bottle Deposits For prompt service,please use this Highlights bottle deposits and returns. number when referring to your account. 1-1 , ,.,°„ 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. •"• rooms�„ .x�,. .W''`oo.., \� Total New Charges: This information provides totals for ;ow". „�� P Mail Remittance With Payment To: various products and transactions. ^=gym° �, w°�rro Please detach remittance and mail ❑_ �a c 5 using business envelope provided. IIIII,IIII,II,IIIIIIII,IIIIIII I M^II1"'n”Will,P- 123 """ 'Important Monthly Message ...,. .T°1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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. I� 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. 141,&j Vayee 5�'P' Purchase Order No. Po /-3/y- 6 6,oS-7 7 Terms _pN C_(_A- S Date Due Invoice Invoice Description Amount Datp Number (or note attached invoice(s) or bill(s)) 6t_�rge- Co -e-K a.,, Total -3- I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 H/ �j C,< (-- � IN SUM OF $ Po 0S,--7 7 $ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), 7t3 or bill(s) is (are) true and correct and that the materials or services itemized thereon 390.9q , 34a for which charge is made were ordered and received except 20 [3 1.0 I na � V Cost distribution ledger classification if Title claim paid motor vehicle highway fund