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232016 04/30/14 CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $**......53.60* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 232016 PO BOX 856680 CHECK DATE: 04/30/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 53.60 04DO119252823 service.icemountainwater.com 0 D 0 io #215 6661 DIXIE HWY,SUITE 403/13/14-04/12/14 04D0119252823 LOUISVILLE KY 40258 ® B ADDRESS SERVICE REQUESTED D MAY 06 0119252823 FR- TUE- JUL 08 WED- AUG 06 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at: 1-800472-9888.It's(reel CARMEL IN 46074-8267 FY reat;NEW taste of:NESTEANOW! Save $3off a 12 pack of 12 oz cans for a promoted price of%$3:99ff a,2-pack of f�lestea 112 liter.bottles,for a promoted pr'sce of X5:99.! Gall 1-000-472-9008,or,visitemauntainwate"r:com:to add toyouur ordert e ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. ® ® BIII M084. Delivery address: CITY OF CARMEL STREET DEPARTMENT,1 CIVIC SQUARE,CARMEL IN 46032 PREVIOUS BALANCE 60.14 4/04 545341 PAYMENT-THANK YOU -60.14 4/09 0877318485 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 30.00 4/12 0879670883 1 OIL/FUEL SURCHARGE 3.16 D6394012 RENT 2'99 TOTAL 53.60 ACCOUNT SUMMARY PREVIOUS BALANCE_ PAYMENT/ADJUSTMENTCURRENT ACTIVITY —PAY THIS AMOUNT to terms on reverse side. 60.14 60.14 + 53.60 53.60 Subject BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL.OR FOR I. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL.1-800-472-9888 OR WRITE US AT- your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE IiWY_SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill Is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing error than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which thehe error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: Your name,address,telephone and account numbers. Date range of this invoice • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that arc not in question. •• Izs<ss7690 Your Account Number You do not have to pay the disputed amount while it is being ouiooloo-oolooloo investigated.During the investigation,we cannot report your account Iz3<se769 1 as delinquent or take any action to collect the amount in question. TaR-Da BA MON,xT z9 Watch here for a wEo-Nov 7+ GENERAL INFORMATION m DEC+B personalized account 1.Payments received after the billing(INVOICE)date will appear on Important 72 1411" del.,U4ditlld,..iI1L61114.,11111..Ihd1.IdU aawr,eaen'MOu^a00 vr�Ue your next invoice.Past due invoices(not paid within 30 days of news and Th `a ankYppmessage n Dpe billing date)may he assessed a late fee as allowed by law not to offers liz?"Malns exceed$20 per month.Additionally,third party collection/attorney olv.W � o 1..A1.4t1,.1,„44Id,d.O expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. ---- -'� dna'�^` :mYW"mfO1�"R= %1'I Pay electronically 2.Each returned check is subject to a service charge subject to the ~� d�pkmrin,wderfranamwkl¢,veae�Y°?Wa�.. �a`-�Ts _J�..�^'°°.l maximum check return charge allowable in your State. Make sure this '? _ .,oP..9m 3. All bottle and equipment deposits are shown as CURRENT Activity :'`" _ --- �~ mna.ewe^^^••" ACTIVITY. RIVITv "• ” "" ""�_ � >_ amount has been since your ACCOUNTA paid in full to 4. Equipment re lacement costs will be charged for bottles lost, Add-, ,pnpDpe'133Ma1"sLre"'ory.s':`°0°°°° x%+ p g last invoice ace"•"� " stolen,damaged or not returned. p,e.,p„:BawMe xH avoid late fees vavme°'.mapkvou wale 5.In accordance with NWNA's Terms and Conditions("T&C"),your Dent 46+e°" sGalunNaw,alspnp9 %%" III l 1788514aM %xX 5 kc MpunN�n S eat Depp+,L Equipment Lease and/or Service Agreement account may be1t 3178851awa Ice Mountains Gal Return % Monthly Oil Dent T, subject to minimum monthly purchases and/or early cancellation 3+7Be11— �5p,Tha,9e 316763881+ Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the m 166ppp97 """ Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TOTAL Fee(see#6 under Leased Equipment Is charged through the end of the billing cycle "General in which service is discontinued. .eTW,T+ _ ."""", %"` " Information") 6.You will be charged a monthly Oil Surcharge.Fuel Surcharge or Mu x x s•a•v Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY c^• lou ____-_ 3 __ — Ay TNIs AMOUNT ev,aw a•• %%%% will apply to each account. The fee that applies to your account _ - '---- �.e, ^' ACCOUNT NUMBER pA`"e4 is stated on the front of the invoice.For further information lease p «,n 17 4567890 ppj00 0O MT.ENCLOSED P INVOKE NUMBE0. BILLING DATE visit the website listed below or contact our customer service wwlw — u3ase7690 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 0003910 V9 2aD4 1B Amount due regulations promulgated by the Federal Food and Drug Iph^Oce Administration(FDA). ICE MOUNTAIN WATER OM�pANr �ryslace5t awoo Submit your •pe„and Ne,ef W+tin" `^` 8.Your first invoice indicates the products delivered on your first ,ORCuSTOMERSEwICEULL,eoo.,7,.988e delivery,along with any applicable bottle and account deposits, 5iee payment by this I�dU.I...1..UI.....11..�.11..11..40,.i.�.1.41.6d..q sin• ❑a.�m A,ry cna^9e+D^R�'e'u d redemption fees,and mry dispenser charges.All future invoices �saN LeEr unDcm s,g^„p eeow,.°onRM'� date will rellect charees for water delivered and dispenser rental,bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No.NW 709 08/12 service.icemountainwater.com 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 04/15/14 04D0119252823 $53.60 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 I VOUCHER NO. WARRANT NO. _ ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $53.60 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 2201 104D0119252823 I 42-389.001 $53.60 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 ` r' Aril 5, 2014 6VVV StreeSgeetOiiimx wion er Title Cost distribution ledger classification if claim paid motor vehicle highway fund