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234035 06/25/14
CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $********61.33* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 234035 PO BOX 856680 CHECK DATE: 06/25/14 LOUISVILLE KY 40285.6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 04FO19925282 44.11 04FO119252823 1701 4239099 14E722032704 17.22 14E7220327048 "k service.icemountainwater.com ®• 8 x I A I A #215 6661 DIXIE HWY,SUITE 4 05/13/14-06/12/14 04F0119252823 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II' 1111111111111111111111111111 II I I"II'II'III I I I I I I I I IN I'I 'II TUE- JUL 08 0119252823 WED- AUG 06 FRI- SEP 05 MON- OCT 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:1-800-472-9888.IYs freel CARMEL IN 46074-8267 I��II���In�rInl�IIuI�IIIIIIIIIIIIII�IIII�IIIIIII��Illllll�rll 77 r F TIy the�Great NEW taste of NESTEA NO�WI;�Sav6n off a 12 pack of 12 oz cans for a promoted price of$3 99 gMD$3offa 92 packof Nestea€112 Ilterbottles,for aesvpromotetl pricebfy$5 99I Ca111-800-4729888 orvls0t , w ��se,�ctce.ic' utt�t.�tn_itv�t�r tom to`add�to iiorclerr��P ����'� ,n "W ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT,1 CIVIC SQUARE,CARMEL IN 46032 PREVIOUS BALANCE 7.31 6/02 862776 PAYMENT-THANK YOU -7.31 6109 0886262278 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 24.00 6112 0888802931 1 OIL/FUEL SURCHARGE 3.16 F6719327 RENT 2.99 TOTAL ; , 44.11 t, L COUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNTect to terms on reverse side. 7.31 — 7.31 �- 44.11 44.11 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO HELp US SERVE YOU BETTER A REPORT ON WATER QUALITY AND I FORMATION, PLEASE 1, Please remember payment is due by the" a y"date CALL 1-800-472-9888 OR WRITE US AT; 2. Remember,if You are renting equipment,yourbt:quipmentted to rentalis barged one month n advance,That nsure the smoothest service, ICE MOUNTAIN SPRING NATER CO. Yom'first invoice will include a pro-rated fee for the current month,plus the next month's rental. 11216 means 6661 DIXIE IiWY.,SUITE 4 3, Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service•icemountainwater.com IfYou think 4. Never hesitate to call us with comments,questions,or concerns. Y your bill is ill,write Or ifyou need more information about a transaction on your bill,write us.on a separate sheet of paper.We mus[he from you in writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your lett give us the following information: er, SAMPLE INVOICE • Your name,address,telephone and account numbers. • The dollar amount of the suspected error, Date range of this invoice • 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 are not in question. You do not have to Pay the disputed amount while it is being k investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. ' ooroo/o0-00/00/00 1234567890 YourAecount Number GENE yr'rnra�1234a!m!: RAL INFORMATION THB.DC pa 23456789 1.Payments received ager the billing(INVOICE)date will a MON-OC129 Your next invoice.Past due invoices(not paid within 30daysof news and t WD,NOV E.DEC 21 Watch here for a billing date)may be assessed a late fee as allowed by law not to TUE.DEC,B exceed$20 per month.Additionally,[herd r IGt✓mlil hl tlltlJgdIII,I IOL.Itlp tG t6IdH Cu°mcr3eMce:1-eoa4n-9BBB personalized account offers 6 D u,,,k,�°r„°a�Lo,m—WnP�°ti message expenses may be assessed at a rate not to exceed 100 o tof the __ _ _ 123 M >Y —' —cyst re 00000 ana><m.ea. unpaid balance or the maxim 1:,i1[Jd ttf q eu'n um allowed by law. 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. � ros�m w smar To m'rr5n+°� 3. All bottle and equipment de osits are shown �ro1Q Pay electronicallyACTIVITY, CURRENT Activity 4. Equipment replacement costs will be charged for bsince oMake sure this stolen,damaged or not returned, battles lost, your ACCOUMACi1VnY . ��."•.�• •'^^^"�°^"a"'""""°°""" 5,In accordance with NWNAS Terms and Conditions("T&C" last invoice amount has been Delivery Addresr.Jahn Dae,/23 Main Street Gry.5ute 00000 Equipment Lease and/or Service Agreement account may be PrerwusesUN� laJoc Paid in full to subject to minimum °ars' 4file9e avoid late fees monthly purchases and/or early cancellation �+ 3vees14444 5 SGaBan NaWml SpOngWa er fees.(A complete version of the c nl 3neeslsaa s keMoun❑asDamepma µr--- LL-_r-`,. may website listed ureentT&C nua be Viewed 99n, 317aB 14w. s r.,%S h r9e lBemm on the 69n2 31H2fi3B811 rael5arm rye l?J,y Q l t,ll 'il l' Monthly Oil below)Upon service discontinuation,rent for the °'J+2 +fi64a497 8enl Leased Equipment is charged through the end of the billing cycle ' Surcharge,,Fuel in which service is discontinued. O P �41ti p o Surcharge or Delivery 6.You will be charged ri monthly Oil Surcharge,Fuel Surcharge or M1 Delivery Fee as descr bed in your T&C. Only one of these fees j Fee(see#6 under will a oBfl'Ious6elnNCL_enxalD+n6arvsm+aN1,*aauxrArnvDr = v rmisnMoaNr "General PPIY to each account, The fee that a Payment stub ACCOUNT SUMMMY « a p n x■ is stated on the front of the' applies to your account Information') visit invoice.For further info •••.,•••_•_ _•_ -- Inform the website listed below or contact our custome�service Demtl"fi14°A mer•ov. lob ” ACCOUNT PAY BY PAYTMSAMOUNr 1234S67B90 00 00 00 I As a food product, bottled water is subject to the rules and INVOICENUMBER BILLING 7. ENCLOSED 123456)890 00100 00 - regulations promulgated by the Federal Food and Drug Administration(FDA). I 0420096307 04282712619 000391049 2114 18 8.Your first invoice indicates the products delivered on your first Amount due delivery, CE MOUN A N WArrA COMPANY john Oce ry,along with any applicable bottle and account deposits, a Wim" """"'" otys"ns1 redemption fees,and any dispenser charges.All th will reflect ch clrswlB 00000 charges for water delivered and dispenser rental,battle deposits and credits 1 wacusroMD<sDMauul-ww7:-9BBB Submit your Pus ch Payment by this charges for any additional products ❑scnwwaEBCEur�arnnsly"unanwmanuere�sev.6e. "'"'^nea'"9e'D"�M"eL°` date ordered by you. Deliveries are made eve - ----- •--'-•` ry 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 fnc, service.icemountainwater.com Form No.NW 709 08/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $44.11 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 104FO119252823 I 42-389.001 $44.11 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 �y. 0, 2014 Street Commissioner Street Commissioner 1 Title Cost distribution ledger classification if claim paid motor 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 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)) 06/19/14 04FO119252823 $44.11 1 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 imservice.!cemountainwater.comW #215 6661 DIXIE HY,SUITE 4 05/01/14-05/31/14 14E7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED Il I I II I II IIII l�lll I I I I I I I I I II I 'll TUE- JUL 08 7220327048 WED- AUG 06 FRI- SEP 05 MON- OCT 06 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 ANN DAVIS Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ CARMEL N 46032-2584 by phone at:1-800-472-9888.It's free! I�III�III��IIII�II��I�III��I��I��IIII�II�III�I�I�I���II�I�I�I�"I - r f, z� � �^.,,«�--'""»m ,..^.,- �, f /".%'�,.' � � c hi ,R 1251 n,yy .� .. �,� s D ,r , "l"*i z:,wli T heGreat NEtasfe of�N STEA NOSave$3 ofiFa12 pack`ofAz.;cans foa promoted pace of$3 99 sr6 „ -� � rzr ,. r�.f�^ � w, 'r�q�' m' ,9,, ,r $3eoff4A,2 pack of Nestaa 1121�ter bottles,for a p omoted prtce�of,$5 99! Gail 1 800-472 9,888 ar u�sl t 5 .x '�i�}ffiiUate, gd £ad t1^i /'. ✓I'MQ �'�fl'»Y z ' ,fa.�.r'�; �i�"'(..r"' ,�,� c'! l�.* 2i'✓ � �� .P� `�` .��.h? w�'z'`Via.. .r ��,�r � � `z�xalt �p :z, ,4"'' � � ,�� : r* �ri.�+.m. �U l3 ✓"/Tc�° .o-�,���,e, °5s z�"7'� �,"�, ^',z"�`£�'�,��`�f.,�° ��S��^ ,w� r�`���31�� '"- t,":w .�F .r z..,� '� ��` "✓'9' ��r'ii iy,�`��.Km',�x��,. �,a"�",v'aL S .a >�,�/*" ry sr ��, z ,., z�4 r-"�"���°m ��'�'6u f � .,�'y" �. .`i m'�'� �' �'`� � �'' �( ��. ` .'� �i�ziz ',.'X �.*.' ��� ,`,,, � tl arxnzva�,., ', �'`T:. ,'?%H"ra`�F`:'�fis.':�ir'�r �,NT,",�'S�,�'Si�",4•'„'J,�f �':1:�3; �a'�:.u;,e ACCOUNT ACTIVITY For questions or a report on water quali and information call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 7.98 5/23 EA2420366 PAYMENT RECEIVED -3.99 5/11 745769 PAYMENT-THANK YOU -3.99 5/07 0881754147 1 5 GAL ICE MOUNTAIN DRK WIHANDLE " 3.49 1 5 GALLON ICE MOUNTAIN BOTTLEDEPOSIT .00 2 9 OZ PLASTIC CUP'50C/SLV 6.58 4 5 GALLON ICE MOUNTAIN,DEPOSIT RETURN .00 5/31 0886780725 1 OIL/FUEL SURCHARG3.16 E6559894 RENT 9`�_-,. TOTAL _,-.1\2 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT �,rSubject to terms on reverse side. 7.98 — 7.98 + 17.22 = 17.22 BILLING RIGHTS SUMMARY INCASE OF ERRORS OR QUF,STIONS ABOUTYOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER UALrrY 1. Please remember payment is due by the payPbyJ by, SERVE ed to B TT the Rhest service. CALL 1-800.472-9888 OR WRITE US AAT-: FORMATION,PLEASE 2, Remember,ifyou are renting equipment,your equipment rental is charged one month in advance.That means #216ICE MOUNTAIN SPICING WATER CO. your first invoice will include a pro-rated fee for the current month,plus the next month's rental, 6661 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 666]DIXIE HVI+1: SUITE 4 LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater°com Ifyou think your bill is wrong,or ifyou need more information about 4• Never hesitate to call us with comments,questions,or concerns. a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights-In your letter, SAMPLE A MP give us the following information L E IISIVOICE Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice an error. • Describe the error and explain if you can,why you believe there is You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being investigated.During €79 i the investigation,we cannot report your account aolootoo-aoroolao izr-+s67avo as delinquent or take any action to collect the amount in question, Your Account Number GENERAL INFORMATION �IN -«r� z1A567E9It L Payments received ager the billing MON ar zp your next, g(INVOICE)date will appear on important �N 21 Watch here for a Y invoice.Past due invoices(not aid Within WE-DEC). billing date)may be assessed a late fee P thin 30 days of news and n;s(„",tft gtattllldlllldAb a[ipa93t1ta[G c�+Pnr sw¢,600 qn-966e personalized account exceed$20 Per month.Additionally,third party by law omeynot to offers 173 Male �I�n9+¢Ma n n n pmaum message expenses may be assessed at a tate not tore weed 00%o the ,z1M 1 se Gry.State oaao6 ,., ,,. unpaid balance or the maximum allowed by law. Ma x st„ar„•,lu a.6a u^e4uta„u , 2.Each returned check is subject to a service charge subject to the maximum check return charge -- allowable in your State. �*_ '� a<�t �`� ,.�t ���aw�ixv •� 3• All bottle and Pay electronically equipment deposits are shown as CURRENT Rh°A ACTIVITY. Activity ...E 4-Equipment replacement costs will be ch since your 6a Make sure this stolen,damaged or not returned charged for bottles lost, last invoice AccoUNracnvnY 5.In accordance with amount has been NWNASTe oet rad6ress rPnnooz+zrMams4 wer.saeooaao paid in full t0 Terms and Conditions("T&C'°),your o6 as¢ o w Equipment Lease and/or Service Agreement account may be ° avoid late fees subject to minimum 08f1 461898 P"'��`- Y >� monthlypurohasesand/orearl m 3neb,aaaa 5 SGalonNaurzl5pnn0Water fees-(A complete version ofthe current T&C may be viewed cancellation the n, 3vees,a44 s w Mu ndms 6a DeP� xx t 13n, 317M5144M s 1¢Maunuu,sca�a:m Monthly Oil website listed below U a4nr 318]638011 Upon service discontinuation,rent for the 0911 16640"' e V' tl Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle in which service is discontinued- °A Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge, Delivery Fee as described in your T&C. l Fuel Surcharge es ; Tee(see#6 under wBl apply to each account IY one of(hese fees payment stub + — amuNrANvrt+ vArras.,1w+Nr "General ACCOUNT SOMMANY s e al is stated on the frontThe fee that applies to your account €" �1„.A,„— __ m _°�. I Information°) of invoice.F «..a.°=°^^_^—"° ------------- visit the website listed below or contact our ustome�service ----°"tl”"bed w PAYBY PAYTM AMOUNT center. AccouNrNUMePa a a ,239567890 0000 F 7•As a food product, bottled water is subject to the rules and NYOKS678"A 6wNO 0ATr FNttOSED 123456]890 Oa100/0a £ regulations promulgated by the Federal Food and Drug 1 Administration(FDA). 0420096307 04262712619 000391049 2004 18 8,Your fust invoice indicates the products delivered on your first Amount due delivery, Jain D.cry,along with any I�MOUMAIN WMra COMPANY Y applicable bottle and account deposits, °8 °H 9fWRe '�� C"S",Stam redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental,bottle ���« • „6Tf t nt t GG'aU con Ns OM A SurnCc w,sxi+n Pees Submit your deposits and credits plus charges for any additional produce ❑�”"'OflDIEA"O Mns”pyg p �O en"sde ❑""`Am°"""� payment by this ordered by you,Deliveries are made eve date a total of 16-17 deliveries per year.You wily receive invoices our weeks fori- -- ”' __,.._.__._...____- ___._. __ 12 times Per year,so approximately two deliveries. 5 of those invoices will reflect 0©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemountainwater.com Form No.NW 709 08/12 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. ayee Purchase Order No. . U D Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice( ) or bill(q)) Total 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 IN SUM OF $ rq ON ACCOUNT OF APPROPRIATION FOR I VIV4 Board Members Po# 4 INVOICE NO. ACCT#!TITLE AMOUNT DEPT..# I hereby certify that the attached invoice(s), f � ? 17, 2Z- or bill(s) is (are) true and correct and that It the materials or services itemized thereon for which charge is made were ordered and received except 44 20 Sign e Cost distribution ledger classification if Title claim paid motor vehicle highway fund