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234545 07/08/14 ''• CITY OF CARMEL, INDIANA VENDOR: 051125 s ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $""""""""10.64' .;� ® ONE CIVIC SQUARE v� ,�; CARMEL, INDIANA 46032 PROCESSING R OX 8ING CENTER CHECK NUMBER: 234545 �.a„ CHECK DATE: 07/08/14 LOUISVILLE KY 40285.6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 14F722032704 10.64 14F7220327048 service.icemountainwater.com ' #215 6661 DIXIE HWY,SUITE 4 06/01/14-06/30/14 141`7220327048 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIIIIIIIIII'lllllllllllllllll TUE- JUL 08 7220327048 WED- AUG 06 FRI- SEP 05 MON- OCT 06 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service:1-800472-9888 ANN DAVIS Did you forget about us? Kindly pay upon receipt. 1 CIVIC SQ Remember past due accounts are subject to a late fee. CARMEL IN 46032-2584 Your prompt payment is appreciated. For your convenience,pay online:service.1cemountainwater.com. If payment has been made,we thank you. se* m ;j ext > sys+:. , ra" ,x'c*.r� ..� ., a +� a . "T6-Me-,"Great`NEWWAiste of N SrTEA NQWt Sane'$3 off a 12 pack of 12 oz,cans for a promoted, rice of$3 99 ,"7 AN $3 off a r12 ackof Nesta 1/2 Iter botles,�forpolrnrnoted price:of$5.991 Cal[ 1;800-472 9888 or ut�slt �servicetcennounta nwater'GA1 tO aCltOe�itftJr OrGlert y . � *�;T'✓��§'rr ,�' ° �k � �r orrsx wsrt�� "*« �+, ' z ,��, t �u #' `vk t y l , 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,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 17.22 6/09 0886262575 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN--- .00 6/30 0891245177 1 OIL/FUEL SURCHARGE 3.16 F6721894 RENT 3.99 TOTAL 27.86 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 17.22 — 0.00 + 10.64 = 27.86 BILLING RIGHTS SUMMARY POUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR A REPORT ON WATER QUALITY ANDFpRIvIATION,PLEASE I• Please remember payment is due by the"pay by"date noted to ensure the smoothest service. CALL 1-800-472-9888 OR WRITE Us AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means I216 CE MOUNTAIN SPRING 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. 6661 DIXIE HWY,SUITE 4 If you prefer,you can a LOUISVILLE,KY 40258 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 lvrong,or ifyou need more information about 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 give us the following information: LE INVOICE • Your name,address,telephone and account numbers. v • 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 investigated.During the investigation,we cannot re ortYourr,. as delinquent or take any action to collect the amount in question.nt 00100100.00100(00 123456J890 Your Account Number GENERAL INFORMATION ��TIO19N ? T"-00. 123456789 1-Payments received atter the billing(INVOICE)date will appear on Important 1E1>N.f 29 Your next invoice.Past due invoices no[ y WEU Nov 2, billing date)may be assessed a late feet paid within law not to news and uE-oEc,e d Watch here for a exceed$20 per month.Additd Additionally, Intl<diln!IL9tt{1•tlltLteA"nta"a•Oddp "'n°m"s`" 's°°'7x-'BBa s Personalized account expenses may Party C011ection/attomey offers t°A^ 7hanYy°uf°ruilnglaMaunWnP,°d— f message P y be assessed at a rate not to exceed 100%of the 23 A»in st aua aMae Pry,SW 00000 - unpaid balance or the maximum allowed by law, — ,inset t titu+.fit dt:•n 6o t..lyta,J.a. 2.Each returned check is subject to a service charge subject to the ~~" maximum check return ch arge allowable in your State. Pay electronically 3. All bottle and equipment deposits are shown as CURRENT """""'°`d"�°�`• `�1ery�� ACTIVITY. RRENT Activity 4, Equipment replacement costs will be charged for bottles lost, since your K e d-•'^«aa"• "°° a"" t Make sure this stolen,damaged r AccouNrarnvm w g o not returned, Last invoiceamount has been 5.In accordance with NwNA's Terms and Conditions(••T&C"), oer nAea eu !°hnoa,b;Mafns�cGry.wte O0000 ` pard in full to Equipment Lease and/or Service Agreement account may be P•m+"uaBaance none a a avoid late fees subject to minimum month) °�n ii;e�s,ua s scan ntr+at°.dsvd+�Raret �.{ >a�c ion fees.(A complete version of the curhentT&C may be viewed oor early nthe "' "'�5144� s BMW�ms�a+o P•t Bsm 2vBBs,uaa s ,aManwmsca+R - Monthly Oil website listed below)Upon service discontinuation,rent for the 2 31626sea ,s°wage « Leased Equipment is charged through the end of the billing cycle B9na ,a4w97 i} 1 Surcharge,Fuel "� -Fl,«sf JCaxM in which service is discontinued. "" - Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee each described in your T&C, Only one of these fees '"T"°"°°" .General vAruwru°rv6,N,N*}cwAvaAcmrn c I will apply to each account. Payment stub " tlNC— is stated The fee that applies to your account accourrr suMnlARv „ on the front of the invoice.For further inform IIIformatl0n� anon please visit the website listed below or contact our customer service ° °" °brd �` A[[OUNr NUMBER PAV BY PAY TNIS OUNT center- 123456]890 OWN i ENUOSE0 7. As a food product, bottled water is subject to the rules and NVOICE NUMBER 81WNO DAIS 1 1234567890 00!00!00 regulations promulgated by the Federal Food and Drug Administration(FDA). p420096307 04262712619 00039b049 2004 16 8.Your first invoice indicates the products delivered on your first Amount due delivery, 123 MAi" along with any applicable bottle and account deposits, .CE�MWNrAN WATERCOMPAlt 23 Main it i N wmewavn r+umameh•inr. aty,state 00000 redemption fees,and any dispenser charges.All future invoices Submit your will reflect charges for water delivered and dispenser rental,bottle Lda�.J^In6 p aI^tun,d."eptte.e wRcusroMEnsEmrceua,mo.n-9eee deposits and credits plus charges for any additional products ❑v°wwRERUAum AnRynuPR 4mreao R me ""` "° "O F" 90e Payment by this ordered by you. Deliveries are made every three or four weeks,for _ date 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. service,icemountainwater.com Form No.NW 709 08/12 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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. p M Pee /nn ,� nay n v_! A_ Purchase Order No. 0 Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) (A 5&-di, Total 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 Ott V, IN SUM OF Toerx 1"'*6ko� I�1)0 &raL Kq' 40 249 $ 104-04 ON ACCOUNT OF APPROPRIATION FOR AIR& Lam Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), l or bill(s) is (are) true and correct and that -OL(9 the materials or services itemized thereon for which charge is made were ordered and received except s0AmA-4w?o *41-4%AJA;%—�— (5� Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund