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235418 07/30/14
�./ CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: S"""""""2.99• CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 235418 PO BOX 856680 CHECK DATE: 07/30/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 04GO11925282 2.99 04GO119252823 service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 i LOUISVILLE KY 40258 06/13/14-07/12/14 0460119252823 ADDRESS SERVICE REQUESTED WE - AUG 06 II I I II I II I II I II IIII I III III' IN II I ' l lFRID SEP 05 0119252823 MON- OCT 06 MON- NOV 03 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.It's free! CARMEL IN 46074-8267 EL ntb&e' f these HOT Summer SaVtngs for a limned time onlyl These savings are on a variety of ncluding referesh'r'ng teas and lemonadeSparkling NaturatSprtng Water and great on the=gosues ce icpmountalnwater com or cad! '! 800-472 988 to order)iz....<'�' ...:n"`r. ,�. 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 44.11 7/11 094768 PAYMENT-THANK YOU -44.11 7/12 G6881650 RENT 2.99 TOTAL 2.99 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT y Subject to terms on reverse side. 44.11 — 44.11 + 2.99 = 2.99 a'I BILLING RIGHTS SUMMARy INCASE OF ERRORS OR YOUR VOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALPfyO ANAD OUTYOURBILLOR P EASE CALL 1-800-472-9888 OR WRITE vs AT. 1• please remember payment is due by the"pay by"date noted to ensure the smoothest service. 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means ICE MOUNTAIN SPRING WATER CO. You first invoice will include a pro-rated fee for the current month,plus the next month's rental. 6661 DIXIE HWY.,Stns 4 1 Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater,com Ifyou think your bill is wrong,or if you 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,Io your letter, SAMPLE give us the following information; r, 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 toP a investi gated.Durin y the disputed amount while it is being g g the investigation,we cannot report your account as delinquent or take an ° oo/ooloo-oo/aD/oo 123+567890 j your Account Number y action to collect the amount in question. GENERAL INFORMATION MR.00,a 113+S6789 t 1.Payments received after the billing .00r 29 Your next invoice.Past due invoices(noottlpa d within ate 130 days of newsand Importantl appear on WEp NOc zl billin 1E.occ le i Watch here for a g date)may be assessed a late Fee as allowed by law not to exceed date) per month.Additionally,thirdattorney john Doe UL iia G:IUi tint Ulgnlli!UJ W, ° 5e a�1 eoo-an-9eRR i personalized account offers 1c6 D6 andse u/6rusinglsMamaekp6amn message expenses may be assessed at a rate not to party 00%of the 123 main St .na,ma� kl Dry SUt WOOD ....; maid balance or the maximum allowedby law I:da f a gt•aft_;U rt L4 t.FLtJ J a ,2.Each returned check is subject to a service charge subject to the ' maximum check return charge allowable in your State. - l _ Pay electronically 3. All bottle and equipment deposits are shown as CURRENT < ACTIVITY. Activity �� - 4. Equipment replacement costs will be charged for bottles lost, since your " Make sure this ACCOUNT ACTIVITY mwvnex.mx. m+^�°i , stolen,damaged or not returned. Last invoice amount has been S.In accordance with Dw�nwa�xmnoo«.IzsM�suetienry.st•teWOW �. NWNM;Terms and Conditions("T&C1%your P'm a awm« aw ." paid in full to Equipment Lease and/or Service Agreement account may be T6znkY6u avoid late fees subject to minimum month/ iii 3178801AM1 s SQgonNa"SP"9 ' _, fees.(A complete version of the current T&C may beor viewed ion the lation " 31MW4444 ° °'"sc,IDe 69111 3170051AC11 5 IaMaunNMSWIRetum Monthly Off website listed below)Upon service discontinuation,rent for the 6kn sle2meanI NOnm` �1z ' 97 • x 1 Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle in which service is discontinued, TO AL ! Surcharge or Delivery .:: 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or 4 Fee(see#6 under Delivery Fee as described in your T&C. Only one of these fees Ngpry,1,A6}ry1fY — 9AYlNSM1�M "General Will apply to each account Payment s ujd A 4—°""" MTM°"+ — Tho fee that applies to tub accouNT SUMMARY a a „�,,,,,"m„ 6Y 6 Information) >a�a { is stated on the front of PP your account - --- e invoice.For further information please ---------- visit the website listed below or contact our customer service OrxnW wk°'R'm �'mµ ACCOUNTNUMBER 9nv ev PAY 7115 AMOUNT center. 72 67890 0000 0 INVOICE NUMBER B1WNG DALE .ENCLOSED ` 7.As a food product, bottled water is subject to the rules and 123/567890 001001DO regulations promulgated by the Federal Food and Drug Administration(FDA), 0420046307 04282712619 000391049 200V 18 8.Your first invoice indicates the products delivered on your fust Amount due delivery,along with any applicable bottle and account deposits, 161mo6e ICE MDUNTNN WATER COM9ANY 121 M•In St 6MIDmdNaN Nv16An<6s1,c City.St6te 00000 redemption fees,and any dispenser charges.All future invoices Submit your will reflect charges for water delivered and dispenser rental,bottle TOR CUr,o1.1ER SEAVKE GLI,860+7F9888 j WJ.«IgQ�:d6.dL lfd;ul.lt Lt�GFl�p deposits and credits plus charges for any additional products seNw oRE�EunoeAnsg 6oRrow ao R :� ❑9an � date payment by this ordered by you.Deliveries are made eveour '-a a total of 16-17 deliveries per year,you will only recefor ive weeks, L He. M 12 times per year, invoices two deliveries, so only 5 of those invoices will reflect ©2008 Ice Mountain Spring Water Company,a Division of Nestl6 Waters service,icemountainwater.com North America Inc. Form No.NW 709 08112 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $2.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#!TITLE I AMOUNT Board Members 2201 104G0119252823 I 42-389.001 $2.99 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 i� 24, 2014 Street COmm'tssinnar Street Commissioner 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)) 07/15/14 04G0119252823 $2.99 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