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235882 08/13/14
q CITY OF CARMEL, INDIANA VENDOR: 051125 ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $**"******3.99* d9 _ CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 235882 PO BOX 856680 CHECK DATE: 08/13/14 LOUISVILLE KY 40285.6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 14G722032704 3.99 14G7220327048 service.icemountainwater.com ®.t_ ® gi a ' #215 6661 DIXIE HWY,SUITE 4 07/01/14-07/31/14 1467220327048 ' LOUISVILLE KY 40258 ® D e ADDRESS SERVICE REQUESTED II'I I II I" IIII I"II I I I I I III' II 'II SEP 05 7220327048 MON- OCT 06 MON- NOV 03 THU- DEC 04 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 by phone at:1-800-472-9888.IYs freel CARMEL IN 46032-2584 IIS'IIIA'I�I�rllrll�lrlrll'l�l'Il�llrll�n'I�I�'ll'lllllli�'�III' _ — Ta5"gyantageyof these HOT Summer Savings for a limited time only!These savings are on a�uariety of ,. - 1 :» s3 € products:including refreshing teas and lemonade, Sparkling:Natural�Sprirtig Water antl great`on the gds zes e ci#�au>ee r octz or c ll'L800472-.91;8£-tQorderL ;a N JPA x " 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 27.86 7/11 094769 PAYMENT-THANK YOU -17.22 7/25 176432 PAYMENT-THANK YOU -10.64 7/09 0008134602 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 7/31 G6884192 RENT 3.99 TOTAL 3.99 ACCOUNT SUMMARY ^`PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS-AAMOUNT Subject to terms on reverse side. 27.86 — 27.86 + 3.99 = 3.99 IBILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUPYOUR BILL,OR FOR YOUR VOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• Please remember payment is due b the" Pay CALL 1-800-472-9888 OR WRITE US AT: 2, Remember,if you are renting equipment,Your bquipm eqy"date uipment ntaled to is charged one monthnsure the into advance ICE MOUNTAIN SPRING WATER CO. Your first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 That means 6661 DIXIE IIWy.,SUITE 4 3. Kindly fill in the amount enclosed, include your account n LOUISVILLE,KY 40258 If you prefer,you can umber er your check and do not send cash. Pay your bill online at service,icemountainwater.com 4. Never hesitate to call us with comments,questions,or concerns. Ifyou think your bill is wrong,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 as,but doing so will not preserve your rights.In your letter, SAMPLE P give us the following information: LE INVOICE • Your name,address,telephone and account numbers. �/G • 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 report o n; as delinquent or take Your account any action to collect the amount in question. 00/00/00.00/00/00 111567890 Your Account Number ' GENERAL,INFORMATION "-OCT" tz3aswB9 I.Payments received after the billingMO&Oa 29 your next invoice,Past due invoicesr(noottlpaid within te i130 days of Important " NW 21 ? Watch here for a billing date)may be assessed a late fee as allowed by law not to TOE-DEC 1B exceed$20 per month.Additionally,third a c Y news and n,tlnin Inelm,tNd(a'1 tttt`dup"113U,Lft4 cn.rotn«se�kea-B0w17z-9BBB personalized account offers 123WC TwMy°ulorusin9lmMounWnpodu4 message _ expenses ma_he_assesse&at.a_rate.nOFt6_ ceedcIoo o , the-_ 123 Mat ss a,•Mre,, R------ Y unst 00000 ' unpaid balance or the maxim 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. Brcdr• �°mw m ' Ta,�tNmga_`attavx tl =k� Crtat'eyow50 3. All bottle and equipment deposits are shown as CURRENT• Payelectronicalty ACTIVITY, Activity 4. Equipment replacement costs will be charged for bottles lost, since our Make Sure thts Y ACCOUNT ACTH TY mwoe.s" ° stolen,damaged or not returned. last invoice amount has been 5.In accordance with NWNNs Terms and Conditions("T&C" DerrenAaat 1 nnDpe,12B Mams ees o ysale 00000 a« ;t paid In full to Equipment Lease and/or Service Agreement account may be ve�sB a"Ce subject to minimum monthlyoer3, 461b9& PavneM-lnankr"� i avoid late fees purchases n, 317Bas,a4aa s s0an>nnamtalsP�uu _•..,__<.,:t papa .. fees.(A complete version of the currentT&C may be viewed oln the "' J1�S°°° 09111 3,7E85,a444 5 ke MounWn SGai Feta I website listed below)Upon service discontinuation,rent for the o9m 3,ffi638a„ wrcnay `, ' ' I 1 1 f Monthly Oil Leased Equipment is charged through the end of the billing cycle �1� ' � Surcharge,Fuel in which service is discontinued. -� t x w O A` _ Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or I Fee(see#6 under Delivery Fee as described in your T&C. Only one of these fees '.1 — — "'TM"^00HT "General will apply to each a Payment stub PUWOus"uFa_— 1A01O Ns F cuuuH Ap rvm _ Ia30c xxaa [ account. The fee that applies to our ACCOUNT SUMMARY a Information') is stated on the front Y account of the invoice,For further information «"""••'«-•°°'—•°-E°•w..,«,.,.«� s�«���-� � ------------------------ -----�' visit the website listed below or contact our c t please ----pi1'°„«""�", ',,,".,,�tMY BY center. us omer service ACCOU 56789-FR 10010 PAY THIS AMOUNT S 1234561890 00/00/00 7. AS a food Product, IWOICENUMBER BItLNG DATE ENCLOSED P t, bottled water is subject to the rules and 1234567690 00WtN regulations promulgated by the Federal Food and Drug tl Administration(FDA) p42a096307 n42B27128b9 Da039ba49 2004 18 8,Your first invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, 123 D9e redemption fees,and any dispenser charges,All future invoices �CEMOUNiAiNWATERCOMPANY aty's le o'..m"+tlr,mew,v,wm k•I CIry,SWte 00000 I will reflect charges for water delivered and dispenser rental,bottle tte�>•[1 Ln„l wtsLLL tnn, fOflNSTOMERSDMCE[ALL1-BOP4R-96B4 i Submit your deposits and credits plus charges for any additional products vw wwF`aE n0P"'"nppQ Q d0nfl E3 W„W D 9.o Fed a 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 two deliveries. of those invoices will reflect ©2008 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Service.icemountainwater.com Form No.NW 709 Q2114 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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 $ ON ACCOUNT OF APPROPRIATION FOR 08 6kr Board Members PO# INVOICE NO. ACCT#!TITLE AMOUNT DEPT..# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that '704 the materials or services itemized thereon for which charge is made were ordered and received except A. 20 Signat re Title Cost distribution ledger classification if claim paid motor vehicle highway fund