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237639 09/30/14
W.Coq CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*********9.60* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 237639 9M�TON_�. PO BOX 856680 CHECK DATE: 09/30/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 041011925282 9.60 0420119252823 service.icemountainwater.com ®b 8 #215 6661 DIXIE HWY,SUITE 4 08/13/14-09/12/14 0410119252823 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II' 1111111111111111111111111111 l l l I l II I 'll MON- OCT 06 0119252823 MON- NOV 03 THU- DEC 04 THU- JAN 08 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 III"III"III"I I I I I I I I I I'1 1 1 1 1 I'I I I I I I'I'1 1 1 1 1 1 I'I I I"I"I I�I I I I SasueonrfantasttcBack�to SchoolEssenflals! Get a$1QO offwhen you purchase(1) 8oz48 pack or(2)12oz ; 24 Pack bottles!8 o%Is lunch`O,boz fr entllV anis 12 ozJS- e,p ect for teens&bus ?Zmms° Call,.' 80D 472 9888�or v slt servlcelcetnountalnwater com�to orderly Nhengkv, 4 77 g z 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 27.09 9/08 404962 PAYMENT-THANK YOU -2709 8/27 0899829444 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 6.00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -6.00 9/12 0902953124 1 OIL/FUEL SURCHARGE 3.12 17207521 RENT 2.99 TOTAL 9.60 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 27.09 — 27.09 + 9.60 = 9.60 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUTyoUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY AND HELP US SERVE YOU BETTER INFORMATION,PLEASE I• Please remember payment is due by the"pay by"date noted to ensure the smoothest service. CALL I-soo 472-sass OR R RITE us AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month ICE MOUNTAIN SPRING WATER CO. your first invoice will include apro-rated fee for the current month,plus the next month's rental. #216 3. Kindly fill in the amount enclosed include your account number Plus your next th advance.That means 666]DDUE HWY gUITE 4 If you prefer,you can a LOUISVILLE,KY 40258 Pay your bill online at service.Jcemountainwater.com k, and do not send cash. If you 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 orproblem a telephone us,but doing so will preserve your rights.In your letter, give us the following information;notPpeafedYOU SAMPLE INVOICE • Your name,address,telephone and account numbers. V • The dollaramount 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 ofyour 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 „ as delinquent or take an amount Your account o0t00roo•0ar0oroo 1234s6]a90 YOnrACCOunt Number y action to collect the amount in question. GENERAL INFORMATION � THR.00T�e 123456789 L Payments received after the billingate M0N 0c z9 Your next invoice.Past due Invoicesh(Doottlpa ddwi h ni130 daysf pear of nws and Important ��21 Watch here for a TUE-DEc la i _ -billing date)_may be assessed a tate fee a_s allowed b law not to ag III HbdAA>.,tltllfakn,61Un1fJlldtl C" ]SIM=1600412-9666 Personalized account exceed$26permonth.Additionall,third y -_offers mnno Th•NY^4ln,usm9leM^unnnProd"� me Y party collection/attorney __123 M I St sage expenses may be assessed at a rate not to exceed 100%of the .na.mna unpaid balance or the maximum allowed by law, .tat t nt.„n,12,12 tttnta�gcr?'n ----- 2.Each returned check is subject to a service charge subject to he ~ maximum check return charge allowable in your state. TO uv�* n n mwz �� ^K•u•m = w" �� t Pay electronically 3. All bottle and equipment deposits are shown as CURRENT a¢ ACTMTY Activity 4. Equipment replacement costs wil! be charged for bottles Post since your Make sure this ACCOUNTAC1wnY 6®°"°^°•e•^a�Mn141ntl1ni•`xm"”' ee11bD�] stolen,damaged or not returned last invoice amount has been 5.In accordance with NWNNs Te DelrveryAOdress:I^hnDoa 123Me1nAree Ory,S ate 00000 aid Terms and Conditions("T&C,,),your P,e.+n"1B"e- xw P in full to Equipment Lease and/or Service Agreement account may be o-I 461996 Pm, T)Mnn yo" avoid late fees subject to minimum 317BB514444 5 SGalbn Nalural5phng Wau, -W l monthly purchases and/or early cancellation • M1951— fees-(A complete version ofthe currentT&C may be viewed on the /11 M195144a4 s keMo nalnscelD Pn 1 r n- ax+ 09/11 31TB831e444 5 keMWnWn5Gal Rehm website listed below)Upon service discontinuation,rent for the 09122 3,a:a3Be,1 w 3",e e9e 1t1'Pa� '. t Monthly pi] 091i2 16640497 ' '`'` ' ; Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle 1 1 in which service is discontinued. TO1AL _ ' i Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in your T&C. Only one of these fees °General WIIIe ramoweuwn_rA.Murt�nMwr+cuxxunAamn _ rT1nsAMo 1 to each Payment stub PP Y ch account The fee that applies to our ACCOUNT SUMMARY a a ,,,,�,.,m Information >n>a is stated on the front of the inv Y account ____ ______ --- ' _ee„•....e,e....^,e.—•,e.e•"gee•^�.,"._ ------------ olce.For further information please visit 'he website listed below or contact our customer service center. AccouNrauMBEa MY 11 9nrTa1s,v4ouNr 123456]690 00 0 0 ENCEOSED 7. As a food product, bottled water is subject to the rules and INVOICE NUMBER BIwNO DATE # 123456]890 00/00/00 $ regulations promulgated by the Federal Food and Drug Admmlatl'ahOn(FDA). 0420096307 04282732639 000391049 2004 18 8.four first invoice indicates the products delivered on your first Amount due delivery,along with an CE-OU NN WATER COMPANY 123 el Y applicable bottle and account deposits, •0 w m4^4W^"^" 23M:mst redemption fees,and any dispenser c a ges.All'fu[1ue'invoie s- - atyswre 00000 will reflect charges for water delivered and dispenser rental,bottle Submit your '_.I::.talafallt..�iL.�.U;.At�4[t„ti•GI,t,Ld.G, POR CUSrOMFR SDMQ GLL1800<>D9888 deposits and credits plus charges for any additional products 0 � � 1 Payment by this ordered by you. Deliveries are made eve - --M - date - a three or four weeks,for Cl a total of I6-17 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 Nestld Waters North America Inc. service.icemountainwater.com Form No,NW 709�OPJ14 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 $9.60 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCTWTITLE AMOUNT Board Members 2201 10410119252823 I 42-389.001 $9.60 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 Frid Se r 14 Title Cost distribution ledger classification if claim paid motor vehicle highway fund I 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)) 09/17/14 0410119252823 $9.60 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