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239545 11/25/2014
%' ""e CITY OF CARMEL, INDIANA VENDOR: 051125 .�, �' ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $ 2.99 s. r CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 239545 9y�TON PO BOX 856680 CHECK DATE: 11/25/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 04KO11925282 2.99 04KO119252823 service.icemountainwater.comY109"" I #215 6661 DIXIE HWY,SUITE 4 10/13/14- 11/12/14 04K0119252823 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® e IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII THD- DEC 04 0119252823 WED- JAN 07 FRI- FEB 06. Access your delivery calendar at TUE- MAR 10 service.icemountainwater.com 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 freel CARMEL IN 46074-8267 I'lll�l lll'lll�llll'I'11111"'11111'llll'lllllll'llllll'lllllllll IMRC?RTANI Please be atl�isetl tt at the nYolc fog our next dellve well reflect a nrlc ceases n SOlect W y�� i aC . �r�ducts F'leasecall us Ifi you�Fiau�e anyquestlons����6 �� ���� � ���� _ it 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 13.09 11/07 755282 PAYMENT-THANKYOU -13.09 11/12 K7537665 RENT 2.99 TOTAL 2.99 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 13.09 — 13.09 -F 2.99 = 2.99 l BILLING RIGHTS Su-MIVIARy IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR 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 by the"pay by"date noted to ensure the smoothest service. CALL 1-800-472-9888 OR WRITE vs AT: 2. Remember,if you are renting equipment,your equipment rental is charged one m 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 g month in advance.That means 6661 DIXIE HWY.,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.icemountaintivater.com Ifyou think our 4. Never hesitate to call us with comments,questions,or concerns. Y bill is wrong,a if you need more information about a transaction on your bill,write us on a separate sheet-of paper.We must bear from you in writingno we later than thirty(30)days after sent you the first bill on which telephone us,but doing so will the error or problem aur rights.In your lettppeared.You cer,an not preserve yoq give us the following information: SAMPLE 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 \ - ` as delinquent or take an action g cannot report your account ooloo/oo 00/00/00 234567890 Y hon to collect the amount in question, f Your Account Number GENERAL INFO >"�`a a 'w 1 1-Pa RMATION nR.cc B, 123456789 Payments received ager the billing(INVOICE)date will appear on Important Your next invoice.Past due invoices not aid MON-OCT 29 Your ( P within 30 days of news and wEo-aov n Watch here for a billing date)may be assessed a late fee as allowed b uE-OEc,e exceed$20 per month.Additionally,thirdparty Y law not to RUG 10 d1 aU1 iNG1 KWIC.1l,p.d(ttLt.l,. Caota-1-1-34OD472-9888 personalized.account expenses may P rlycoIlection/attorne Offers 123W)e I,. P-1— message Crybt t 00000 unpaid balance or the maximum allowed by law• aQa 1 u 11 u;n Gp 1 6i tt opts maximum check return charge allowable in your State. 2.Each returned check is subject to a service charge subject to the ' ---' so- mina 7Rm d y 4 pY waw°ens s 3. All bottle and equipment deposits are shown as CURRENT ? Pay electronically ACTIVITY. omoa� a sa * , Activity � ��' �. 4. Equipment replacement costs will be since your Make sure this stolen charged for bottles lost, Accourrrarnvm �..«m damaged or not returned. last invoice amount has been 5.Inacc r � „�,yaadre:z lonpooe,u3Mamsnee,,cnr,stateRBooB accordance with NWNA's Terms and Conditions("T&C")I your paid in full t0 Equipment Lease P edpnsBalan e and/or Service Agreement account avoid late fees subject to minimum may be Oft 3, 48,apR monthly purchases and/or earl cancellation m 3,7s9s44a 5 BGallonNamral5prin9Water �� fees.(Acomplete version ofthecurrentT&Cm Yviewed m n>ees,as44 s I�MwntsnsGIo 1 a t x Ry/,i 3,78&514NW 5 MounW nSG IR t �; website listed below U may be viewed on the 99/2 3,e:6nBBn fuelsurcn rge °° Monthly Oil Upon service discontinuation,rent for the o9n ,6W49T Rent a a Leased Equipment is charged through the end of the billing cycle Surcharge,Fuel Fy rl Fr s� >oim in which service is discontinued. TpTA1- Surcharge Or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or m- Fee(see#6 under Delivery Fee as described in your T&C. Only "General y One of these fees RmousRNANCE_PnrMurtnnry M t NRREN ACR OY _ PATmu N Will aPPIY to each account The fee Payment stub ° x O that a lies to ACCOUNT SUMMAAYz >axR ,s stated on the front of PP Your account „e :�N�mumume�emye°�. Information") the invoice.F - visit the website listed below or contact our customer please ----a ,, ,n A a w PAY BY PAY MIS AMOUNT j ACCOUNT NUMBER customer service Bo 00 oB center. 1234567890 DAn ENCIOREO 7.As a food product, bottled water is subject to the rules and NVOICE 67890 BI 01Of0a 1234587690 00/00!00 regulations promulgated by the Federal Food and Drug Administration(FDA). 0420096307 04282712619 000391049 2004 18 S.Your first invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, 123Wl redemption f ICE MOUMAIN WATER COMPANI' P fees,and an � ""'°° u3 Mam st } y dispenser charges.All future invoices CyMare �� will reflect charges for water delivered and dispenser rental,bottle Iddt t J jlG„t! U n;611 ga41 Et#ut. FOR CU6 OMFR SERV CE CA 1tE90.02-9888 Submit t by t deposits and credits plus charges for an ❑ Payment by this ordered b y additional products ❑SIGNUP OflFRF OA 59nUp onR ea s ,} date y you, Deliveries are made every three or four weeks,for a total of 16-]7 deliveries per year.You will only receive invoices _- ___..�____._ .-_�.._- ..._ �_-- - ---� ---- 12 times per year,so YOU 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 70902/14 VOUCHER NO. WARRANT NO. Ice Mountain ALLOWED 20 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 AMOUNT Board Members 2201 104KO119252823 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 Frid , No r 14 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)) 11/14/14 04KO119252823 $2.99 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