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240006 12/09/14
CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*********3.99* r CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 240006 PO BOX 856680 CHECK DATE: 12/09/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 14K722032704 3.99 14K7220327048 service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 11/01/14- 11/30/14 14K7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II'I I II I'I IIII I I'lII'I I I I III' I I 'II WED- JAN 07 7220327048 FRI- FEB 06 TUE- MAR 10 Access your delivery calendar at WED- APR 08 service.icemountainwater.com CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 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 'III"�I�III��'ll'll�ll'III'�I'�II�II�I�I�II��I"�'I�II'�'I�II��I convenience,pay online:service.icemouritainwater.com. If payment has been made,we thank you. Br ng art the Holtday.Season with Sparkling CelebratlonS Enjoy premium brands Including San,Pellegrmo,' . F e�r�rler antl'Acgpa Panna,Look for Spec ial.:hiDlidaysavings going on.Trom now until the end'of the year Call'" carver-e h'E�!llZ4nh►?tpJ +t>htQ-CtIeLI t ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. o s ® ® e ® .._.,,. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 13.89 11/30 K7540028 RENT 3.99 TOTAL 17.88 f ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 13.89 — 0.00 + 3.99 = 17.88 F ILLING RIGHTS SUMMARY OF ERRORS OR QUESTIONS ABOUTYOURBILL,OR FOR YOUR INVOICE-4 WAyS TO HELP USSERVE YOU BETTER N WgTER QUALITY qND fl.IpORMATION,PLEASE 1• Please remember payment is due by the"pay by+'date noted to ensurethe smoothest service. 72-9sss oR WRtTE os qT, 2, Remember,if you ora renting equipment,your equipment rental is charged one month er advance.That mTAIN SPRING NATER CO, Yom•first invoice will include a pro-rated fee for the current month,plus the next month's rental. iI216 ears 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)ac If you think your bill is wrong,or if you need 4• Never hesitate to call us with coout mments,questions,or concerns. a transaction on,your;bill,write us on a separate sheet ofapaperbWe must hear from you in writing 10 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 tights.In your letter, SAMPLE give us the following information: LE 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 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 c as delinquent or take any action to collect the cannot i�question,Your account 00/00)00-00100100 234567b90 Your Account Number GENERAL 4uestion, E , INFORMATION „tR-0C,0a 123456789 §, 1.Payments received after the billingM O.Da 29 Your next invoice,Pas[due invoicesr(noOtlPaid dwith nate i130pdays of nws and Important WE6 NOV 11 ' Watch here for a billing date)may be assessed a late fee as allowed b tUE-DEc,e , exceed$20 per month.Additionally,third Y law not to tx� ILl1�a�tG 111 ttdlli:�litf,l ilii�Illtlafl;,U,f.1F1 C",�111tase1,,�,e,,.aoo.v2.9eea personalized account offers ahnDo ThankYautarusln9lceMounanP ; message expenses may be assessed at a tate not tore ceedc100°/B of the 123Mainse ane em«.. Otys�l o600D unpaid balance or the maximum allowed by law, is tti a m:,.p•.%_iti n to I btuGa„p 2.Each returned check is subject to a service charge subject to the _IPWA .7 — maximum check return charge allowable in Your State. nk as Yz: ^w°^°'ry me mea 1aJnwwa�.4w4 Y'"""`”*� "'"„""� '� t Pay electronically 3. All bottle and equipment deposits are shown as C a1" o .kxYaa o nm«e ACTIVITY. CURRENT Activity i 4. Equipment replacement costs will be or not returnede charged for bst, since your AccouNrarnvnv Make sure this stolen,d bottles lo �°„a„a•4"M °�^'•'^•••`^`""" "'°°°"'A ; . 5.In accordance with N last invoice 123 Maln Soeet.Gry,State 00000 � amount has been WNA'sTe •UeliveryA9dresc JohnOce, rms and Conditions("T&C"),your PrtAou Ba once IX 4 paid in full to Equipment Lease and/or Service Agreement account may be D P �„ �,ggg PaymenM1TtwnkYou ,�,a ? avoid late fees subject to minimum monthly purchases and/or earl cancellation n, 3veeslaa44 5 SOaOan Naua SpUngWa fees.(A complete version of the current T&C may be viewed on the 3'x161, 3 � S-Tn ns�aiDew�t u a 09/il 3178&514444 5 Ix Mounlatn5Ga1R website listed below U W/13 1661E30811 `""5u"° a �« Monthly Oil Upon service discontinuation,rent for the 09/+' t�40091 Bent f Lt ` ` t in'laat f Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle in which service is discontinued. 0 PLC, . Z1, Surcharge or Delivery 6.You will be charged a monthly oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in will a your T&C, Only one of these fees mm�uSauANa PA MUR/wry " t - PNM ACRYI+Y MY1Nt3��WM ppO to each account. The fee that applies our ace Payment stub ACCOUNT SUMMARY o o - o ,„ M , Inform )0:1:1( is stated on the front of the invoice.For lies toy account -------- c _-- Information,) n' visit the website listed below or contact Our �n��P'� ACCOUNTNUMBER PAY BY PAY iN+S AMOUNT center, xxx 1234561890 00 DN00 4 7.As a food product, bottled water is subject [o the rules and NV0IC 567ago R B1 0110 DANE ENCLOSED 123/567690 00100/00 3 regulations promulgated by the Federal Food Administration(FDA). and Drug 0420096307 04292712619 000391049 2004 36 S,Your first invoice indicates the products delivered on your first € Amount due delivery, CEO OUN NN WA1FA COMPANY 123 Da° along with any applicable bottle and account deposits, dNM10111AN` z3 Mau st redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental,bottle G Y,s ate DDBBo deposits and credits plus charges for an t• i ^.-!t^1,n tn•,u f'6GI;,Iati EO0.CUSTOM RSFRVLFCA 1-000�7b9666 ? Submit your 51GNUPfO6EBFE AUIDP VI519n Up8K Ire40nftevse5tle ❑PM,M,a,•9"�n��°.� ��. payment by this ordered by you. Deliveries are made every y addse or Tonal products ks,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 fce Mountain Spring Water Company,a Division of Nestle v Waters North America Inc. y' "serviCe•icemountainwater.com Form No.NW 709 02JI4 �' \ 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. M a�lyee t' `V AP,p l/ 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 C�iC o Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I 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 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund