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242978 03/11/15 r C.Iq CITY OF CARMEL, INDIANA VENDOR: 051125 4/ 45 ® �I ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $********14.92* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 242978 PO BOX 856680 CHECK DATE: 03/11/15 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 15B722032704 14.92 15B7220327048 service.icemountainwater.com NPI-010"11 =11 #215 6661 DIXIE HWY,SUITE 4 02/01/15-02/28/15 15B7220327048 LOUISVILLE KY 40258 ® e ADDRESS SERVICE REQUESTED II'I I II I'I IIII I I'II I I I I I I I I I'I I 'll TUE- MAR 10 7220327048 WED- APR 08 THU- MAY 07 Access your delivery calendar at MON- JUN 08 service:icemountainwater.com 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.IPs freel CARMEL IN 46032-2584 ��'Ill�ll�l�l��lllilllllllllr�lil�'�IIIII��II�I�I'��IIII'��'I��rr - < . - u dT .hx/ .---..... Start„the year o alight and�savel 6AV -$210 When you buy 120”ZA a MountainNatural Spnng Water, perfect fo �on the gol Vtstteservlce�cel'nountalmvter coin 'J �, P 03, 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 18.21 2122 343848 PAYMENT-THANK YOU -18.21 2/06 0923000236 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 2/28 0927781179 1 DELIVERY FEE 3.95 88034471 RENT 3.99 TOTAL 14.92 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q Subject to terms on reverse side. 18.21 — 18.21 + 14.92 = 14.92 BILLING RIGHTS SUMMARY IN CASE YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT T ERRORS OR QUESTIONS ON WATER QUALITY AND D INFORMATION, BILL,OR FOTION,PLEASE R I. Please remember payment is due by the`pay by"date noted to ensure the smoothest service. CALL 1-800472-9988 OR WRITE US AT: 2. Remember,if you are renting equipment,your equipment rental is charged One month in advance.That means I#216CE MOUNTAIN SPRING WATER CO. your first invoice will include a pro-rated fee for the current month,plus the next month's rental. 6661 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 DDCIE HWY.,SUITE 4 p can you f r If you peer, a LOUISVILLE,KY 40258 y your bill online at service.icemountaimvater.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 orproblem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, SAMPLE give us the following information: 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 ifyou can, an error. why you believe there'is 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 your account as delinquent or take an ao/aproo-pD/DDJOB 1234567840 Your Account Number y action to collect the amount in question. y GENERAL INFORMATION w-DG a 23456789 I.Payments received after tJ0 he billing AON° " g(INVOICE)date Will appear on Important "'NOY 21 Watch here for a your next invoice.Past due invoices(not paid within 30 days of news and UE DEC,B billing date)may be assessed a late fee as allowed by law not to Il,11a:11li.04rdIlII�L.�11161Jt11,.�.1{ItlaiL�tl.l.lu Customer 5ervke:1-8004]2.9888 personalized account exceed$20Per month.Additionalateferd a offers 9h^b0e rna^kro•r« nvlreMo„^ml^pma°" Message ----expenses may-be-assessed-at P rty collect on/attorney 23 Ma01 s` a rate not-to-exceed-100% - ay'sam amwas Nea. unpaid balance or the maximum allowed by law of the- _Jaad,l u6•^0,.,.11.,0!'n'•6"t'u46a,.n 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. a-e Pay electronically 3. All bottle and equipment deposits are shown as CU aw«dgr"no4w'e ai�v rBdu4 ' M^^« ACTIVITY CURRENT Activity 4. Equipment replacement costs will be eh since your '°" Make sure this charged for bottles lost, ACCOUNTACTIVITY P BN ��^ °° ^"^" '' "" stolen,damaged or not returned. last invoice � amount has been 5.In accordance with N pelm jAddms:John Dm 103MalnSOeet,G*Staa 00000 o w paid in full to WNA's Terms and Conditions{"T&C"),your p,n^•*B la^u Equipment Lease and/or Service Agreement account may be �ymem-Thank You Wa, avoid late fees subject to minimum monthly purchases and/or early cancellation oM31 a41B9e >«xk ` /11 w89814449 5 SGalion Nat rJSpring Water ..i 1 /lt 3178BSt44a4 5 ite MountalnSGal Depoill fees.(A complete version ofthe current T&C may be viewed on the o9/1t 3,azoa l 1 I 1 n alnSGalRnum Monthly Oil website listed below)Upon service discontinuation,rent for the o9n2 31ez63Ran wtwmnaree o w 09.12 ,6690697 Leased Equipment is charged through the end of thebilling Surcharge,Fuel g cycle 10"0` in which service is discontinued. O A Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in our T "General Will a y &C. Only one of these fees PP WwaB6una_•""H^/"D/O A + """"" — P NAa. ` pply to each account. The fee that applies to Payment stub p O is stated on the f ACCOUNT SUMMARY rant of the invoice.For PP our account „L 0 „^.aa.,ta.a„„tom„-- a T 0 Information') ------------- visit the website listed further information please -----m�qn iwFugnm A F P9•t AGGOUNTNUMBER ---------------- PAY Ry PAYTHIS AMOUNT below or contact our customer service 000000 0 0 center. 1034567890 NG DATE .ENCLOSED NUMB 7.As a food product, bottled water is subject to the rules and NV123,679” BILU10D/00 1239567890 00/00100 regulations promulgated by the Federal Food and Drug Administration(FDA), 042009630? 04282712619 00x391049 2004 18 8.Your first invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, aCOE MOUNTNN WA ER COMPANY Jahn Doe redemption fees,and any dispenser charges.All future invoices w^,rNne Am r3 Maur st City.Stote 00000 will reflect charges for water delivered and dispenser rental bottle u.md•d•mwa a„.x•tn.dnl.w,GAaa WRNSTOMEPSDNCE(ALL1100.<11-9888 Submit your deposits and credits plus charges for any additional products ❑ GN4P DR R EAu D"nsB^wP 9'R°°”"`s"° payment by this ordered b date y you. Deliveries are made every three or four weeks,for a tots[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 Ice Mountain Spring Water Company,a Division of Nestid Waters North America Inc. S rservice.icemountainwater.com Q] • Form No.NW 7pg 0y14 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 w ' r v vv►� Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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 ,I 1 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 �a the materials or services itemized thereon f for which charge is made were ordered and ti received except j I i o 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund