243519 3 /24/2015 r.4Qg
CITY OF CARMEL, INDIANA VENDOR: 051125
I CHECK AMOUNT: $********31.97*
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 243519
+MltoN c� PO BOX 856680 CHECK DATE: 03/24/15
LOUISVILLE KY 40285.6680
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 150011925282 31.97 1500119252823
service.1cemountainwater.com
#215 6661 DIXIE HWY,SUITE 4
02/13/15-03/12/15 1500119252823
' LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII WED- APR 08 0119252823
THU- MAY 07
MON- JUN 08 Access your delivery calendar at
WED- JUL 08 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.Irs freel
CARMEL IN 46074-8267
Spring Forward and save! Save $2:00 Why y u buy your choice of ready`to drink iced tea Nestea;Sweet
Leaf,or.Trade�niinds►1%Islt service icemoUhtatninrater,com. _
i
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 3.99
3/08 414902 PAYMENT-THANK YOU -3.99
3/10 0927929026 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45
5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 30.00
2 9 OZ PLASTIC CUP 50C/SLV 6.58
5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -30.00
3/12 0929906584 1 DELIVERY FEE 3.95
C8195221 RENT 3.99
TOTAL 31.97
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Q Subject to terms on reverse side. 3.99 — 3.99 -{- 31.97 = 31.97
f BILLING RIGHTS SUMMARY
IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO
A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• Please remember payment is due by the e""Pay bLP yJ date noted to ensureVE thet e smoothest
oo h
CALL]-8pp-g7z_gggg OR WRITE US AT:
2. Remember,if You are rentingequipment, est service.
ICE MOUNTAIN SPRINC WATER CO. your first invoice will include a rPro-rated fee forequipment
current nmonth,plus he next month's rental.
#216 That means
#216
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.icemountainwater.com
Ifyou think 4. Never hesitate to call us with comments,questions,or concerns.
a transaction on your bills vhite us on a separate sheet ofapaper.tion bWe
must hear from you in writingno later than thirty(30)days after we
sent you the first bill on which the error or problem appeared,you
e
telephone us,but doing so will not preserve your rights.In our lcan
e
give us thfollowing information: - ytter, SAMPLE 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 of your bill that are not in question.
You do not have to pay the disputed amount while it is being
investigated.Duringthe investi ation,we cannot report g n your account 1334567890
as delinquent or take any action al collect the amount rt u 3 00100100-oolooroo Your Account Nu
question. tuber
GENERAL INFORMATION 123456789
1,Payments received after the bilin
TNF-O N
Your next invoice,Past due invoicesNnOICE)date will appear on Important MOH-oa x9
billing date) y ( paid within 30 days of news and wEallov3 Watch
„a-0EG,R here for a
g may be assessed a late fee as allowed by law not toti
a,n:elir„mnNtti,lamLLptuN,nlu.,tLaiJ.ul a„ome°seM«:Taoo4rz.9aeB personalized account
exceed$20 per month.Additional) offers ani oaa nantyaala,a„nO,eeMaunmm Noaum message
expenses may be assessed ata to not Po exceed collec100°/a on/ano the z3 Main St
unpaid balance or the maximum allowed by law. a anmeml:,.
i_w.l tut 1t...U.,A:.Ln d,oLLLLann
2.Each returned check is subject to a service charge subject to the
maximum check return charge allowable in Y tate. M aamw w,ate-e«r,a n6 ;a, -
s ro c«aHanra,�eaa,
3• All bottle and equipment deposits are shown as CURRENT N as m"um ani nxaya��anneaN��4e,•r«Rae�9 Pay electronically
ACTIVITY. nm«m
Activity
4. Equipment replacement costs will be charged for bottles lost, Since your Make sure this
Vote”,damaged or not returned. ACCOUNT acrl nrr e ge nu»�'
5.In accordance with last invoice
NWNA's Terms and Conditions oeu.�nA6are:,:tonnooe 1z3Mamsvee>,aLyslate 00090 amount has been
("unt ma your r!.,Bolam= �x Paid in full to
Equipment Lease and/or Service Agreement account may be earnRnl-mankraa ql,a
subject t0 W31 46'898 SGeOon.TNnky-u Water >Woc avoid late fees
J minimum monthly purchases and/or early cancellation n, 3178851-1 s xxx
fees.(A complete version ofthe currentT&C may be viewed on the 1 3,TBBs,44w s °Ma nums0 o ao,IT x x
a9nt 3nees444+ 5 IceMoantaln6GalPetvm + Monthly Oil
website listed below)Upon service discontinuation,rent for the
o9n3 318..II t3uNu,9e
Leased Equipment is charged through the end of the billing cycle �' X97 Surcharge,Fuel
in which service is discontinued. u a Surcharge or Delivery
T07AL
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 theseNa aa,R Ani MFHn,alamn R+ n n = •"Y N6 "General
A M°0aM
pply to each account. account fans
Payment stub
is stated on the front of the' The fee that applies to your account ACCOUNT SUMMARY
invoice.For �,,.,„,.,,°..-.aaae�-a,a.°a.,=a.a.,,.,.---------------- �^�^^^��"_. Information's
further information please -'"-----------
visit the website listed below or contact our customer service RemAum�WnovnvanP•+^.na ACCOUN7 NUMBER Sar BY PAY THIS AMOUNT
center.
133456)890 00 00 W
7.As a food product, bottled water is subject to the rules and ENuosro
I,NVICENUMBER BIWNG WE
regulations promulgated by the Federal Food and Drug 123456]890 owooioo
Administration(FDA). 0420096307 0426Z7126Y9 000391049 2004 1B
S.Your first invoice indicates the products delivered on your first Amount due
delivery,along with any applicable bottle and account deposits, Jahn Ooe
redemption fees,and an ICE MMOOHNTAIN WATER COMPANY 33 Main st
a H.nn K Oty,Swe 00000
voices
will reflect charges for water tdel delivered and dispenserrental,rentalture itbottle Submit your
deposits and credits plus charges for an t•.+nt...t•ro•.•w••n,..n.;t.u..L,.Lct�t•t�a FOR fUSTOMER SFANfEGLL,-BOW)1'9888
❑B6mAM9 a R sin• Payment by this
ordered b Y additional products O 9aHurfaRTREEAumeAnsgnaeR.9areda,R�usHe date
y you. Deliveries are made every three or four weeks,for
a total of 16-17 deliveries per year.you will only receive invoices
two deliveries.
]2 times per year,so approximately 5 of those invoices will reflect
00 2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc.
Q selvice.icemountainwater.com
Form No.NW 709 02114
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF$
P. O. Box 856680
J
Louisville, KY 40285-6680
$31.97
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
2201 15C0119252823 42-389.00 j $31.97 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
I
U"
i
l l �
Frr Wr20,�2015'
Street Commissioner
Street Commissioner
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))
03/14/15 15CO119252823 $31.97
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