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244099 04/09/15 CITY OF CARMEL, INDIANA VENDOR: 051125 ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $********18.41 s CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 244099 9y�ioN'�O PO BOX 856680 CHECK DATE: 04/09/15 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 150722032704 18.41 1507220327048 service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 An 03/01/15-03131/15 1507220327048 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 11111 I'II Mill I'III I I I I I I I I I II I 'll WED- APR 08 7220327048 THU- MAY 07 MON- JUN 08 Access your delivery calendar at WED- JUL 08 service.iceniountainwater.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.IYs free[ CARMEL IN 46032-2584 ri gForward�and'savel,Save $2 00 when you buy dour choice of ready to drtnk Iced tearNestea,Sweet , 'Ceaf;0 Tradewlndsl Vlslt service]cemountalnwater com x n ' 3 ;x ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. 0-11Delivery address: CIN OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 14.92 3/20 505084 PAYMENT-THANK YOU -14.92 3/05 CA2714937 WATER ADJUSTMENT -6.98 0927966572 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 3/31 0932525827 1 DELIVERY FEE 3.95 C8197821 RENT TOTAL 18.41 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT I y Subject to terms on reverse side. 14.92 - 21.90 + 25.39 a 18.41 BILLING RIGHTS SummARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR VOICE- A REPORT ON WATER QUALITY AND INFORMATION,PLEASE l Please rememberPayment4 WAYS TO HELP US SERVE YOU BETTER CALL 1-800-472-9868 OR WRITE US AT: 2. Remember,ifyou are renting ue by the"pay by"date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO, your first invoice Will include equipment,pro ated fee forgthe rental is plus the n #216us t one month in advance.That means 6ti61 DIXIE HWy,,SUITE 4 3. Kindly fit[ in the amount enclose LOUISVILLE,KY 40258 If you prefer, d, include your account number on ext month's rental. you can pay your bill online at service.icemountafnwater.comr check, ifyou think your bill is wron 4• Never hesitate to and do not send cash. a transaction on g,or ifyou need more information about Call us With comments,questions,or must hear from your bili,ou write us On a separate sheet of paper.we11, concerns. sent you the first bill ntwhich the error or probleriting no later than m 030)days atter we telepheared.You call one us,but doing so will not preserve your rights.In your letter, e give as the following information: SAMPLE • Your name,address,telephone and account numbers, INVOICE • The dollar amount of the suspected error. • Describe Date range of this invoice the error and explain ifyou can, an error. why you believe there is You are obligated to pay the parts of your hill 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 o as delinquent or take any action to collect the am Your account Dunt in question. ' 00/00/00-00100100 iz3as67s90 ypnr ACC GENE Dunt Number 1.Payments�rece veedd afterth�ll n ION Your next invoice.Past due invoices date wiU a TNR-OCTw 123456789 billingd Ppm on Important MON OR 29 ate)may be assessed a late eeoas allowed b 30 days TUEWEC-Nov r, exceed dal per Y of news and TUE-DE0,6 Watch here for a h month.Additional), y law not to n,tbntl6,11L tlttt.BAJJal.,dlN"I6,IW,ItI. c4° ,servk°:1 BBw7z.9B66 personalized account expenses may be assessed Y thiate rd to exceed offers 123 aln St Thankp,for using ke M^unM npmdum unpaid balance or the maximum allowedby law, 100%of the cast 00000 -6 eMalmessage 2.Each returned check is subject to a service charge subject to the m t t ttt n.»ai tr un,.i"tour t a maximum check return charge allowable in your State, 3. All bottle and T'mev9el acewxNany m°,dana �Yxco°r ro,�.,�s,tteat _ equipment deposits are shown �- ACTIVITY. as C .. avezeaenwwx"•�+ron am heuMwaccaxneawue,ewewY9R up.:wnfiR - - --CURRENT pay electronically 4. Equipment replacement costs will be ch Activity stolen,damaged or not rete charged for,bo since your Make sure 5.In accordance med. ttles lost AaouNrnrnvm �9 4 nom, ^m"^ o aa�d, " last invoice this o dance with NWNA's Terms and Conditions T 111re,Addn Ioh.0-Nz3MamsLee 011,11 Te 00000 amount has been Equipment Lease and/or Service Agreement ac Dunt may be subject to mini )Your 0Y5�,nee mum monthly purchases gB3, 06,696 P�m�tahantr4^ aur Paid in full to fees. Aco and/or early cancellation n 31786514M4 5 SGaBon Namrzl5p in9Water ,ocR:t ( mpleteversionofthecurrentT&C may /u 3v66s+^a^ s G.1.1-11 opo avoid late fees website listed below ybe viewed on the 01 3neas,a a, s Ire Mo^R ainswlfle°.^ nu Leased Eservice discontinuation rent for the quipment ischargedthrough the end of the b)ling cycle 09"7 3,626366u a se n ree Monthly Oil 09/7] 1669099> (lent in which service is discontinued. Surcharge,Fuel 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Surcharge or Delivery Delivery Fee as described in your T&C. Only one of these tees Fee(see#6 under Will apply to each account. is stated on the The fee that applies to o payment Stub ° _ ++ _ front Your account ACCOUM SUMMARY M a +C0M N ' "Q O p" "General visit[ of the invoice,For further information ____ he website listed bel please °°"°`"°"°'°'°'"°'°`—°"'`°""`"°""`"'"' Information") -------------------------- center. Ou or contact ow customer °`"Rm°"a°"""°"°"° ACCOUNT NUMBER PAY BY PAY THIS AMOUNT service 12MS67990 000W00 %K R 7,As a food product, bottled water is subject to the ENCLOSED INVOICE NUMBER BIWNG DATE regulations promulgated b rules and 1234567890 00/00100 Administration(FDA). Y the Federal Food and Drug 8.Your first invoice indicates the products delivered on 0420096307 04282712619 000395049 2ao4 3e delivery,along with an Your first Amount due redemption fees,and Y applicable bottle and account deposits, .CE MOUNTAIN WATER COMPANY 123 O« oMumdNa6t w�m(Nou��n++.+�^•- 123 M&St future will reflect charges for waterny spenser charges.delivered and dis Anlser rental invoices bottle oRCUSJ 00000 Your deposits and credits plus charges for an t».>n>a»�.••mN.t n.,tn..h hte,t„i p FOR CUSTOM RSERVQULLi800A7dA8R6 Submit ordeed b Y additional products ❑vcNUP{oR{RaAv DPAnsi9RUPRwindo�xnesm ❑ ^rw4owy o R w se payment by this 12 Y You, Deliveries are made every three or four weeks,for date a total of]6-17 deliveries peryear.You will only receive invoices - wtimes per year,,so approximately 5 of those invoices will reflect two deliveries. ©21708 Ice Mountain Spring Water Company,a Division of Nestle -_ service,icemountainwater.com Waters North America Inc. Form No.NW 709 02114 Prescribed by State Board of Accounts City Forth 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. �n APayee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1 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 & V 3?1 0�rl 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 Signat Cost distribution ledger classification if Title claim paid motor vehicle highway fund