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245514 5 /20/2015 CITY OF CARMEL, INDIANA VENDOR: 051 125 6 I ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*-'208.70* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 245514 vM. PO BOX 856680 CHECK DATE: 05/20/15LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 02DO12120276 104.29 05D0121202766 2200 4239099 OSDO12004852 31.31 05D0120048525 1125 4350900 05DO12009535 73.10 05DO120095351 service.icemountainwater.com B #215 6661 DIXIE HWY,SUITE 4 0 LOUISVILLE KY 40258 04/01/15-04/30/15 05DQ121202766 ADDRESS SERVICE REQUESTED B MON- JUN 01 0121202766 30 THU- JUL I 30 Access your delivery calendar at I FRI- AUG 28 service.icemountainwater.com MAY 0 8 2015 CITY OF CARMEL PARKS DEPARTMENT II(�-;`�r: Customer Service: 1-800-472-9888 MANDY SPADY L-- _ — - 1411 E 116TH ST Pay your bill online at:service.icemountainwater.com or CARMEL IN 46032-3455 by phone at: 1-800-472-9888.It's free! 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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 PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 52.84 4/24 695910 PAYMENT-THANK YOU -52.84 4/30 0936137413 15 5 GAL ICE MOUNTAIN DIRK W/HANDLE 64.35 BOTTLE DEPOSIT: 15 CHARGED, 10 CREDITED 30.00 0937249571 1 DELIVERY FEE 3.95 D8429790 RENT 5.99 TOTAL 104.29 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT r,. Subject to terms on reverse side. 52.84 — 52.84 + 104.29 104.29 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged One month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4.Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about 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 or problem appeared.You can SAMPLE INVOICE telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. • 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. 1a34s67a90 Your Account Number You do not have to pay the disputed amount while it is being 00100/00-00100/00 investigated.During the investigation,we cannot report your account t • as delinquent or take any action to collect the amount in question. mII Oa oa 234s67a9 MON-OCT 29 NVatch here for a vrto-Nov x, GENERAL INFORMATION NE-OEC 10 personalized account 1.Payments received after the billing(INVOICE)date will appear on Important ',w0.4]z-9aes me„,m"uF�na .„1114„w„tt.laa �4at"m«5<M«:- message your next invoice.Past due invoices(not paid within 30 days of news and ,„pq.l,m4 man%�jle,yalnyl«Ma�nlal„Rt°a"<ta billing date)may be assessed a late fee as allowed by law not to offers �113-i'I St C"'s— DOME) •, exceed$20 per month.Additionally,third parry collection/attomey t„dPJ.anpt,,,„ti,,,.a,yn.4e„u„6t,uha"n i expenses may be assessed at a rate not to exceed 100%of the *ice, rear unpaid balance or the maximum allowed by law. ` ,tk "' iau�",t`e'',rea�°+ % l Pay electronically 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. .wfls• "'� , ,,za�� Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. Since your ACCOUNT ACTIVITY ,.„a.x....... -” amount has been Main st,<c onstaa a0000 aid in full to 4. Equipment replacement costs will be charged for bottles lost, Md,Is.mnn oo<, p last invoice %%%% stolen,damaged or not returned. avoid late fees VaYment-TM1an%Vou 5.In accordance with NWNA's Terms and Conditions("T&C"),your 11 3, 46169a , SoanonNawmlSpnn9watn xxs; Ilt 31J0851W° eMeuntalnSGal DaW„t . Equipment Lease and/or Service Agreement account may be „ 3ns6s,4w4 8 NeMountam3w a am / xx Monthly Oil 09/1+ 31]685,4444 6 fes^ 1`:..!`...".1�:�v: <i subject to minimum monthly purchases and/or early cancellation r9ds°"""" r¢..,” <� Surcharge,Fuel o9n2 11x2636°++ acm ii, ':. .. : g e Surcharge or Delivery fees.(A complete version of the current T&C may be viewed on the 69n2 668048] f "- :' %xxx '� / ; website listed below)Upon service discontinuation,rent for the rorAE -r Fee(see#6 under Leased Equipment is charged through the end of the billing cycle J "General in which service is discontinued. Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or MMARY u%x% a•59„ °eL"" % x a.,•„ - ACCOUNTSU Delivery Fee as described in your T&C. Only one of these fees Payment stub -- -•9 __----_ aAY wls WOUNT will apply to each account. The fee that applies to our account __'"-"- «a^M MPAY oPAYo 00 PPY PP Y ye„a”m n ACCOUNT NUMBER %x% is stated on the front of the invoice.For further information please 123456]°90 61WNG OATS .ENCLOSED INVOICE NUMBER OOIW/� visit the website listed below or contact our customer service 23456]°90 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04202712619 000391049 11” 16 I. Amount due regulations promulgated by the Federal Food and Drug i„NnDx Administration(FDA). IC�a�wAm„„OMS 'i"S'.°tOOp00 Submit your S.Your first invoice indicates the products delivered on your first 2988° payment b this delivery,along with any applicable bottle and account deposits, au�a„6a„4.66414„P „�.„aa5aa � p y Y redemption fees,and any dispenser charges.All future invoicesom„anU'^e"On date �:,cNuv raalaEE euroa6n s9nunr<m.a<^o"^"”` x_ .. will reflect charges for water delivered and dispenser rental,bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for 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 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Form No.Nw 709 08/12 Q service.icemountainwater.com r, service.icemountainwater.com • ®9 U #215 6661`DIXIE HWY,SUITE 4 e Xa LOUISVILLE KY 40258 X /15-04/30/15 05DO120095351 ADDRESS SERVICE REQUESTED • ® e N �� I��I I EN I I I I �� I I�-U1� MON JUN 01 0120095351 TUE- JUN 30 THU- JUL 30 Access your delivery calendar at T-N 7.9:,— FRI- AUG 28 service.icemountainwater.com CARMEL CLAY PARKS AND REC DEPT. MAY O 215 Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA 1411 E 116TH ST _ Pay your bill online at:service.icemountainwater.com or CARMEL IN 46032-3455 by phone at: 1-800-472-9888.It's free! i�illl�lill�nlrilnlli��lllllnin�llli�llll���lll�Ill�nl►Ilrl ,���., . ::. .<c ;;y. �.✓r'�;.'-�;"-"Ty��i�e,,����-' rs,��",``";�,,u.fx-":,,�-;:i>, � ',s"k .'<rh'/,,�� 'f'l5; z!' :ffi.. �pdit .,Forward a`nd save► Save$2 OO:uvheir you buyxyour choid'e'of.readyAo'.drinkn°Iced aea.FNestea Sweet �: �..qe ;« ,: . d.��'` .. -y eaf -Trade+ands-.Uls t,serv�ce icemountalnwater:com: „W f by -m „`” r. ,: -. ��` L .;��� ",� ;;"✓a' ,lbw �. ra,:;y,t�P''^y,Tsy 5 'xxrsX-r'-= Fp. %' a ',<a ,r. �<�•. ,z<;'*: >3' _» fC,lse w .> §',"r F."S' a.,., .4" '" ':- .r"t,'' ...✓_ri' �,F-.;, ,s ,r.,s:rr�� a.^'F, ?°?:`::n%iG" %Yf.' e .;�r�,:rl Y" <'' N„`.�'F<,. "..,+xi, s'°,gym;,.�;"s .6°'-Ln:•e,,i;,� , }g', „ r,�r._...adw.$:,u✓�>,r f�: �',.,r` -;1��r,'S>,r,'-:2, ::;�r'`�° :',J,d°`:�.:�'>%!`;L'<:�rl'...,�.✓.>.,s,.s; `°i',�F;,Sti-'.� .;cF;"�-*"?`r,!%�." x'--",r�<�>�'-. _? .'b''. .�iW x'��r��J.'. �/������;���3%l. C«.<1'"�.i✓��°9''>':F4i $,1,� /' 9i'...n ,,,j y,., .�,.y.�. _ ��Yn�,.�. I,".,.>ar"y.,'.a"d:,�-..�!��,�i',�_:`�.,✓'s? .$N,",:, ,'xiF°' ,3^�,�'s a'.a'�.',�.23�H�':,�'.'�.,s✓i�.'�s.q �f%�'�:Y,�s ...Y,>��� ��.,�P'.. .S�f'�:?:. ;r�;;i> R,,. E< r �'<"„✓r,'s'r., `,."`'."P..t' ',rs'�.,.-�, :;'�„�"si' ,A'. '���r � ;;'F,7r' ::.. "-,...,, �'s`cA.�,_. -""r'r:�%v.' ;:: Fsi'=;� - ✓;::;;, - 4 ,,.�,��. ` >w. ,,��c�.,�,��r�°�,. �r,.�s.�z,::� �.r"�� �-�< x ��z'a:�a�.> :>r,.,...r'�, as„ � _r�:°.,; 't": ria;:" ",i�• ACCOUNT ACTIVITY Q For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com• Delivery address: CARMEL CLAY PARKS AND REC DEPT.,1411 E 116TH ST,CARMEL IN 46032 S! PREVIOUS BALANCE 62.12 4/24 695909 PAYMENT-THANK YOU -62.12 4/30 0936137363 10 5 GAL ICE MOUNTAIN DIRK W/HANDLE 42.90 2 .5 L NATURAL SPRING WATER ICE MTN 10.98 1 9 OZ PLASTIC CUP 50C/SLV 3.29 BOTTLE DEPOSIT: 10 CHARGED, 10 CREDITED .00 0937238699 1 DELIVERY FEE 3.95 D8345676 RENT 11.98 TOTAL 73.10 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 62.12 — 62.12 + 73.10 = 73.10 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER / IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 2, Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 4216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about 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 SAMPLE INVOICE sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice • The dollar amount of the suspected error. • 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. 1z34s67a90 Your Account Number You do not have to pay the disputed amount while it is being 00/00100-00100100 investigated.During the investigation,we cannot report your account F - an 71;456789 as delinquent or take action to collect the amount in question. TMR ° °a q y q MON-�79 Watch here for a GENERAL INFORMATION WEE NOV 71 TUE-oec,e personalized account 1.Payments received after the billing(NVOICE)date will appear on Important Ne � m„ .dlU.blUk�dlip+n;ndan a:rome,ze ,-B10172-99Be messy e your next invoice.Past due invoices(not paid within 30 days of news and pi;,013,1 nanEy°°+°•°al^9'eMwnalnProa° g oh,Doe billing date)may be assessed a late fee as allowed by law not to offers 1123 Man St any ae^n°.. CIry,S[a[e 88088 exceed$20 per month.Additionally,third party collection/attorney 1Lt•U:LU+L«IS,Lbd+U .. . expenses may be assessed at a rate not to exceed 100%of the dnUta.,.n•«t- unpaid balance or the maximum allowed by law. vy g da nNb,° �'” YwN x„ Pay electronically 2.Each returned check is subject to a service charge subject to the .3Ce-"""'-, '^• "'3i°)g"P"'oma m„ ° maximum check return charge allowable in our State. yep E "'' g y �`�r�: - �- Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity a+�«�°'^". 'ten Y amount has been 6Ba�•e ACTIVITY. sincerrY Our Acrn Acme.. lohnD° ,23Mam5vee,, h'Snm ooOoo paid in full t0 4. Equipment replacement costs will be charged for bottles lost, last invoice peOVery xxex stolen,damaged or not returned. we"°°:M..Ce .0avoid late fees Paymem-Thank You 5.In accordance with NWNA's Terms and Conditions("T&C"),your 5 ,.1-_,,a'sP'I^s 3,]0a5,µ keMoumNnSGa P° xx Month/ Oil Equipment Lease and/or Service Agreement account may be �„ 3vee5'u'a s me Mn4ma,nswlRe[°,n 2,� xxxx Y 091,1 31]806,a4M FuN 5u-ge subject to minimum monthly purchases and/or early cancellation „z 31016308,1 Re^, iG` ;,,y:„`, �".`'.� Surcharge,Fuel fees. A complete version of the current T&C may be viewed on the 09/12 [6088'] ` �` Surcharge or Deliver ( P y 5 6S g Y �P,x..�.. website listed below)Upon service discontinuation,rent for the TOTAL M.=_1 c;, "'” ,j Fee(see#6 under Leased Equipment is charged through the end of the billing cycleTM3�1p1H, f "General in which service is discontinued. _ Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or M[A" 1 = I Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY_ a. -_ -_ -- .i PAY BY PAY AMOUNT will apply to each account. The fee that applies to your account __�� Pwmn:m �°^w�,Pam•a•.. ACCOUNT NUMBER xxxx is stated on the front of the invoice.For further information please 123667890 BILLING OATS MT.ENCLOSED IM'OICE NUMBER po1WIW visit the website listed below or contact our customer service 1734567898 ' center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 0003910'19 zoo° la Amount due regulations promulgated by the Federal Food and Drug i°6n Doe Administration(FDA). ICE MouWr N NOER�yC,omp CIry Sale`GGB88 p,,,,„ Submit your 8.Your first invoice indicates the products delivered on your first RvrcE CAEu-BBo.n-9aea ' FOR e45mME86E a b delivery,along with any applicable bottle and account deposits, dL;,dLdtl«LU•.L+yLLLd.0 ❑�,,,,tH„ye,onRaw<,.•z1m - payment Y this redemption fees,and any dispenser charges.All future invoices 1" ,,,,,,,,Rama�•ao^R�'e51°` V date will reflect charges for water delivered and dispenser rental,bottleNwwRFuew�6n deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for 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 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Form No.NW jos 08/12 service.icemountainwater.com ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 051125 Ice Mountain Terms P.O. Box 856680 Louisville, KY 40285-6680 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 5/4/15 5DO121202766 Drinking water&cooler- MCC $ 104.29 5/4/15 5DO120095351 Drinking water MO AO $ 73.10 Total—r$— 177.39 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20_ Clerk-Treasurer Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 177.39 ON ACCOUNT OF APPROPRIATION FOR 101 General fund/109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 5DO1 21202766 4350900 $ 104.29 1 hereby certify that the attached invoice(s), or 1125 5D0120095351 4350900 $ 73.10 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 May 12, 2015 1pkmpk��U! Signature $ 177.39 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com ®® #215 6661 DIXIE HWY,SUITE 4e p LOUISVILLE KY 40258 04/01/15-04/30/15 05D0120048525 ADDRESS SERVICE REQUESTED MUMNII �I�I�I�I I�I) flI����� ITHU MAY 07 0120048525 MON- JUN 08 WED- JUL 08 Access your delivery calendar at THU- AUG 06 service.icemountainwater.com CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT Pay your bill online at:service.ice mountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 ,,, „;'",'�^ -, . d--'�,�r.,r fr"�.ns...;r .SpringFonwardanc!°savet{Savez$2:O!)wheny yy ti � 1,0 oubu. our:;ctoiceof;read ntq drin!c-'I ced�tea:;Nestea;;SWeet; ,,. %'Leafori radewin =:V .,T ds!- isiservice icemountai� .�,� a .,,. _,r - s c'°% :?%'ry✓ •,,3;,' 9. . '�,'�: ,.;k•, _ «'rx" ,�:, .--r.r®s�, .-�;*.•-s�rx« ..,*•.r,,s ®-fie. �--.� .r�;.---av,:r�. 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'; ""gin°.:'s _ ;v° 'n.`r�glr� %���:`."r?r'rs"z' -ax ,$rt,"d'�''�'"r_s:;:°w'r�:'?`';� r 'ai,.•':�''� „' :r.,;~%'i^ •Sy .r "- '-'��,_r- �,�,� s,,'"-o�x`�.� .,,� ».✓,. .€a„ ,,.` ;�:"�•.. �9 any.;-' ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. PRI Delivery address: CITY OF CARMEL,1 CIVIC SU, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 35.40 4/24 695913 PAYMENT-THANK YOU -35.40 4/08 0932321094 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 3 9 OZ PLASTIC CUP 50C/SLV 9.87 7 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 4/30 D8328800 RENT 3.99 TOTAL 2200 -_L423gpcicl 31.31 woo•j9jPmu!elunow9o1•901AJ9S au8o hoc MN'ON w,o=1 'oul eo!aawV 41JON SJaleM allsaN 10 uols!A!Q e`Auedwoo aa;eM 6uudS u!elunoW ao!g00e O BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR I. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2- Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING NVATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about 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 SAMPLE INVOICE sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: Your name,address,telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. • 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. t tz3as67B9o � Your Account Number oolool00 You do not have to pay the disputed amount while it is being 00100100- investigated.During the investigation,we cannot report your account i234s6739 as delinquent or take any action to collect the amount in question. n R'ou 04 I MON"OCT 19 =, Watch here for a wEo-No 1, GENERAL INFORMATION NE-DEC ni personalized account 1.Payments received after the billing(INVOICE)date will appear on Important m¢ssa�p,'„(n„gt„itilb6„Itll,b@4daUp.0«l1aJd Customer 5erv�ce.1-800-e73-9888 ¢ your next invoice.Past due invoices(not paid within 30 days of news and ,nenpyoutorusln9l<eMow^ulnpr°a°� g J.W Dce end—0. billing date)may be assessed a late fee as allowed by law not to offers 123 Mal-St ° exceed$20 per month.Additionally,third party collection/attorney otystau 0000ODDO I.apa�.ar 6.a1...t61,n"L.WFMa.q expenses may be assessed at a rate not to exceed 100°/of the P Y ola ° unpaid balance or the maximum allowed 6 law. W °=n;uta ydtea,: !^'.9^yy ;.""" Pay electronically P Y t inaM9eYaB uu�-N 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. a` ` 77 Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. amount has been since your nccour4TAarvm winstreecatY'swteo0000 aid in full to 4. Equipment replacement costs will be charged for bottles lost, cer.ervAddre:,. DOe inxxxx .€ P last invoice x xx avoid late fees stolen,damaged or not returned. vre.w°yBalan`e %xxX 5.In accordance with NWNA's Terms and Conditions("T&C"),your 08/3, +"1890 5 spwo�l /11 311885,4- ceMwntaln S Gal a—,l, r - l %%%% -1 Equipment Lease and/or Service Agreement account may be 5 Monntaln5GalBt°r^ i`r „'; Monthly OU g Y n, 31,BBs,MM 0q/„ 319895'Mµ , ruN SmcM1ar9e i••: :•:r ., I Surcharge,Fuel subject to minimum monthly purchases and/or early cancellation _ g 09111 3181630011 Pent l�tj�"�g,iy!".k.. .'T.a� f fees.(A complete version of[he current T&C may be viewed on the 09/12 1fi6°91 ' Surcharge or Delivery website listed below)Upon service discontinuation,rent for the ToTAE ; =;.u-e...' ,. Fee(see MI6 under Leased Equipment is charged through the end of the billing cycle N11M�„ "General in which service is discontinued. ,,,, ppENT ATTMn. = p"" xxxx 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or „a Aur+ ---x -" , _ Information") ACCOUNT SUMMARY yxcXx Delivery Fee as described in your T&C. Only one of these fees Payment stub a"°^ - --__ pAr TwS AMOUNT ; • NUMBER FAY BY x%X% will apply to each account. The fee that applies to your account _ -" ,�, „,a,-„,.:*« -- ACCOUNT �00 Bo "t is stated on the front of the invoice.For further information please 1134561890 BILLING GATE ENCLOSED i pryO,CE NUMBER /�/� visit the website listed below or contact our customer service 13.561890 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 0003910`19 20p4 16 Amount due regulations promulgated by the Federal Food and Drug IpnnD« =t Administration(FDA). Ic tlNYMMWATER COMA ANY 1ovsT^�°[00400 Submit your 8.Your first invoice indicates the products delivered on your firs[ ,DpcaSTDMEpSERYNECX41i-6ppd139pBB > delivery,along with any applicable bottle and account deposits, P a ment b this uaa.s.a"m."as•.a�.at.a,a..t,.t,w.t,a.a e �p„^tAm�aaa9•l��.e�SMe Y Y redemption fees,and any dispenser charges.All future invoices ❑�Bp"pEEAOTopAn99"o,14w4�°np'"ru4° date will reflect charges for water delivered and dispenser rental,bottle ,, .. deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for 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. 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 Ice Mountain Purchase Order No. POB 856680 Terms Louisville, KY 40285-6680 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 51412015 051D01 Water cooler $ 31.31 Total $ 31.31 1 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 VOUCHER NO WARRANT NO. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF $ Louisville, KY 40285-6680 $ 31.31 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 0 05D01 2200-4239099 $ 31.31 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 5/18/2015 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund