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245871 06/03/15 CITY OF CARMEL, INDIANA VENDOR: 051125 j ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*********3.99* :.. � CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 245871 PO BOX 856680 CHECK DATE: 06/03/15 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 15EO11925282 3.99 OTHER MAINT SUPPLIES service.icemountainwater.com •f ® : ' #215 6661 DIXIE HWY,SUITE 4 / LOUISVILLE KY 40258 04/113/15-05/12/15 15E0119252823 Ji ADDRESS SERVICE REQUESTED 1JEJ ® is ® PMEMO II'I II I II'II I II'III IIII IN l I lIII 'll MON- JUN 08 0119252823 WED- JUL 08 THU- AUG 06 Access your delivery calendar at FRI- SEP 04 service.icemountainwater.com CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Pay your bill online at:service.icemountainwater.corn or 3400 W 131ST ST by phone at:1-800-472-9888.It's free! CARMEL IN 46074-8267 It's he Sw rnmer Tea! Save when you buy your favorite ready to drwlced tea $2"OO off Sweet Leaf or 'fratilawindscid Ay o-1 ACCOUNT ACTIVITY' For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. '41 40 Delivery address: CITY OF CARMEL STREET DEPARTMENT,1 CIVIC SQUARE,CARMEL IN 46032 PREVIOUS BALANCE 17.81 5/12 789974 PAYMENT-THANK YOU -17.81 E8520269 RENT 3.99 TOTAL _. 3.99 ACCOUNT SUMMARY "PREVIOUS BALM,'ICE PAYMENT/ADJUSTMENT CURRENT ACTIVITY _ PAY THIS AMOUNT Subject.to.terms on reverse side. 17.81 t — 17.81 + 3.99 = 3.99 1 BILLING RIGHTS SUIVIlVIARY IN CASE OF ERRORS OR QUESTIONS ABOUT YDURBILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITy AND INFORMATION,PLEASE 1• Please remember payment is due b the"Pay b " CALL 1-800-472-9888 OR WRITE US AT: 5 Y dale noted to ensure the smoothest service. 2. Remember,if you are rentin a ui ment, rvice. #21 MOUNTAIN SPRING WATER CO. Yom'first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 g q P Your equipment rental is charged one month in advance.That means 6661 DUDE HWY,,SLJJU 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 If out 4. Never hesitate to call us with comments,questions,or concerns. Y -bink your bill is wrong,or if you n_eed more information about a transaction on your bill,write us on a separate sheet ofpaper.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 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 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.During the investigation,we cannot report your account -• as delinquent or take E oolool.o ao�oo/o0 1234567990 Your Account Number any action to collect the amount in question. GENERAL INFORMATION �' E 1,Pa 7NR-OC 04 123456789 Payments received after the billing(INpOICE)date will a Mauer 79 R your next invoice,past due invoices(not paid with] appear on Important billingWED NOV 2' Watch here for a date)may be assessed a late feet allowed i �0 days of news and TUE-DK 10 exceed$20 per month.Additional] then Y not to 7tiil tItO1081:i�t1tf4:t[tgatlii.itl; Cu tamerSeMe:1800472-9888 personalized account offers iah o TnanEy°�r°.unn9Ma°mm�P�a°m message expenses ma R d Party coflection/attomey a3 s o000o ana aeM e Y assessed a[a rate not t eexce 100%`of the 6arygt d ss ,h�dt Rdu?-6,bl.uJgd unpaid balance or the maxim 2.Each returned check is subject toll sed by charge subject to the ~' maximum check return charge allowable in your State. 3, All bottle and equipment deposits are shown as CURRENTsaFd Strut ua I'aYelectronieally ^- zna Baan ACTIVITY. Activity stolen,damaged or not re # 4. Equipment replacement costs will be ch Race your Make sure this charged for bottles lost, Accousrramvm fumed. 5.In actor last invoice dance with NWNA's Terms and Conditions DeR.e[yAeeas: cw,nDa,123Mamso-eec azy,sra[e amount has been Equipment Lease and/or Service ("T&C"),your PM°nasslan a ,a,a } paid m full Agreement account P ThanRY°v avoid Iate fe to subject to minimum mon u1t may be BB11 G61B90 ane^[ es monthly Purchases and/or earl cancellation m 3vass1aa4 s sGalwnNammisP[m9wa[e[ raga fees-(A complete version Y n, 31)BB6141GG 5 IeMn minSGalDeposi[ f _� of the current T&C may be viewed on the B9/n 3vseslaa4a 5 Im Mwn aIn 3 Gal Re um website listed below)Upon service discontinuation,rent for the11 Monthly Oil W11 3103638811 1 Wel Surther9e �F l ry 6 09n2 16690497 Rene *Y=jti(�yr kolt' 1� � raw1 Leased Equipment is charged through the end of the entSurcharge,Fuel in which service is discontinued billing cycle O AE Surcharge or Delivery 6.You Will be charged a monthly Delivery Fee as described in ourFT&C barge,Fuel Surcharge or es Fee(see#6 under Y Only one of these fees PaYa°sAawa PA7M Dam N+��B^"�R - ""'TM' "General will apply to each account. The fee that a Payment stub ACCOUNT SUMMARY - xm - s a° is stated on the front of the' applies to your account •°°,,,�„^ Information') visit the web ite mvoice,For further' oron er please --- ACCOUNTNUMBER PAY BY PAY THIS AMOUNT s listed below or contact our customer service wmmu me amw mw vm em ”" Center' 1234967890 00°°°° .EN[EOSED DAIL 7.As a food product, bottled water is subject to the rules and NVOICE NUMBER BILUNG100 1234967890 00/00/00 regulations promulgated by the Federal Food and Drug Administration(FDA). 042.096307 04282712619 .00341049 2004 19 1 S.Your first invoice indicates the products delivered on your first Amount due delivery CE MOUNTAN WA ER COMPANY John Doe ry,along with any applicable bottle and account deposits, I.CEM JRa6 WATNuCCZ"�L 123 Mato 9t redemption fees,and any dispenser charges.All future invoices Will reflect charges for water delivered and dispenser rental,bottle aryl�dte�� deposits and credits >tiana„a.[>b.�t.it,tt:;ha+lwhstE.a„u` EORC45T°MERaFMICFCAu1d00-1>z-Peas Submit your plus charges for any additional products ” ” QN^s' Payment by this ordered b ❑Rw uvwR R EwroPAns9 uPR wrta°a vera date Y You. Deliveries are made every three or four weeks,for _ _ " " a total of 16-17 deliveries per year.You will 12 only receive invoices two deliveries,times per year so approximately 5 of those invoices will reflect ©-2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inq, service,icemountainwater.com -Form No.NW 709 08/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 $3.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 2201 115EO119252823 I 42-389.001 $3.99 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 T r 15 Li 6 Cal 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)) 05/14/15 15EO119252823 $3.99 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