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247894 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 051125 ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $"*""'`63.48" CARMEL, INDIANA 46032 PROCESSING R Box 85 CENTER CHECK NUMBER: 247894 LOUISVILLE KY 40285-6680 CHECK DATE: 07/28115 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 05FO12004852 45.27 OTHER MISCELLANOUS 2201 4238900 15FO11925282 18.21 15FO119252823 601 5023990 15FO11925282 -18.21 15FO119252823 2201 4238900 15GO11925282 18.21 15GO119252823 service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 06/13/15-07/12/15 15GO119252823 0 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® B e II'I II I I"II'II'I'I I III IN I IIN ll I 'll THU- AUG 06 0119252823 FRI- SEP 04 TUE- OCT 06 Access your delivery calendar at WED- NOV 04 service.icemountainwater.com CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN For your convenience,you can pay your bill online.It's 3400 W 131 ST ST CARMEL IN 46074-8267 fast and easy! I�I�I�I�IIi��llll�lli�illlllnllll�ll���lllr�il�lli�l�ln����lll n(:.. - se4.'. Ne• - vz*-t".• ..,. `,�j„ .°z In August;-,yoiI-Wiil.know us aS-KeadyRetresn--by=Nestle:It's;th!e 3me�se`ni cerand products.""ou°.love,Wn *at features9,like,custom delive o tions for"an b era'a>y ou choose For mlore hfor" 'h'vi ' ' mat on sit �S@YVICe71Cemo ntai, dir.e clelIY ° �. t: ":fir' ! •"c- i~t- `''}-r '.�.a WX ��, � P. �;, 410 ��g -' y„.K p; - e'� ..�, i.e....,,. "z.: .w »r`::db ✓ ad'�a6^� »:. -+;"^{:Yc>•�- .w� +4_1tet ,. �rg ` .1'•i�r�v:-. '.F,-•4 e`��-+�+a.w .°^.Y-+✓ ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. ®+ s ® B .._ e vp Delivery address: CITY OF CARMEL STREET DEPARTMENT,1 CIVIC SQUARE,CARMEL IN 46032 PREVIOUS BALANCE 22.20 6/18 012813 PAYMENT-THANK YOU -3.99 7/09 121811 PAYMENT-THANK YOU -18.21 7/08 0946478476 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC CUP'50C/SLV 3.29 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 7/12 0948812664 1 DELIVERY FEE 3.95 G8847069 RENT 3.99 TOTAL 18.21 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 22.20 — 22.20 18.21 e 18.21 - --- --- -- - ------------- ------ - ------ --- ------- BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR 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 NATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 DIXIE HWY.,SUITE 4 If you prefer,you can pay your bill online at service.icemountainwater,com 6661 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. 1234567890 Your Account Number You do not have to pay the disputed amount while it is being 00100100-00100100 Investigated.During the investigation,we cannot report your account " '"' ' � • 123456789 as delinquent or take any action to collect the amount In question. rH,-oa w MON-DGr,9 Watch here for a GENERAL INFORMATION tyED-NOV 71 TUE-oec,R personalized account 1.Payments received after the billing(INVOICE)date will appear on Important I' ' ,,,ipy„n:,uaatl Customer Service 1-00048-988 your next invoice.Past due invoices(not paid within 30 days of news and q,p"'itl"tlu'IflDJ�•�tllladNa Tnantyoumrua1n91ceR1uumaiop,oducEa message,.' billing date)may be assessed a late fee as allowed by law not to offers �iis reaosl ana seMaes exceed S20 per month.Additionally,third party collectionlattorneyAU onstage 00°°° Y 6 expenses may be assessed at a rate not to exceed 100%of the — ""'4 Pay electronically unpaid balance or the maximum allowed by law. T C,,.;.Tc!ns^ce :tours.r,Jra!Yp" ard'rt+ ,,m,9<hmayi .Each returned check is subject to a service charge subject to the =/-s:- - m °1° " mdt15t4,y.... 1. '•.,,,4;.aetat?:orE<°"',. ,t^;•'�',"» '' 4` .u,`?,;:rp".�. maximum check return charge allowable in your State. ,r;; :_< -✓-,., 4 �:;: =dpi' - Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity �"-�''1�" ..".,��'., "`"F� m°'^+""°"""'°° aaaaR,I"• ACTIVITY. �� TAamn/ ���� amount has been since your COUNT a a MSUP st_,Gtygate00000 paid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice D 11-4 Addre,a mm D«, Xx x. stolen,damaged or not returned. pe„R"S Balance xxxx avoid late fees PaYmen[T1,ankYou %%%X 5.In accordance with NWNA's Terms and Conditions("T&C"),your 08131 461090 s scan„n Natural sp"n9wale� xx x>„ 111 31700514484 Ice Mountain DeWv1 X%x% Equipment Lease and/or Service Agreement account may be 0911 31708514444 1„ 3veas14•w 0 IFceueMOVnum5surcwr9e BGal GalRetum xx%% Monthly Oil B 1l subject to minimum monthly purchases and/or early cancellation .„7 3 B 63Be„ e[ Surcharge,Fuel fees.(A complete version of the current T&C may he viewed on the Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TarAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General 1n which service is discontinued. __ "`°"n - `"`"I'xx"xM Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or xXzxaMeM+ M J ,,,,,-. Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY xXXx Y _____ pqY THIS AMOUNT will apply to each account. The fee that applies to your account ----- N.a P^Y'-- ACCOUNTS PAY BY XxXx ,.— °m 00100180 is stated on the front of the invoice.For further information please " rz'110890 MT.ENCLOSED "m INVOICE NUMBE0. BILLING DATE visit the website listed below or contact our customer service 1234567890 Wo 100 center. 7. As a food product, bottled water is subject to the rules and 0420096307 042&2712619 ❑00391049 2p04 1& Amount due regulations promulgated by the Federal Food and Drug �9nn Doe Administration(FDA). ICE Mou�NTaN wATEa°e„„oM, ,kNv �ryses`00000 8.Your first invoice indicates the products delivered on your first "" ° es Submit your &00.CUSTOMER SERV"CE CALL'-0004)7-9 B a ment by this delivery,along with any applicable bottle and account deposits, Laut a„tla,„U4,,,la.al.Gu.:11.661a.a.,tl e ❑P ” ,,,,e P Y y redemption fees,and any dispenser charges.All future invoices aroPArB,9"0oRe4°„ado"Bry="`5i° date will reflect charges for water delivered and dispenser rental,bottle SIGN UpFoBFREE A 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 Nestle Waters North America Inc. Form No.NW 709 02/14 Q service.icemountainwater.com 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)) 07/14/15 15G0119252823 $18.21 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $18.21 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 115G0119252823 I 42-389.001 $18.21 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 l � Tihu�r /ta'123r 15 A// k" M treet mmisslone�rr Title Cost distribution ledger classification if claim paid motor vehicle highway fund seryice.icemountainwater.corn #215 6661 DIXIE HWY,SUITE 4 06/01/15 06/30/15 05FO120048525 o LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II 119 01�I I I I I�10l l l l l l l l l ll I SII WED- JUL 08 0120048525 THU- AUG 06 FRI- SEP 04 Access your delivery calendar at TUE- OCT 06 service.icemountainwater.com CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT For your convenience,you can pay your bill online.It's 1 CIVIC SO fast and easy! CARMEL IN 46032-2584 10�111�1�1111���11�111111111'��I'�'llllll��l��ll�'��11�1'll���l�� %f;JhrA,U ust;Ice Aou'ntaln scha^n`ingy tfie name of,its' seryice..We�re becoming ReadyRefr sh by,PNesi Wsoahata. �.:;%d.°i '< '3''"«a� ry°e'�`� °`.d,,,., �, 75' y, ..;. ,s.,; rp;, - .,.,...., :., ..-'d`:m;.�6 ....,: zFra° y ...:,f��, ;.r. 4# wecan_serveFyo„u better.:,It<s thexsame,great`service you love;along Wth someinew features For;mor,.eF r�fo;' - -' M. ” r" ,F- _ °`',.;?4_ .. .fir«✓ A_.—: n-,` ., . ... - ��¢ Y.". . pa° ^'Y'Fs'y�;` � .,'♦' Vr�fbTxr� .y ry*` 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 SO, CITY ENGINEERING DEPTczszv CARMEL-IN-!46032 PREVIOUS BALANCE '_ 86.65 6/05 922429 PAYMENT-THANK YOU '�, -31.31 6/28 056433 PAYMENT-THANK YOU Q, -55.34 6/09 0941701070 9 5 GAL ICE MOUNTAIN DIRK W/HANDLE 31.41 9 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .� 00 3 9 OZ PLASTIC CUP 50CISLV �j t 9.87 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN 00 .00 6/30 F8654742 RENT a 3.99 TOTAL L.AV 45.27 z£2 zzoc�.._4239 oct ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 86.65 — 86.65 + 45.27 = 45.27 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 NATER 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 NATER 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 HNVY,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 later than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which thehe 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. You do not have to pay the disputed amount while it is being 001 0100-00100100 1234567890 Your Account Number investigated.During the investigation,we cannot report your account1 ` as delinquent or take any action to collect the amount in question. ➢1R-0a 0423456789 1 MON DCT 29 Watch here for a GENERAL INFORMATION TED-N21 TUE-DE C 1B personalized account 1.Payments received after the billing(INVOICE)date will appear on Important u,n..dn�nb,nma.•ama,rnu,calln«n rnaan Cu^mer Semce 1-BW 4]b9R8 message your next invoice.Past due invoices(not paid within 30 days of news and thanky^um."sl^9I<eM^"mm�P�d°<o. billing date may be assessed a late fee as allowed b law not to �o 3M ana.em«a. Y Y offers ,23 Mains, o,es'a'e 00000 ' exceed$20 per month.Additionally,thud party collection/attorney expenses may be assessed at a rate not to exceed 100%of the P Y dnw"- - athar"wn"n. unpaid balance or the maximum allowed by la3v. �-;I.;,s���,a „;u„arc;;y3maemi w' �� 'I r^���;;" Pay electronically 2.Each returned check is to the subject charge to a service subject J g J tY's�:`�',^,.'deaMeit�e's:?iatt�mmdaneaa§yniwer...,.. .,;». vr,•i:.�s.�:' `axr��-'., maximum check return charge allowable in your State. '9=.� ,,.,,,d:% F,...••a_ aa9,a-Paaa<,, Make sure this 3. All bottle and equipment de deposits are shown as CURRENT Activit P Y `' mu '�`' �w.�. a1 a•°Ae°"` amount has been ACTIVITY. since your AccouNTAa1wTM ° 4. Equipment replacement costs will be charged for bottles lost. last invoi •xeewenAee,e:. 39n^x«.121Ma1nS e`omS.""'I" paid in full to ce xx stolen,damaged or not returned. P,er,W:Bala^<e avoid late fees payment-ThankY^n %X%% 5.In accordance with N WNA's Terms and Conditions("T&C"),your oet3, q6,898 BGaibn Nawral sva^9waoer - Xxxx 111 )1]88514444 8 1<e Mountain BGal De Wait Xxx Equipment Lease and/or Service Agreement account may be 1„ 3ve9s,4++4 s ,e¢M9unt„nsoalaemr^ - nisx Monthly Oil subject to minimum monthly purchases and/or early cancellation "' "]�514M rpe's°`<ha`9e 2 3102638911 P-1 Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the M n] ,66 d91 00x0 Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TDTAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. MeM L T�RREmARNOa = °•TT"'*;x°x"` 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or 9IOR --x"x" =aa ,d• Information") Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY E 0x,0 U r 4a,,,,,.-ore PAY THIS AMOUNT will apply to each account. The fee that applies to your account `—a---- ACCOUNT NUMBER PAY BY xxX% .,a^Ya,P•ym.�. ----a„r„u,u nun ane,ewm 123110 90 00100100 MT ENCLOSED is stated on the front of the invoice.For further information please INVOICE NUM BER BILLING DATE visit the website listed below or contact our customer serviceoorooloo 123456]890 center. 7. As a food product, bottled water is subject to the rules and 0420x9630'] ❑1212']12619 000391049 2004 11 Amount due regulations promulgated by the Federal Food and Drug 1,,— Administration(FDA). ICE MOUNTAIN WATER COMPANY 1123Main Sc Submit your 8.Your first invoice indicates the products delivered on your firs[ .Owionm N..Ja wae^w�amea,mr 123 State 00000 OR CUSTOMER SENILE CALL'900s]I 9�8 delivery,along with any applicable bottle and account deposits, t,tt,ua.n O P a p15, payment by this redemption fees, and an dispenser charges.All future invoices I"aaa.,a"n6�.d6«alp«n«4u.,L« „e40^Re.e,+• ° date P Y P € �s,0"uPvoe rREE AOroPAn uPRn� 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 Nestle Waters North America Inc. Form No.NW 709 02/14 service.icemountainwater.com 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 7/2/2015 05FO1200 Water cooler $ 45.27 Total $ 45.27 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 $ 45.27 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 05FO1200 2200-4239099 $ 45.27 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 7/27/2015 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund