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187338 07/07/2010
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $37.22 o: PO BOX 856680 CHECK NUMBER: 187338 LOUISVILLE KY 40285 -6680 CHECK DATE: 717/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 0119252823 37.22 OTHER MAINT SUPPLIES se Nice. icemounta1nwater.com b 215 6661 DIXIE HWY, SUITE 4 05/13/10 0OF0119252823 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED M N 11111111111111111111111 I I !III TUE- JU 27 0119252823 WED- AUG 25 FRI- SEP 24 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1 -800- 472 -9888 BONNIE CALLAHAN Did you forget about us? Kindly pay upon receipt. 3400 W 131ST ST Remember, past due accounts are subject to a late fee. WESTFIELD IN 46074 -8267 Your prompt payment is appreciated. For your I I I I' 111 1 111111 1 1111 11 11 1 I' 11 convenience, pay online: icemountainwater.comiservice. If payment has been made, we thank you. Get idna D61ivered and,SAVEI Add gteat`tasttng Arr ona ".I ta. your nextxorder Choose from 7 Lemon Tea Green Tea, Diet Green Tea, ArnoP ld almer °and Suveet Tea available r 11 5 oz cans an 1 gallon, Hugs Calfor go`nnitne:to add!"" our order ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntainwater.com or by phone at. 1-800-472-9888. It's free! Delivery address: CITY OF CARMEL STREET DEPARTMENT, 2 CIVIC SO, CARMEL IN 46032 PREVIOUS BALANCE 32.71 5126 0673870234 8 5 GAL ICE MOUNTAIN DIRK WIHANDLE 27.92 8 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 48.00 8 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -48.00 1 9 OZ PLASTIC UP 50C/SLEEVE 2.99 6112 0677780181 1 OILIFUEL SURCHARGE 2.32 F9348082 RENT 3.99 TOTAL 69.93 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY T." Subject to terms on reverse side. 32.71 0.00 37.2 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 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.icemountain.com. 6661 DIXIE HWY, SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. Ifyou 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. 123456 Your Account Number You do not have to pay the disputed amount while it is being omomoo oolOmDo investigated. During the investigation, we cannot report your account [2345b78 as delinquent or take any action to collect the amount in question. TNe ccr w M ©N -«T =9 Watch here for a GENERAL INFORMATION personalized account wro -ND 7 m e -ofne I. Payments received after the billing INVOICE date will a p p ear on Important 9 1[:; itLdl [Ud,.181.1,1t16�,3litlrtlLlldd4l ennome, s °rv�a: e� -Bae Y g PP message your next invoice. Past due invoices (not paid within 30 days of news and M1tt "j ^9 Bonn Do° a billing date) date) may be assessed a late fee as allowed by law not to offers tz3Mn�ns exceed S20 per month. Additionally, third party collectionlattorney ry 5 00000 1 dall..J na dL VL.,II "ha 464f.J..a expenses may unpaid balance or t he maximum allowed by l. exceed 100% of the °n 4 9 ",.a Pay electronically 2. Each returned check is subject to a service charge subject to the .?Vnrmaroa maximum check return charge allowable in your State. `s Make sure this 3. Al bottle and equipment deposits are shown as CURRENT Ac OI1Ce A ccoul+rnarvrr' r g ar amount has been wg ACTIVITY y n noe�,x3rn s Pe +env.s poaa° n� paid in full to 4. Equipment re lacement costs will be charged for bottles lost, oe „e Aae. stolen, damaged or not returned. 4r« avoid late fees p°y".¢m:S0.an4YOU SOW 5. In accordance with NWNA's Terms and Conditions "T &C your 3 ,70g5�MM T [e Mp,In,xln5 Gal O•Pe l96 Monthl Equipment Lease and/or Service Agreement account may be 3 ❑aes,w+ s °m "„min seal A ",n y Gil subject to minimum monthly purchases and or early cancellation Surchar Fuel fees. (A complete version of the currentT &C maybe viewed on the 'r 6gpp97 sz49 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the rom Fee (see 96 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. Information 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or Delivery Fee as described i T &C Only en one of these fees P a y ment stub ACCOUNT SUMMARY ry F d Y Y y mtu----- PAY YNIS AMOUNT pP Y e ry w° nk rtu m ACCOUNT NUMBr0. PAY 8Y 40 will apply to each account. The Tee that applies to our account o 0109 W ,699 OR: T.FNCLOSF is stated on the front of the invoice. For further information please I uMera a,wNC OnrT visit the website listed below or contact our customer service ,734567 00 1 Center. P f o "rugh3al 012 ®8712614 ooa39LO an 1° Amount due 7. As a food p bottled water is sub [o the rules and regulations promulgated by the Federal Food and Drug Jo D« Administration (FDA). ICrMOUNTAINWFTFRCOM ANY 123— ,"0009a Submit your S. Your first invoice indicates the roducts delivered on our first aO"'°'" °uEw.,n.Nn P Y MEw r k app-9ara p ayment by this delivery, along with any applicable bottle and account deposits, V. d0.d" t.. a6. «.16.,dL:,II„I:a..G•:LLI�I,l ^U nsnr redemption fees, and any dispenser charges. All future invoices date s gnuoa"+ °lase: will reflect charges for water delivered and dispenser rental, bottle sw >,0P,0°r• 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. Y7 M s gain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. Nw cos t ilo8 "i k 1 VOUCHER NO. WARRA NO. Ice Mountain ALLOWED 20 IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $37.22 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# I Dept. INVOICE NO. ACCT /TITLE I AMOUNT Board Members 2201 00F0119252823 42- 389.00 $37.22 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 f /Thu dray, July 01, 201 C -I Street Commilssioner Cost distribution ledger classification if claim paid motor vehicle highway fund 1 1 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)) 06/15/10 OOF0119252823 $37.22 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 I