162369 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL. INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $44.77
PO BOX 856680 CHECK NUMBER: 162369
LOUISVILLE KY 40285 -6680
CHECK DATE: 817/2008
DEPARTMENT T ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 086011925282 44.77 OTHER MAINT SUPPLIES
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06/13/08 7/12/08 08G0119252823
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0
service. icemounta!n.com
THU- AUG 14 0119252823
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TUE- OCT 14
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#0400001192528234#
CITY OF CARMEL STREET DEPARTME Customer Service: 1- 800 472 -9888
BONNIE CALLAHAN
3400 W 131ST ST Thank you for choosing Ice Mountain Home Office
WESTFIELD IN 46074 -8267 Delivery! We value your business.
Visit our website to learn howao beat the heat with delicious iced coffee recipes from Starbucks For a limited z
Male; save $3' -.vhen you ro;onlin'e and add:a 1 1Ib bay of•coffes to :your order' Offer expires 8/15/08. Log onto
C service. ic emountainwater.com to order t
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It free!
Delivery address: CITY OF CARMEL STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 27.44
7/11 346727 PAYMENT -THANK YOU -27.44
6/16 0569417546 6 5 GAL ICE MOUNTAIN DRK W /HANDLE 20.94
6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 36.00
4 9 OZ PLASTIC UP 50C /SLEEVE 11.96
6 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -36.00
7/12 0574876835 1 OIL /FUEL SURCHARGE 2.88
G6097331 RENT 8.99
TOTAL 44.77
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
�hiart to tarmc nn ravar cirla 27.44 m 27.44 44.77 e 44.77
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CAST: 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 WAFER QUALITY AND INFORNIATION, PLEASE, 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means
CALL 1 -800- 472 -9889 OR WRITE US AT your first Invoice w ill include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING 1VATER 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 lMr. 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 SAMP I
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:
)our 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.
lieu me not hav to n pay the parts of your bill that are not in question. Iz3 +se7R four Account Number
You do not hate pay th m w
e disputed amount while it is being t oolooloo oolo
investigated During the investigation, we cannot report your account
12345
as delinquent or take any action to collect file amount in question. tnR -a
W,,. oa 7v Watch here for a
WED NOV 21
GENERAL INFORMATION DEC 1R l m m personalized account
I. I'avnlenls received after the billing (INVOICE) date will appe on I m p ortant e
P ortant "RR messy
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your nest Invoice. due invoices (not paid within 30 days of news and rnanErw «�.n
billing date) may be assessed a late toe as allowed by law not to offers 123 S, ,nm.M•••
exceed $20 per month. Additionally, third party collection /auomey o "r's`a1P ll It
L., Ina,,, l„ pl,,,, ,p,,,,a,,,a „I,u „I,,,I,I,I,I,.L.
expenses may be assessed at a rate not to exceed 100% of the 'ate
unpaid balance or the maximum allowed by law. wmam x' �a ra^' 9 i °a°i Pav electronically
to mana9eYwre<c mYOO Can cheAYo"raaw�nlutM1,mVCN maN
2. Each returned check is subject to a service charge subject to the Nke. is "ha„�,,.„;ae.�
i
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity „p,.,,,M
ACTIVITI,. amount has been
since your ACCOUNT ACTIVITY C y$1l "oww
13 M,1 s paid in full to
4. Equipment replacement costs will be charged for bottles lost. last lm'oil'e
stolen, damaged or not returned. 735 avoid late fees
5. In accordance with NWNA's Terms and Conditions ('`T &C'), your 9 3 .w1R9x s saca��Nta^,^x„ISO�i ^qw °1P'�
9/11 11)BRS 3 keMwntainST++'Del°1"i' 29M1 Monthly Oil
Equipment Lease and /or Service Agreement account may be msev+a+' laMO ",amssalxe
091,1 311RR5 i fuel SU�cMr9e
subject to minimum monthly purchases and/or early cancellation „7 1,R16390n Surcharge, FOCI
fees. (A complete version of the current T &C may be viewed on the ogn7 '�eD°s' 5—
Surcharge or Delivery
websilc listed below) Upon service discontinuation, rent for the TO Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge of "9q Information
Delivery Fec as described in ourT &C. Only one of these fees P stub ACCOUNT SUMMARY
y PAY 61 PAY TS7 AMOUNT
,,ill apply to each account. The fee that applies to your account u �w,,, p M,m„aE,aarn^•^' ACCOUNTNUMeER s „o
00 00 a
is stated on the front ofthe invoice. for further intmolation please ,zl +se7s R t t,NC DAre MT ENaosro
INVOICE R p01W100
visit the websilc listed below or contact our customer service NUM9E
,13+SOW
center.
7. As a food product, bottled water is subject to the rules and 0420096307 09282712619 000391049 Amount 16
Amount due
regulations promulgated by file Federal Food and Drug
Adnninislr Lion (FDA).
ICE MOUNtNN WATE0. COM 113 Main 5, PANY Ci,rState 0000D Submit your
S. Your first invoice indicates the products delivered on your first 'p =,c
dclnvcry, along with any applicable battle and :account deposits. b.. nl,
o x CUSTUMERSENIC ECALE,.R09 „7 ayment by this
redemption fees. and any dispenser charges. All future invoices �r,•w.. Cl r ^l, ^ran•^^ °s” date
y ,u, vvfoxfxEE A Uror,v. w "ur"•^"
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.
0 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 5 /08
VOUCHER N_O, WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF$
.P, O. Box 856680
Louisville, KY 40285 -6680
$44.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 0860119252823 42- 389.00 $44 -77 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
Thursday, July 31, 2008
Street C missioner
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))
07/15108 0860119252823 $44.77
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
2p
Clerk- Treasurer