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Home My WebLink About201491 09/14/2011 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $45.55 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 201491 LOUISVILLE KY 40285 -6680 CHECK DATE: 9/14/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 01HO11782108 45.55 01HO117821082 service.icemountainwater.com 0 D 0 215 6661 DIXIE HWY, SUITE 4 08/01/11 08/31/11 01 HO117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED B e FRI- SET 16 0117821082 MON- OCT 17 TUE- NOV 15 FRI- DEC 16 Customer Service: 1 800 472 9888 CITY OF CARMEL STREET DEPATMENT Thank you for choosing Ice Mountain Home Office 3400 W 131 ST ST Delivery! We value your business. CARMEL IN 46074 -8267 ��II�I�III�II�I��I�I�IIIII�II�IIII "III "I11111111111��1111111�� A: �.F. e�«- ,,9 sa�- E new TRADEWINDS re"��br6W d`iced" as Mac!64ith high quality tea leaves, real suga all E red�ents. !t s. iced tea made _slmply,_�ust the° Way•it=should -1150For;a�llmlted,tlme, save $2 /case. Call a our nextorde ME R ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1 -800- 472 -9888. It's free! e s B s MA Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074 PREVIOUS BALANCE 93.69 8/07 276186 PAYMENT -THANK YOU -48.10 8/28 386608 PAYMENT -THANK YOU -45.59 8/17 0736879834 2 9 OZ PLASTIC UP 50C /SLEEVE 3.98 10 5 GAL ICE MOUNTAIN,DRK W /HANDLE 34.90 10 5 GALLON ICE= MOUNTAIN-BOTTLE DEPOSIT 60.00 10 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -60.00 8/31 0739948693 1 OIL /FUEL SURCHARGE 2.68 H1291068 RENT 3.99 TOTAL 45.55 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 93.69 93.69 45.55 45.55 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 SAMPLE IN 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. 123+s62s90 Your Account Number You do not have to pay the disputed amount while it is being 001 00,01100 investigated. During the investigation, we cannot report your account tz3as67e9 I as delinquent or take any action to collect the amount in question. TNB _c, MONOCS Watch here for a GENERAL INFORMATION personalized account I. Pa wEo-Nwt NE -DEC'B I Payments received after the billing INVOICE date will appear on p ,Boo <2z -9888 Ym g( PP Important Ibpr. 01a0W11141«.t @d,Nb „dGtl•,B.AldJa a•m""' 4 message your next invoice. Past due invoices (not paid within 30 days of news and TN «u+ billing date) may be assessed a late fee as allowed by law not to offers biz wi st exceed S20 per month. Additionally, third party collection /attorney city ab.n.bo. expenses may be assessed at a rate not to exceed 100% of the s m ,,,„,,,e :a.a� unpaid balance or the maximum allowed by law. ToPOn+aOrPw N "PL°` Wi I Pay electronically 2. Each returned check is subject to a service charge subject to the .r maximum check return charge allowable in your State. I Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since our ACCOUKTACTtr199Y 1 Y Mnpo 133 MainSVee4r Sa1eBoo01 n.99 paid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice ce' ""y" stolen, damaged or not returned. P,0A�0sea yw 12A5 avoid late fees 5. In accordance with NWNA's Terms and Conditions T &C our ws" P I wat” so.aB i y OBr3 sGa14M Na, «alscore I BBS,aa s Month, Equipment Lease and/or Service Agreement account may be 3neBS,4•+4 s M n Dlns c•I Ba�P I Y Oil subject to minimum month, purchases and/or earl cancellation e;wr wm•' =f J Y P Y 3 13.11 Bey 1 l Surcharge, Fuel fees. (A complete version of the currentT &C may be viewed on the 5740 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the roar Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. wrM A�rPA y Pay T., w` 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or M,,. Information SUMMARY 99 Delivery ee as described in our T &C. Only ne of these fees P stub AcC rY y our Y PAy v PAY TN's AMOUM will apply to each account. The fee that applies to your account ,;,w «drt„� wNw�•P•f'°" 1 ACCOUNT NUMBER w/Dow s w is stated on the front of the invoice. For further information please 1234567890 BIWNG DATE MT. ENCLOSED visit the website listed below or contact our customer service INVOICE NUMBER WIWIDO ,2N562890 center. 000391049 2004 16 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 Amount due regulations promulgated by the Federal Food and Drug pm D« Administration (FDA). ouNral+wATER eDMP" 2 Ct3YACit St oo000 Submit your w A 8. Your first invoice indicates the products delivered on your first wpC0n0,,,EBSE.,,,rEC,,ujpp°2 -9800 delivery, along with any applicable bottle and account deposits, �,•a„m„wab .ab.,u.6n.6. bbbW.0 D,• uD„,,,,;,._ ,�h payment by this redemption fees, and any dispenser charges. All future invoices date Sraw,oB raEE N „ovrnsmwnm«•^°n Pe""`sn. 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 1 1/08 S r 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)) 09/02/11 01 HO117821082 $45.55 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 N WA RRANT N ALLOWED 20 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $45.55 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 01 HO117821082 42 389.00 $45.55 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 Monday, Septembe�12, 2011 j f, Street Commissioner I Street f Cost distribution ledger classification if claim paid motor vehicle highway fund