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Home My WebLink About203484 11/09/2011 a CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $19.09 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 203484 LOUISVILLE KY 40285 -6680 CHECK DATE: 11/9/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 01J722032704 19.09 01J7220327048 service. icemountainwater.com 215 6661 DIXIE HWY SUITE 4 10/01/11 10/31/11 01J7220327048 LOUISVILLE KY 40258 6 B e ADDRESS SERVICE REQUESTED II I I I� I IIII I III I I I I I I I (II I I �II TUE- 22 7220327048 DEC TUE- DEC 06 THU- JAN 05 MON- FEB 06 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1- 800 472 -9888 ANN DAVIS Thank you for choosing Ice Mountain Home Office CARM EL Q 46032 -2584 Delivery! We value your business. �I�IIIII' I. �I" I�II�"" �II�II' II�II '��'�I�I�'I'll T•ln'o�_. -ate• y Now's the perfect�tlme -to try our San Pellegrino Spark) "rng eve ages -the appeal of aTsparkling Hulce and F ord the tndulgenceof a premium sotla:A�allalle tn�Lemonand Orange: En,oy.;$3 o`ff per case Call 1 800 =472 9888 to" "add C your next er) E xp 12/31/11 4` 3 ACCOUNT ACTIVITY Pay your bill online at: service. icemou nta 1 nwater.com or by phone at:1 -800 -472 -9888. It's free! B 8 B 8 LVA 9 Delivery address: CITY OF CARMEL, 1 CIVIC SQ, CLERK TREASURER OFFICE, CARMEL IN 46032 PREVIOUS BALANCE 12.15 10/28 717348 PAYMENT -THANK YOU -12.15 10/24 0746735299 1 9 OZ PLASTIC UP 50C /SLEEVE 1.99 3 5 GAL ICE MOUNTAIN DIRK W /HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 10/31 0749009585 1 OIL/FUEL SURCHARGE 2.64 J1629769 RENT 3.99 TOTAL 19.09 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 12.15 12.15 19.09 19.09 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 yon are renting equipment, your equipment rental 15 charged one month in advance. That means CALL 1- 800472 -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 SA MPLE 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 1 00100100 00100100 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. T "R oa a 23456789 MoNocT 79 Watch here for a GENERAL INFORMATION WED DEC E I DE -DEG t6 personalized account 1. Payments received after the billing (INVOICE) date will appear on Important message na i��tu: nuaelta tniartau al! n „n;,ti,tan CuStomerSer �MOUnc R aloPr a your next invoice. Past due invoices (not paid within 30 days of news and Th.nk Y lor °sl „91 billing date) may be assessed a late fee as allowed by law not to offers 1 123 M111 sL exceed $20 per month. Additionally, third party collection/attomey cm state 000w expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. Pay electronically 2. Each returned check is subject to a service charge subject to the R maximum check return charge allowable in your State. ,t Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity „•mo 5 amount has been ACTIVITY. since your ppp00 nccouNrACrrv 4. Equipment replacement costs will be charged for bottles lost, ice DerrveryAaere lo na0 °e•1z3Ma °s "e e c rys ate paid in full to last invo 11 stolen, damaged or not returned. 42 as avoid late fees Payment -Thank YOU Water 5. In accordance with NWNA's Terms and Conditions "T &C your oen, X 1898 s sc,noa Nat4Mi sP ery so oo It l 317085 „826,x„ 144.4 Ice Mountain 5 Gal Deem" Surchar Equipment Lease and/or Service Agreement account may be 3vRRSla+a s iCeMR „m Monthly Oil subject to minimum monthly purchases and/or early cancellation osm 3 170RS g e, Fuel fees. (A complete version of the current T &C maybe viewed on the 09112 ,6640497 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TOTAL Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. "T eo88.N AlD ^YT "y o Information 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or U" Delivery Fee as described in your T &C. Only one of these fees Payment stub AccouNT suMMAav 9s PAY BY RAY TNIS AMOUN will apply to each account. The fee that applies to your account we ��2,•m „";a ro. wY AccoUW NUMBER o0 0o 5240 is stated on the front of the invoice. For further information please 12345678 MT. ENCLOSED 1 RauNC DA E INVOICE NUMBER WI001DD visit the website listed below or contact our customer service 123456789 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04262712619 00[1391049 2004 1B Amount due regulations promulgated by the Federal Food and Drug ton Doe ICE MOUMAIN WATER COMPANY 123 Maio S[ Administration (FDA). a„q,,,"o„I,.m• clry.stare 00000 Submit your 8. Your firs[ invoice indicates the products delivered on your first R80 p b this FOR CUSTOME0. 0E0.VICE CALL''00°AI29 delivery, along with any applicable bottle and account deposits, atw "1611AU "`R td "a a" e „es;ae. P Y Y redemption fees, and any dispenser charges. All future invokes 1 date s EcAUro e•nse•uPRe4e; 4o Rewe „e 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 O 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 uMts, price per unit, etc. ay o 1(� 1► r Purchase Order No. Terms Date Due Invoice 'Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) W�CM, Total 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 0 1 tQ a b� IN SUM OF �v 4 (9.09 ON ACCOUNT OF APPROPRIATION FOR -T M" A t&-, Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or O ITT,4,03a 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 s X) 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund