169472 03/04/2009 F CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $19.53
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 169472
LOUISVILLE KY 40285 -6680
CHECK DATE: 3/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 0119252823 19.53 OTHER MAINT SUPPLIES
720106
01/13/09 2/12/09 0980119252823
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
THU- FEB 19 0119252823
III IIII II II II II III III II I VIII III III II IIII I II THU- MAR 19
FRI- APR 17
#BWNNWYR MON- MAY 18
#0400001192528234#
CITY OF CARMEL STREET DEPARTME Customer Service: 1- 800 472 -9888
BONNIE CALLAHAN
3400 W 131ST ST Did you forget about us? Kindly pay upon receipt.
WESTFIELD IN 46074 -8267 Remember, past due accounts are subject to a late
fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com/service. If payment has been
made, we thank you.
F En cial savings! Save $3 /case on 700m1_ Sport Top Bottles. Also, add a little flavor to your delivery, save
Nestea Flavored Tea St9.,ks. Dffer limited to 6 each delive ry, ex plies 2/2Z/09. More in fo. go to emoun #aiinwater,com or ca11800- 472 9888.
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. Its free!
Delivery address: CITY OF CARMEL STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 23.18
1/25 433096 PAYMENT -THANK YOU -3.99
1/20 0602577439 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00
2/12 0607501863 1 OIL /FUEL SURCHARGE 2.08
B7104517 RENT 3.99
TOTAL 38.72
z ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT AC T IViTY PAY TIIIS AMOUNT.r hiect to terms nn reverses side 23.18 3.99 19.53 38.72
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 smootheF4 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 1IOUNTMN SPRING WR'I'ER 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 DIME 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 he n
later than thirty (30) days after we SAMPLE INVOICE
sent you the first bill on which the error or problem appeared. You ca
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. „t; tlt_.
You are obligated to pay the parts of your bill that are not in question. Tz3as67a90 Your Account Number
You do not have to pay the disputed amount while it is being t DO/ oo /Do- oorooloo
investigated During the investigation, we cannot report your account :t 7
72345678
as delinquent or take any action to collect the amount in question. TrR -ocr w
MDNOCT 29 Watch here for a
GENERAL INFORMATION aE DE C 2,
NL DEC ,g personalized account
1. Payments received after the billing (INVOICE) date will appear on Important
pa ".N,.�aReN message
Your next Invoice. Past due Invoices not aid within 30 days of news and
a
billing ate m be assessed a late fee as allowed by law not to °Oe m...r�ca.
g y offers I ,21 M
exceed S20 per month. Additionally. third party collection /attorney Sl
°`y'$td1Q 00000
I nr u it
expenses may be assessed at a rate not to exceed 100% of the owv -m`aL
unpaid balance or the maximum allowed by law. f Tqy a< a m! y5 �"e oaun�.rculewtm y Pay electronically
2. Each returned check is subject to a service charge subject to the
a
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity 't!=.+1.� w�� ^m amount has been
ACTIVITY. since your ACCOUNT ACTIVITY P
4. Equipment re replacement costs will be charged for bottles lost, Der r Aeere55. D°e�lzsM "g "et1'o�ysrare00000 „g9 paid in full to
P last invoice I I 0
stolen, damaged or not returned. 5 avoid late fees
Equipment Lease and/or Service Agreement Thankyou
SBAB
5. In accordance with NWNA's Terms and Conditions "T &C your gg n6,R9g sGalb "Nawral soa "9wT`P'
31]egsln°°
E ui account may be 9n, ,CeMO� ",a, "SwlDen 7.
q P y OIII 3178BS S ReMounta�nSGalRecu,n 1199 Monthly Oil
11 3t]R85 5 FuelSwcl+arge
subject to minimum monthly purchases and /or early cancellation PZ63egn Re" Surcharge, Fuel
fees. (A complete version ofthe current T &C may be viewed on the g9nz 166 °oa9] szw
m
Surcharge or Deliver,
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. TnITr "y
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or ,.w. "99 Information
99
Deliver) Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY cpu 1LF ^u 1AY THIS AMOUNT
will apph to each account. The fee that applies to your account
ACCOUNT NUMBER PAYByo 57.. ooloolo
is stated on the front of the invoice. For further information lease 1234567990 DATE MT. ENCLOSED
p u 81LLING
INVOICE NUMBER pOIww
visit the website listed below or contact our customer service uB4s67g9
CC a p sub 542A2i12619 040391049 200V 1E
7. Asa food p bottled water is sub�ect to the rules and Amount due
regulations pronmlgatcd by the Federal Food and Drug 1oh,,
Administration (FDA). IGE MOUNrAIN WATER CoIAPAni r_ n cur scace
8. Your first invoice indicates the products delivered o your first Submit your
delivery, along with any applicable bottle and account deposits,
IDRCUS MLRSo,vI IAN,.aao =9888 payment by this
P ^,a "ycna "9• ^Re�•n
r... m, i,,, I„ ul,,u..r.,,Ia,t,r.,t„ ^R...,,eS,eP
reclean fees, and any dispenser charges. All future Invoices date
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 5/06
Se
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))
02/14/09 09BO119252823 $19.53
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 N
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Pox 856680
Louisville, KY 40285 -6680
$19.53
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 09BO119252823 42- 389.00 $19.53 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
a Fr1ay, February 27, 2009
r SStreet Commissio r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund