167632 01/07/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $3.99
.oH PO BOX 856680 CHECK NUMBER: 167632
LOUISVILLE KY 40285 -6680
CHECK DATE: 1/7/2009
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 08LO11925282 3.99 OTHER MAINT SUPPLIES
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0 720106
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11/13/08 -12/12/08 08LO119252823
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 g o
service. icemountain.com
TUE- JAN 20 0119252823
III IiII lI II II II III III IIO�I II9 III �I III iI 9I THU- FEB 19
THU- MAR 19
#BWNNWYR FRI- APR 17
#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.
j Special delivery just in time for the holidays! For a limited time you can save $5 on a case of Sparkling
beverages and get a $5 Starbucks card when you order two bags of Starbucks coffee. Log onto
service.icemountainwater.com or call 800- 472 9888. Expires 12/31/08.
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 24.14
12107 176150 PAYMENT -THANK YOU -24.14
12/12 L6815553 RENT 3.99
TOTAL 3.99
ACCOUNT SUMMARY I PREVIOUS BALANCE o PAYMENTIADJUSTMENT+ CURRENT ACTIVITY o PAY THIS AMOUNT
uh'i to tarmc nn ravarca siria 24.14 24.14 3.99 3.99
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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. If you
4216 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.
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 SAMPLE INVOICE
writing no later than thirty (30) days after we sent you the first bill on
which the error or problem appeared. You can telephone us, but doing Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. P1000,00 us+ssze9
The dollar amount of the suspected error. 0o- oolooioo
Describe the error and explain if yo u can why you believe there is
zusbta90
an error. Mp -0CT0' t
You are obligated to pay the parts of your bill that are not in question. w °o: Your Account Number
You do not have to pay the disputed amount while it is being
Cuvto„,« S<,Vic <:''gpp.�),9888
investigated. During the investigation, we cannot report your account n n,,, ni„ ni „unt Mw^w ^P ^aua1
Watch here for a
as delinquent or take any action to collect the amount in question. i °n ^oP< "a +•m.•+
.t ^S' personalized account
GENERAL INFORMATION Im p n oa000
ortant t u t, t„ a., m.... ai „l. message
1. Payments received after the billing (INVOICE) date will appear on
news and
a
our next invoice. Past due invoices not aid within 30 da s of T9„�•u°Y'"”` °on
Y P' Y offers
billing date) may be assessed a late fee as allowed by law not to
exceed $20 per month. Additionally, third party collection /attorney 1 T Pay electronically
expenses may be assessed at a rate not to exceed 100% of the p cc o u Mx rnvtTV —.1
unpaid balance or the maximum allowed by law. ens R pppp0 Make sure this
cei nneo }ion D"e
2. Each returned check is subject to a service charge subject to the <n<s amount has been
Activity H °u ^k.W
maximum check return charge allowable in your State. ,,,,9< s °s" paid in full to
swiDro» our n ees,a s
3. All bottle and equipment deposits are shown as CURRENT since Y eases• ^s wiP.. avoid late fees
ACTIVITY. last invoice o9n, 31 0. 3 1 1 w1S.,hm
4. Equipment replacement costs will be charged for bottles lost, o v> 1 s
stolen, damaged or not returned. Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be
subject to minimum monthly purchases and/or early cancellation Your new aEhw Surcharge Or Delivery
i aea
foes. (A complete version of the current T &C may be viewed on the delivery nccouNT SUMMARY -0°w
Fee (see under
website listed below) Upon service discontinuation, rent for the calendar. "General
w»
Leased Equipment is charged through the end of the billing cycle M y Deliveries
Information')
`D' indicates
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled t
it
Delivery Fee as described in your T &C. Only one of these fees delivery �r
will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information please
visit the website listed below or contact our customer service
center.
Payment stub
av
.m.
PNY aY PPY TNIS /,MOUNT
7. As a food product, bottled water is subject to the rules and eauuwHUMeEx rotates v.ao Amount due
^•j Mrt ,1}.56)890 N<EOSED
regulations promulgated by the Federal Food and Drug „noicENUMeDt s'ujN
Administration (FDA). Izsosaze ppjpp
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, o9zoo9t,3oz nazezzss9 DDO3gio�" 2 pp
n Submit your
redemption fees, and any dispenser charges. All future invoices will payment by
r w y s ,s
reflect charges for water delivered and dispenser rental, bottle ¢E MOU NwnrEx coMPnNY
w co” this date
deposits and credits plus charges for any additional products waasr oMEaEP•T <r<u u eowT =9aea
ordered by you. Deliveries are made every three or four weeks, for t ti, t,,, i,, ai,,., d1 ^•tt °t Pm M w.9»onP�•^•
a total of 16 -17 deliveries per year. You will only receive invoices :w °pfeE` P
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 708 1 1/08
service. icemountain.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))
12/16/08 08LO119252823 $3.99
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. Box 856680
Louisville, KY 40285 -6680
$3.99
ON ACCOUNT OF APPROPRI T O FOR
Carmel Street Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Member:
2201 081-0119252823 42- 389.00 $3.99 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
/Wedne'sday, December 31, 2008
VVV Street Commis ioner
C7 �v' cirlt'1P.P
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund