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170901 04/16/2009 \,f CITY OF CARMEL, INDIANA VENDOR: 357977 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN CHECK AMOUNT: $32.20 CARMEL, INDIANA 46032 P O BOX 856680 LOUISVILLE KY 40285 -6680 CHECK NUMBER: 170901 CHECK DATE: 4116/2009 DEPARTMENT A PO NUMBER INV OICE N UMBER AMOUNT DESCRIP 1205 4239099 090012177619 9.76 OTHER MISCELLANOUS 1701 4239099 090722032704 22.44 OTHER MISCELLANOUS eo '0v 0 720106 3/01/09 3/31 /09 0900121776199 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0 service. icemountain.com FRI- APR 17 0121776199 III IfliIH IN�IHIIWNII1 MIN HIIMH MOD MAY 1 WED- JUN 17 #BWNNWYR FRI- JUL 17 #0400001217761992# CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 -472 -9888 SHELLY LINGELBAUGH 1 CIVIC SQ Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery! We value your business. STOCK UP SAVE on a variety of ice Mountain Direct products! Take an additional $3 off on Half Pint, .700mL,1 Liter, Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit- beverages. Limit 6 discounted cases i per deliv Call 800 -472 -9888 or go online TODAY! e 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 HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032 PREVIOUS BALANCE 33.51 3/08 668968 PAYMENT -THANK YOU -16.69 4/01 806130 PAYMENT -THANK YOU -16.54 3/19 0611709478 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 3.49 BOTTLE DEPOSIT: 1 DELIVERED, 1 RETURNED .00 3/31 0614426831 1 OIL /FUEL SURCHARGE 2.00 C7214951 RENT 3 9 SALES TAX TOTAL 10.04 1 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE Or 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 INFORMAr1ON, 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 USAr: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE NIOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 1216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE IIWY.. SUITE 4 LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or ifyou need more information about a transaction on your bill, write its on a separate sheet of paper. We must hear from you in writing error than thirty (30) days after we SAMPLE INVOICE sent you the first bill on which the he error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter, give its the following information: Your name, address. telephone and account numbers. Date range of this invoice t The dollar amount of the suspected error. Describe the error and explain if you can. why you believe there is an error. Mao You are obligated to pay the parts of your hill that are not in question. 1234 567190 Your Account Number You do not have to pay the disputed amount while it is being 00/00/0000100100 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. Tnn 12 3 456 99 Watch here for a WED -NOV 21 GENERAL INFORMATION DEc'B personalized account I. Payments received after the billing (INVOICE) date will appear on Important ILll,.dll „III•.IIIII•L., 1111,1,1116 „IIIII,al,.11.l,lll c °a9,11e1 s =mpeLI aN.47 message your nest invoice. Past clue invoices (not paid within 30 days of news and m. °Er °9ieeM billing dine) ittit' he assessed a late fee as allowed h lave not to Iin"I a °e,.mee, b Y offers nA +4 °s' exceed $20 per month. Additionally, third party collection /auorney ons+ale 00000 6.1ILL..L.IR.....11.•.. 11.•,11 „I,II,J,,,1,1,1,1,.1,.11 expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the a r g^a °^I Pay electronically maxmuun allowed by law. aro,am 1�4leww°' Ta mm+a9°Y°” °m, Y°V d>�4S U1. much mwN 2. Each returned check Is subject to a service charge subject to the x� �ft� O „;a wunro•w�p maximum check return charge allowable In your State. I u 4... Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your AccouNUrnw st' clr s ale oOBOO 4. Equipment replaccmcnl costs will be charged for bottles lost. I,l ,yArrr °u` '°anOOe ,z3 Ma paid in full t0 last invoice 4:45 avoid late fees stolen. clamaecd or not rcnuncd. 50.00 5. In accordance with NWNA's Terms and Conditions T &C). our 31 Pa ^k Y sera Na, °gat s °9wa e. so_m I, ]08614444 5 nta�n SGa...... t 3.96 Equipment Lease and /or Service Agreement account may be Tees, 4 e w ie, 99 Monthly Oil p9111 31]085 S IIFUeI5u1cM9e subject to minimum monthly purchases and /or early cancellation 09112 31B263BBn rte Surcharge, Fuel fees. (A complete version of current T&.0 may be viewed on the osr12 16wo49' Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TOTAL Fee (see 46 under Leased Equipment is charged through the end of the bilging cycle "General in which service is discontinued. u cT ,,,m P•�TM" s G. You will be charged a monthly Oil Surcharge. Fuel Surcharge Y c or Delivery Fee as described in our T &C. Only one of these fees Pay ment stub ACCOUNT SUMMARY .4,gg 99 PAY BY PAY TNIS AMOUNT will apply to each account. Tile ACC e fee that applies to your account „m,*�,WyP�"""` OUKr NUMBER 0oloo sz4o a °TWA °'•1w•.N •n is stated on the front ofthe invoice. For further information please INV0ICENU 1234567890 BEN BILLING DATE T. ENCLOSED visit the website listed below or contact our customer service pojo 12 CE NUN center. P J p42Dp9630T 04262"112619 000391049 2004 1B 7. As a food roduct. bottled water is Sub to the rules and Amount due regulations promulgated by the Federal Food and Drug I_DOe 23 Administration (FDA). iCE MOurrrnw wAreB CO6 +PANY 0 w N•.m.�... �M. acy. slate 0000 8. Your first invoice indicates the products delivered on your first roB CUSroMEB SEBVICrcuLlaoo <n -96ee Submit your delivery. along with any applicable bottle and account deposits, ayment by this 1.., ma,,, l.. nl,,.. dl .•.dl.•al,a,n „I „a,l,l•I••I•11 •,.6b= P., ",Am�°a"9� "9e.4 „esa= redemption fees, and any dispenser charges. All future Invoices date :GN T +wiOn uoae9u1re° 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 it 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 5/08 PrescriDKd by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 Ice Mountain Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) nwm/nd 09C01:21776 Wafer Geeler Rental Total _T, I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accorda with IC 5- 11- 10 -1.6. 1 20 Clerk- Treasurer A VOUCHER N00 ft3l &ARRANT NO. ALLOWED 20 ce ountain P.O. Box 856680 IN SUM OF I n' lir-ville, KY 4E)H5-6680 $9.76 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1205 Administration Board Members PO# or DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the IZUb 900121776199 390 -99 $9 6 materials or services itemized thereon for which charge is made were ordered and received except r Si Cost distribution ledger classification if claim paid motor vehicle highway fund c 720106 co o 3/01/09 3/31/09 09C7220327048 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 O 0 service.icemountain.com FRI- APR 17 7220327048 IIII Ili III I III III III II III II 119IIli II II III II MOD- MAY 18 WED- JUN 17 #BWNNVVYR FRI- JUL 17 #0400072203270488# CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 472 -9888 ANN DAVIS 1 CIVIC SO Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery! We value your business. STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL,,1 Liter, Aqua'Pod, Perrier 1/2 Liter plastic and San Pellegrino_ Sparkling Fruit beverages. Limit 6 discounted cases per delivery. all 800 -4 -9 888 or o online TODAY! rY' g i o 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 OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 29.25 3/08 668969 PAYMENT -THANK YOU -12.71 4/01 806134 PAYMENT -THANK YOU -16.54 3/19 0611709528 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 3/31 0614561710 1 OIL /FUEL SURCHARGE 2.00 C7250724 RENT 3.99__ TOTAL !2 4 4 ACCOUNT S UMMARY CURR PAY THM FtZcV10Uj 6MLHNV•EI Pi,YMEi�TiADSTMEi�iT C::�:�� T rlli l i/ r,�� ihiart to terms an reverse side. 29.25 0 29.25 22 44 22.44 r 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. #216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE IIWY., SUITE 4 LOUISVILLE. KY 40255 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 sent[ hear from you in writing he n error than thing (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. You are obligated to pay the parts of your bill that are not in question. 1234567990 Your Account Number You do not have to pay the disputed amount while it is being 00100/00 0 0 1 00100 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. Trte ocT 0a tza4seze9 ,0'­T 29 Watch here for a weo n GENERAL INFORMATION UE OE Nov C ,B personalized account I. Payments received after the billing (INVOICE) date will appear on Important ILII,.. 111„ III, �IIIII, I,. �III1 ,1,1111����11111,.11,.11.1.111 as "se""` =�'A0o -a�z 9esa message your next invoice. Past due invoices (nor paid within 30 days of news and ma "Eroo g oce bdhng (late) may be assessed a late fee as allowed by tae not to offers 1 n" z1M SE ..d,.--1 oar. state 00000 exceed S20 per month. Addmonally, third party collecti �II�„II,�I on /attorney 1...IIII..I.IIL III. !,1,1,6A,.1 cxpcnses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. T,m9 Pay electronically 2. Fach returned check Is subject to it service charge subject to the maximum check return charge allowable In your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity AC "fIVIr),. since amount has been 'our n couNTACrIwTY y 4 Equipment replacement costs Yvill be charged for bottles lost. O 3OhnDpe' s o'rsla1e 0o000 ,.v p aid in full to last invoice «a5 stolen, damaged or not returned. P,e+ame avoid late fees e ma "EVOO so 5. In accordance with NWNA'sTerms and Conditions ("T _C`), your 4a,B9e saw oN4w,a,sPa�9wa�e� s o0 l,ieBS,4^^a 5 ",a� "se4i oevmB 19e Equipment Lease and /or Service Agreement account may be 3 s e4, Be 99 Monthly Oil 3 ]B 0.14 S Surcharge, FU¢I Benl Su�cMrge subject to minimum monthly purchases and/or early cancellation osnz l+BZelaen fees. (A complete version of the current T &C may be viewed on the o9,a ,x.91 5 7 Surcharge or Delivery websitc 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. r s Information 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or wA 9 Deliver\, Fee as described in your T &C. Onh one of these fees Pavment stub ACCOUNT SUMMARY o c L E YOU PAY BY AY TS,S AMOUNT will apply to each account. The fee that applies to your account 140 ACCOUM NUMBER n.o.wn,M „sue. �n�im 0000100 M is stated on the front of the invoice. For further information please 133456)890 w ,NV 2345 7890 to DAT T ENCLOSED E visit the ebsitc listed below or contact our customer service 2;456)8 center. 7. As a food product. bottled water is subject to the rules and a42UU96307 04282712619 0003910V9 200 1 Amount due regulations promulgated by the Federal Food and Drug Ion "Doe Administration (FDA). ,CE MO �NTA,N WATE CD P er+�n� oy M,ate S �0oo 00 8. Your first invoice indicates the products delivered on your first •0^^ E Submit your w oB TOMEB EBY,< <A ,.e"o z.9EBe this delivery, along with any applicable bottle and account deposits, p ayment b ,ca.�9•�o�a<.n.. m e redemption fees. and any dispenser charges. All future Invoices L" 111'1...1 "111...,ILIL „11111 1 1111 l ea o�B...�u 510 date y will reflect charges for water delivered and dispenser rental, bottle s 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 Nestl6 Waters North America Inc. Form No. NW 709 5/08 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)) l� rt ]Z 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 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or CY�L'li �Z 1 IDI 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 fa f 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund