172367 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $18.95
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 172367
LOUISVILLE KY 40285-6680
CHECK DATE: 5/13/2009
DE PARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUN DESCRIPTIO
1701 4239099 09D722032704 18.95 OTHER MISCELLANOUS
B 720806
4/01/09 4/30/09 09D7220327048
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
MON- MAY 18 7220327048
11111 IN 11111111111111 WED- JUN 17
FRI- JUL 17
#BWNNWYR MON- AUG 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.
i
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. Call 800- 472 -9888 or go online T ODAY!
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800 472 -9888. It's free!
Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 22.44
4/24 934110 PAYMENT -THANK YOU -22.44
4/17 0616127643 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98
2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
2 9 OZ PLASTIC UP 50C /SLEEVE 5.98
4/30 0619293970 1 OIL /FUEL SURCHARGE 2.00
D7392421 RENT 3.99
TOTAL 18.95
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTAR
IN CASE OI' 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 INFORNINFION. 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 WVFER 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 I`IWY., SUITF 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 its on a separate sheet of paper. We
must hear from you in writing later 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 us the following information:
Sour name. address, telephone and account numbers. Date range of this invoice
'file dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
You arc obligated to pay the parts of your bill that are not in question. 12 3456799 0 Your Account Number
You do not have to pay the disputed amount while it is being 0100100- 00100
investigated. During the investigation, we cannot report your account
12345
as delinquent or take any action to collect the amount in question. TBB -oc*B^
MONOCl I9 Watch here for a
GENERAL INFORMATION WED NOY 21
TaE -DE< p ersonalized account
I. Payments received after the billing (INVOICE) date will appear on Important
II,IL„ III ,.III,IIIII,L.IIIIIIIII,„11111 „tI.ILl,lll „5^Ie.x MWl^aw�u�BB message
your next Invoice. Past due Invoices (not paid within 30 days of news and T n EY°umrusi ^9
billing date) may be assessed a late fee as allowed by law not to offers hzs
exceed S20 per month. Additionally, third party collection /attorney c�eYSl^[e 0000B
L and „d, Alb ,..dl... a.d u ,A
expenses may be assessed at a rate not to exceed 100% of the
P Y co w,L�
unpaid balance or the maximum allowed by law. anal a r g ,I�.Ieww a Pay electronically
2. Each returned check is subject to a service charge subject to the 1o „ACe.i �wy
maximum check return charge allowable in our State. tlelrvenYT.«ae'
b Y Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity x• „a,,, amount has been
ACTIVITY. since your ACCOUNTAC»vR1
4. Equipment replacement costs will be charged for bottles lost, +DeliveryAtldless'. loAnDce,123M s ea
l s,a, <°°°p „a9 paid in full to
ast invoice 1
stolen, damaged or not returned. p,^,w ^,BalaMe ,2. s avoid late fees
5. In accordance with N W NA's Terms and Conditions T &C” our oen, a5,a9e Tarn• -ww
l Y Jn"BSS+a4 s season NTM,xl svnnywa,e, n
y Ice MOOnldln S Gal Depoa;I 395
Equipment Lease and /or Service Agreement account may be s,2Bes,a4^^ k<MOnmams 99 Monthly Oil
subject to minimum month) p urchases and /or earl cancellation
Y P Y "1 52 d0
63 Surcharge, Fuel
09/12 BHA9a9 Pent
fees. (A complete version of the current T &C may be viewed on the o91 1 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. ,,,,,,,,,.<.Nm
6. )oil will be charged a monthly Oil Surcharge, Fuel Surcharge or Information
WAN 99
Deli very Fee as described In our TfiC. Only one of these fees Payment stub AC COUNT SUMMARY eo• c99w
Y
pAY BY PAY THIS AMOUNT
will apply to each account. The fee that applies to your account p; a,,, m�,«•w>^�" ACCOUNTNUMBFA w wt szw
is stated on the front of the invoice. For further information please 1890 MUJIGDATE MT. ENCLOSED
'wolcE NUMBER 00100100
visit the website listed below or contact our customer service 121 +5 5)990
Center. 42p096303 042,2712619 000391049 2004 16
7. As a food prod bottled water Is sub ect to the rules and Amount due
regulations promulgated by the Federal Food and Drug I4nn D«
Administration (FDA). I CMOUMAINwA 1E R b C M OM A �ry5[a,eS`BDDDD Submit your
8. Your first invoice indicates the products delivered on your first wrt^
DB<D :TONER ER,<E<ALLLao4 29BaB b this
delivery. along wnh any applicable bottle and account depose n,,..u,.dbL
s. I„ And., .n „I,,.Ia,I,bA„n �,<m<. p ayment Y
redemption fees, and any dispenser charges. All future invoices 8< ,,.,,aNnB•••^• date
will reflect charges for water delivered and dispenser rental, bottle s +D4,BEE
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 dfliveries
apls astanat uo swiai of IDaign
96 21, 96'2 1 1 bb ZZ
1Nf10WV smi kVd A.LIAI13V 1N3mano 1 1N3w1snraV /1N3WAVd 3ONV snOlA321d kdvwwns 1Nn000v
Prescribed by State Board of Accounts City Farm 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))
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. 1 hereby certify that the attached invoice(s), or
'D`19�Mq t. -'51b 7 S bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
.�a., -,%a.L 1
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund