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211328 07/31/2012
a CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ` ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $149.89 PO BOX 856680 "OM` CHECK NUMBER: 211328 LOUISVILLE KY 40285-6680 CHECK DATE: 7/3112012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 149 . 89 0260119252823 0 service.icemountainwater.com ®® m #215 6661 DIXIE HWY,SUITE 4 06/13/12-07/12/12 02G0119252823 0 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g MON- AUG 06 0119252823 �I�II 69 0 IH I� 11111H III fl H N IH N WED- SET 05 THU- OCT 04 THU- NOV 01 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Did you forget about us? Kindly pay upon receipt. 3400 W 131ST ST Remember,past due accounts are subject to a late fee. CARMEL IN 46074-8267 Your prompt payment is appreciated. For your '�IIII'�II�'II' 'I��'I�I��II�III�'��"II��IIIII'll�'�III'�III��I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. `Re`#reshing Drinks Refrestiin`g�Savings. For a�limited�tirne,enjoy$1�off select cases ofTR%1DEIRIINDS8�� �' �SWEE�T�LEAF Be�era es With prices this cool, bringon the�heat►Log ontorseruice.icemoan#ainwa"ter corn or ��1�1-�0�7�2=9888�to:atldto�WOUr nett_orcle�l;„Offer ex�ires�8/.3�1112� °�` �= ��° k ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472.9888 or visit service.icemountainwater.com. ®l P • ffewlablamil 0 Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W.131ST ST,CARMEL IN 46032 PREVIOUS BALANCE 44.74 6/13 0780830543 6 5 GAL ICE MOUNTAIN DRK W/HANDLE 20.94 6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 36.00 4 9 OZ PLASTIC CUP 50C/SLV 13.16 3 5 GALLON ICE MOUNTAIN DEPOSIT,RETURN _.. -18.00 6/21 0782366074 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE,MOUNTAIN BOTTLE,DEPOSIT- 30.00 4 9 OZ PLASTIC CUP 50C/SLV, 13.16 6 5 GALLON ICE MOUNTAIN'DEPOSIT RETURN -36.00 7/02 0783438328 12 5 GAL ICE MOUNTAIN DIRK W/HANDLE 41.88 12 5 GALLON ICE MOUNTAIMBOTTLE`DEPOSIT 72.00 12 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -72.00 7/06 0783253230 7 5 GAL ICE MOUNTAIN,DRK W/HANDLE 24.43 7 5 GALLON ICE MOUNTAIN,BOTTL"E"DEPOSIT�" 42.00 7 5 GALLON.ICE MOUNTAIN''DEPOSIT:RETURN -42.00 7/12 0785796715 1 OIL/FUEL SURCHARGE 2.88 G2992176 RENT 3.99 TOTAL 194.63 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 44.74 — 0.00 + 149.89 = 194.63 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 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.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 sent you the first bill on which the error or problem appeared.You can SAMPLE INVOICE 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 --1 an error. 5 You are obligated to pay the parts of your bill that are not in question. 123+567890 + Your Account Number You do not have to pay the disputed amount while it is being coluoloo-ootooloo investigated.During the investigation,we cannot report your account r i21asb7a9 �l as delinquent or take any action to collect the amount in question. m8-cc B+ Watch here for a GENERAL INFORMATION ' wE-�,e personalized account 1.Payments received after the billing(INVOICE)date will appear on Important ,.eao.En-'Bea ! our next invoice.Past due invoices not aid within 30 days of news and q,p..Ip:64dMUttd'NF"aUU.dIaC4tdU c�+`°'"`s""" message Y ( P Y —E ra m.•,a,9 R.Mw„u�a•^„n' billing date)may be assessed a late fee as allowed by law not to Offers �iiwin St exceed$20 per month.Additionally,third party collectionlattorney c'ry's�"•wom expenses may be assessed at a rate not to exceed 100%of the +- unpaid balance or the maximum allowed by law. „ Pay electronically 2.Each returned check is subject to a service charge subject to the ,, maximum check return charge allowable in our State. € Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity !: •s..,..+-•��°^° amount has been ACTIVITY. °J � since our ACCOUNrAC�m WON aid in full to Y ,23 Ma;n St M CnY State 4. Equipment replacement costs will be charged for bottles lost, last invoice Add, I p stolen,damaged or not returned. lne l.=Y .2s avoid late fees r,anEw 5.In accordance with NWNA's Terms and Conditions("T&C"),your 08�, M s iws `Nn,,,asr"9 ' - _SdW n, 31788ne+.. ice rAOUmnmsGaoewm nv6 Equipment Lease and/or Service Agreement account maybe zess,+w s R•Mw"umsr�RE'°" ,.99 i Monthly 011 subject to minimum monthly purchases and/or early cancellation 09"' B"�s'Eµ E�'w" 9•I�'r rf$� ,�'i�"^ `= Surcharge,Fuel a9nz na26tee„ fleet �'t!t fees.(A complete version of the current T&C may be viewed on the X664'9' Surcharge or Delivery nP f website listed below)Upon service discontinuation,rent for the Toru _- ----_- ! Fee(see#6 under Leased Equipment is charged through the end of the billing cycle ! "General in which service is discontinued. _ y 0„�B,,,,F,O,n 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or ,eEwosa.a"»° .at , '°` Information") Delivery e as described in ourT&C. Only one of these fees Payment stub Accou,+rsuMruRr 01L_•�K __---- 4 ''Y Y Y Y _ - enrlwSN^°U'n will apply to each account. The fee that applies to our account ____"- ------ '"rte s a } WIN PPY PP Y m,,, ��° --ACCOUr+rNUMeEn is stated on the front of the invoice.For further information please 12MS678W &w,,,c DAM .Erv`E°sEn visit the website listed below or contact our customer service 'N,"CE NUMBER ,2e+sbre9u taAwt� i center. 7. As a food product, bottled water is subject to the rules and 0,20096307 0,282712619 000391049 2004 16 3i Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). icEMWr4rarvwArEMM cnr.st •st0p000 �,,k 8.Your first invoice indicates the products delivered on your first • ""'�""'"' uEEj39p68 ; Submit your delivery, 0.ct oMUtsERVKr a ment b this ry along with any applicable bottle and account deposits, t.�a>ra rt�a6aG4.ur�d:e � s P Y Y redemption fees,and any dispenser charges.All future invoices 5,,,,0o,�eOO°"`"""�”` - _, _�.,� 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. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. Form No.NW 709 11/08 service.ice mountainwater.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)) 07/14/12 02G0119252823 $149.89 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 NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $149.89 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members 2201 02GO1 19252823 I 42-389.001 $149.89 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 �i Thursday, J, 1 26, 2012 r Street Commission "r �traat ( nm„„r-, zcinn�- Title Cost distribution ledger classification if claim paid motor vehicle highway fund