213717 10/10/2012 \,f CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $13.57
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 213717
LOUISVILLE KY 40285-6680
CHECK DATE: 10/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4239099 12I722032704 13 . 57 12I7220327048
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ADDRESS SERVICE REQUESTED
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CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888
ANN DAVIS Did you forget about us? Kindly pay upon receipt.
1 CIVIC SQ Remember,past due accounts are subject to a late fee.
CARMEL IN 46032-2584 Your prompt payment is appreciated. For your
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If payment has been made,we thank you.
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ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com.
Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032
PREVIOUS BALANCE 13.57
9/05 0792339772 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49
1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
1 9 OZ PLASTIC CUP 50CISLV 3.29
9/30 0797565587 1 OIL/FUEL SURCHARGE 2.80
13318096 RENT 3.99
TOTAL 27.14
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 13.57 — 0.00 + 13.57 = 27.14
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