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ICE MOUNTAIN- 003164- 9/20/2012 CARMEL REDEVELOPMENT COMMISSION 0 0 316 4 Ic&Mountain Check: 3164 PO Box 856680 Date: 9/20/2012 Louisville, KY 40285-6680 Vendor: ICE MOU1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 02H0121975593 25.84 25.84 0.00 0.00 25.84 August water 25.84 25.84 0.00 0.00 25.84 Yjy TiiE gyitozDOGirmTv SECURITY IGTJ recip i U BiPRINT•ADD1TI01VXintc- igrfr FEATURES INCLUDED•SE4/4cic AIDE-1-0;s ."4��1�tr. . �..,...,.-�'',r.A. .r.. �.-.,...w. J[.r�..,,,..%..i.�..� ...,...w—w,._,....+.-r_..�.s..... �F>.....,........_a._, ... ...�.a�.�....4 «_..t....,..,.:1...,....,..,-..,..:....,..17: } PPo 6°ES��4 30 West Main Street Carmel Redevelopment Commission LEGIONS 003164 -A 20-1 azlnao a r Suite 220 CI- EL-, Carmel, IN 46032 3164 DATE AMOUNT 9/20/2012 ***************25:84 PAY THE SUM OF TWENTY FIVE DOLLARS AND 84 CENTS**************************************************** TO THE ORDER OF Ice Mountain PO Box 856680 E�"r Louisville, KY 40285-6680 .4> � � , JC 0°0031,6'., " 1:0740 Li, 2L3u: 0087504LLLH° CARMEL REDEVELOPMENT COMMISSION 003164 Ice Mountain Check: 3164 PO Box 856680 Date: 9/20/2012 Louisville, KY 40285-6680 Vendor: ICE MOU1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 02H0121975593 25.84 25.84 0.00 0.00 25.84 August water 25.84 25.84 0.00 0.00 25.84 /ice X-11-52 COMPUTEREASE FORMS DIVISION(877)577-5791 T-71771 - fe 1 • let-MOUNTAIN serviceicemountainwater.com BILLING PERIOD — ` - INVOICE NUMBER IC fii #215 6661 DIXIE HWY,SUITE 4 08/01/12-08/31/12 02H0121975593 direct LOUISVILLE KY 40258 UP OMJNG DEi IVERFES AGCOUNT NUMBE-R ADDRESS SERVICE REQUESTED FRI- SET 07 0121975593 I I II I1I III II III 111 I I I I I I NI 10 MON- OCT 08 MON- NOV 05 THU- DEC 06 CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Pay your bill online at:service.icemountainwater.com or SUITE 220 by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-1938 iIiI111111111111111111IIIIII111111111111111111iIIIiIIIIIIIIIIiiIu / '.--fer 1454, .=A-4,rr �,f.' rP:'.°1�°d' ',.fit �8%r,riir. A/y °, . '.r7� /"7 „q,,;, % v>' ,9v' ',4;74S-'4 &!.z;4,, ' a:.',?� Save now throughIl.%31%x1.2-onacases'of F ADEWINDS'Cans Atiusti2;cases<for-n$134you�can;mlz6and rrmatch from a`:variet`"of refreshin flfavors aiOffe =n6Iu es;7cases of ARIZONA c o1d�Patmer� C6111 800"472=9888ccir " Yy ._� .tea .�-wr3:./:;(4 ),,:^-;x < „„.( .rgr),::-r- „a: .'.•.'er/ ss ;e- ,� ,� '4,P,,, ,,,,.3� „, Iog,ronto”erv1ce"'ICemou"�ntainwate convto add Pyoukriext.deIwery?� - 3 ' ' - '� 5' °,, '1,7 ry, a c _. 3x.ds t.-4,, j4�. vd q r.i.K,. /0-e,V - /",,., r , �."., m-4"^�s -T�,-:,w r,7.� �s`� . �' .z:�� z �� v.%?. :a' r '` • €'�� ,w � ��s• °'a'.' 3s:i'�-, ''.a�,s,��: ..r'" }3'`�' .{r �r? x5;;b1F y, rsAe4 "�8fie` ,"�.�5 fi, ,, r��. ".�a' ?18c, .,w--..�>-�or s . 47," ,):"0.-7.0;4',0,,n' s t"�,•-.,. '' > Fr /..s„ s 6V'�, .tz„,y'`,, •q q ,, ...• .a-? .,s=g"�.,d^ .,, ., ,s ; r•,? h Baer,, �,_ ..� p 'as �F 4,,,,,q '. ' '.- dr � ,, .s`,Ham^ _:�,'` .» � �sl�.� `:s:. .,°� �laat�i'}..ct-"i<;`-`" a' ;`a,�."�` r,� k�'� �t�, .moo �, - .r„,r,- .- rep>;:i f,. ,0,,,z„,%' w, dgvo'`2i: s'�;'.?",” :,Q 2 ,,, ,�oz�... °tr .,A,ae , -f4,4' � .F� -r,,:r-^, '",ras .,7, ',.°. "�.;.a`a -" "R",`,'sa .'�'a�:.' w',.:Ayt` ^°3' '''-.5.)44;,-1).r '6, � 4r A.,...4-,,,4‘,,,.• ,`' ,A, 4,°' .s � �4 -, ��y'.4, ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. DAT=.E REFERENCE# QTY DESCRIP--ETON —t AMOUNT_: Delivery address: CARMEL REDEVELOPMENT COMMISSION,30 W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 20.56 8/21 310979 PAYMENT-THANK YOU -20.56 8/08 0788102812 1 5 GAL ICE MOUNTAIN DRK W/HANDLE 6.69 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 6.00 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 1 9 OZ PLASTIC CUP 50C/SLV• 3.29 8/27 0792075251 3 5 GAL ICE MOUNTAIN DRK W/HANDLE 20.07 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 8/31 0792967051 1 OIL/FUEL SURCHARGE 2.80 H3186155 RENT 10.99 TOTAL 25.84 Ply ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 20.56 — 20.56 + 25.84 = 25.84 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 p C 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 an error. -7- E ii-' t You are obligated to pay the parts of your bill that are not in question. 1234567890 �. Your Account Number You do not have to pay the disputed amount while it is being ICfMCl/NTA/N 00100,00 00,0°1°° ,•.- investigated.During the investigation,we cannot report your account :direct- ?Et iN Zi3En+�cz�c`ou45NUMBER: i i .1PCdM 12345676900 as delinquent or take any action to collect the amount in question. mR.ocr w Watch here for a MON-O 79 WEO NOY 71 GENERAL INFORMATION vE-o +R 1 personalized account Important 1 tlAJdp6.JIIq H FWd6 Cusa Mx KB"1$004739BR8 1.Payments received after the billing(INVOICE)date will appear on message next invoice.Past due invoices(not paid within 30 days of news and ��'„t0„p6dN4.� Tn."A you re. nN°M°""`"Produ"' mesa e billing date)may be assessed a late fee as allowed by law not to offers �°z3 M^sE �' ••� ` stare 00000 exceed$20 per month.Additionally,third party collection attorney c y $ 6,dQ t.d.06..d1..d1«.n.411 i WI f MAN expenses may be assessed at a rate not to exceed 100%of the - ?B7y'(1ORSI�i%P -;r..bsxemr„ee, 1 unpaid balance or the maximum allowed by law. .,° ”` aa rov`'�?`,°'” <' , :. Pay electronically 2.Each returned check is subject to a service charge subject to the h ,--'` �„µt,.Y.AMx**E*9d'"" .,5.,4, to•e".17',..r ,;;,t zF f maximum check return charge allowable in your State. a -a,. _ `t , ° Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity - ...a_ "'•-ter---z- �A 1°`�=r amount has been ACTIVITY. since your Ac-co.' " ' -"�' -� y 9, occ ,,,,u � ,, ons� paid in full to 4. Equipment re replacement costs will be charged for bottles lost, €isATEF EpErt�"-5,E4 '" irer0Aa/,50 o""°°`'„"" P P g last invoice stolen,damaged or not returned. pe,,,"a:aa�aM= 4000 avoid late fees ThankY,w w00 P m^t' 5.In accordance with NWNA's Terms and Conditions("T&C"),your wn, 161;:00 sca.,:i .a+sP""9Wa`° -sow „n, 317Rw,4W+ 5 Re Mau"tzmsw�Dea ,1.9 Month, Oil Equipment Lease and/or Service Agreement account may be ,."„ 78BS+4M4 1CeMO""ta,nsc_iRn�m - Y wm r,rees, " S Noso., 1--!.a SY"•,r€:._ subject to minimum monthly purchases and/or early cancellation 0j"- # - Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the wnz + "y .'j i i4;? ; ., Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TorAE - _-- Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. ,.,A<"tmv = '"""':"5744 H.IAa11,MaN.+`"°" n+0 Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or wmooa E-P""" +99 tee, = Delivery Fee as described in your T&C. Only one of these fees Payment stub AccouE4rsuMMAa1' , .,..,A.aa ---____-- n rY Y Y Y - ---- PAY THIS AMOUNT will apply to each account. The fee that applies to your account wn^•"` AccouNr NUM6E6 n+0 , is stated on the front of the invoice.For further information please u3+se7690 NEUNC GATE INVOICE NUMBER polwlw visit the website listed below or contact our customer service ,z34sayR90 center. 7. As a food product, bottled water is subject to the rules and ns20U963U7 05282712639 ooa391oy9 a0°y' Amount due regulations promulgated by the Federal Food and Drug , Administration(FDA). ICE MOUMNN WATERq OMA,�•a cry s'esc ,,,„,w„,N Submit your 6.Your first invoice indicates the products delivered on your first pp COnoMEA SE.vKE U❑ 'w+'z.9ee4 delivery,along with any applicable bottle and account deposits, 6 d6..U.4tM4.LILA^p Pisa. pa}'m¢nt by this redemption fees,and any dispenser charges.All future invoices ❑ OPE�EO,,,sg,,,,PR .40^^�"`s"` �'�` , 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.icemountainwater.com Prescribed by State Board ofAccounts 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 is a 6v;14,'i-7 0, r Purchase Order No. P &?' Terms 2ay.?ulf/�/ /0" 47/‘'';US- r?G' Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) J1?1/1 z 02h/01:07552'3 Gi 4- fziz-,/-2c1/2 Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 2012 ' P easurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ /°0 8S66,?o '/028-5(,60 $ 25. ON ACCOUNT OF APPROPRIATION FOR Board Members P or INVOICE NO. ACCT#/TITLE AMOUNT hereby certify invoice(s), DPT.# I hereb certi that the attached invoices , 9G2 02/0/V9753- 93 25.-/ or bill(s) is (are) true and correct and that 23309 9 the materials or services itemized thereon for which charge is made were ordered and received except 20 /22 Si nature Executive Director Title Cost distribution ledger classification if Carmel Redevelopment Commission claim paid motor vehicle highway fund