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228569 1/28/2014
f CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $36.27 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 228569 LOUISVILLE KY 40285-6680 CHECK DATE: 1128/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1801 4350900 03LO12197559 32 . 28 03LO121975593 2201 4238900 04AO11925282 3 . 99 04AO119252823 service.icemountainwater.com # 215 6661 DIXIE HWY, SUITE 4 / LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED CITY OF CARMEL STREET DEPARTMENT BONNIE CALLAHAN 3400 W 131 ST ST CARMEL IN 46074-8267 12/13/13 - 01/12/14 04AO119252823 THU- FEB 06 0119252823 MON- MAR 10 TUE- APR 08 WED- MAY 07 Customer Service: 1-800-472-9888 Pay your bill online at: service. icemountainwater.com or by phone at: 1-800-472-9888. It's free! 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 STREET DEPARTMENT, 3400 W. 131ST ST, CARMEL IN 46032 PREVIOUS BALANCE 2.14 1/12 A5869305 RENT 3.99 TOTAL 6.13 ACCOUNT SUMMARY Subject to terms on reverse side. PREVIOUS BALANCE PAYMENT / ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 2.14 — 0.00 + 3.99 = 6.13 BILLING RIGHTS SUMMARY IN REPORT ER ORS RRQUA STY AND NQUESTIONS FORMATYOUR BILL,OR OR YOUR INVOICE-4 W WAYS TO HELP US SERVE YOU BETTER CALL 1.800.472-9888 OR WP ITE US AT, I• please remember payment is due by the"pay b ICE MOUNTAIN SP Z• Remember,if You are renting equipment, Y"date noted to ensure the smoothest service. #216 RING WATER CO. your first invoice will include apr -ted fee for the current month,plus the next month's rental. Your equipment rental is charged one month in advance.That means 6661 DIXIE HWY,SUITE 4 3, Kindly fill in the LOUISVILLE,KY 40258 ifyou prefer,you cY your bill online an a amount enclosed include Your account number on P at service.icemountainwater.comr check, and do Ifyou think your bill is wrong,or if 4. Never hesitate to call us with comments, not send cash, a transaction on your bill,write us on need more information about Questions,Or concerns. must hear from you in writing no later than[hate sheet of paper.We sent you the first bill on which the error or problem irty app days ager we telephone us,but doing so will not preserve your rights In our letter, give us the following information: SAMPLE Your name,address,telephone and account numbers. INVOICE The dollar amount of the suspected error. you can,wh Date range of this invoice Describe the error and explain if an error. YYou believe there is You are obligated to pay the parts Of your bill that are not in question. You do not have to pay the disputed amount while it is being investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in 11110111111111d HNNUMENNOMM GENE question. t ooro0ro0-ooloowo 12345e7990 Your Account Number RAL INFORMATION ' 1.Payments received after the billing(INVOICE)date will appear on Important rNR.�a 7z3asBrB9 Your next invoice.Past due invoices(not paid within l a MON-ocr z9 1NED-N00 x, Wateb here for a billing date)may be days of news and WE-Dec la Y assessed a late fee as allowed by law not to It,h,D» �MurIm.41Wt".1tIAR8.�lIJdp c�.mm.,sen xe:,aoo<n-9saa personalized account exceeds per month.Additionally,third party collection/attorney offers ion"Doe expenses may be assessed at a rate not[o exceed tz3 Mam sc mmxyo�m.°:mgla MnuRutR w�"n. message Bed 100%of the city's`"` °00°° unpaid balance or the maximum allowed by law i...�aaeaaa�....n.,..n.,1lA0AA!,hlJ.a 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. Tu 3. All bottle and equipment deposits are shown as CURRENT lnarw9eyxa wvuwemR j' S aeti'&uiGemczmafou•YxAuik58wMaM YCW'p4°R#9 ACTIVITYActivity in.rs,«u� a '� Pay electronically �' - 4- Equipment replacement costs will be charged for bottles lost, stolen, since your •� Make sure this damaged or not returned. AccouNT Arnutn 5.In accordance with N last invoice - a` k. 6VNA's Terms and Conditions o•IIx Aftess.mhnD ,z3Mamsve tl a,y,s,a,e a000B amount has been Equipment Lease and/or Service Agreement (�&C)'Your Wawa"Ce Full subject o xxxx paid in f0 J to minimum monthly p se m/or account may be ea 3, ele9e Par ",-rna"xvo" urcha and/or earl n, 3veas,anae s sGallonNamral5pingWate, xxxx avoid late fees fees.(A complete version of( Ycancellation n, alress,+<+4 s IceM"°",a�"scalDzw,la xxxx website listed below current may be viewed on the ovn s Re Mo„",al�sGalRe,e," xx-vx }Upon service discontinuation,rent for the wnz 3,b:630a„ 9e xx Monthly Leased Equipment is charged through the end of the billing cycle o9ni I9x Re", xx.xx y Gil in which service is discontinued Surcharge,Fuel 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or TD a Surcharge or Delivery Delivery Fee as described in your T&C. Only one of[hese fees Fee(see#6 under will apply to each account. T N rwNaN•N+<9 " "General he fee that a Payment stub TMI, 1S Staled Ile$[O ACCOUNT SUMMARY xxxx x — xX xz on the from of the invoi pp Your account xxxx visit the website ce.Forfurtherinformationplease -------------------- � .��. ,KK Informah fisted below or contact --'-- '-__- On") OUI CU$turner service n°P+v^�^ ACCOUNT NUMBER PAY BY PAY THIS AMOUm center. ���� xxxx 7, Asa food product, bottled water is subject [o the rules and 34se7a90 oorooi0D INVOICE NUMBER BILLING GATE W. ENCLOSED regulations promulgated b ia3ass7M ooroorao Administration(FDA). Y the Federal Food and Drug 8.Your first invoice indicates the roducts 0uaoo9s3az 0gzaznz619 000391089 2DDV 11 delivery,along with an p delivered on your first Amount due Y applicable bottle and account deposits, .cEMarNTaNwa�ENoMPaNv tan"oma redemption fees,and any dispenser charges.All future invoices 113 Ms`ESt will reflect charges for water delivered and dispenser rental 6 c,asca 000ao deposits and credits plus char es for i.a4l...t»tlb..db,ae.,ti.6u,.t...t,At.6a,.p �acus.oMCRseBVKEULLI-aur-ezz-9sae Submit your g any additional products etlotAoyO"""�OnR`•"`sN` Payment by this ordered bveries ❑sNNRP,oPFREE"[ROPA.�.s�9��PB°9e,�moeR•..Re:�- are ry three or a total of 161 7 deliveries per Year.YOU YOU will only receive invoices ur weeks,for date 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 I Q service.icemountainwater.com Form No.Nw 709 08112 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $3.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members 2201 104AO119252823 I 42-389.001 $3.99 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 r i v / 1 VtJw�°esd , January 22, 2014 Street Commissioner Street Commissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 01/15/14 04AO119252823 $3.99 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 5-11-10-1.6 120 Clerk-Treasurer Dservice.icemountainwater.com on #215 6661 DIXIE HWY,SUITE 4 12/01/13- 12/31/13 03LO121975593 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED THU- JAN MON- FEB 00 0121975593 WED- MAR 12 THU- APR 10 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 I�1�1111111111�11'I1111�1��111��11�11��1���1111�11��1111'I�I�I1�� 1N1'ORT�0.�1T:,Efifiecti�ve Januarxy 1.,20$14,there Will be a pnce increase onselect product's For detail"s please visa eservice:icerriauntainwater:cortlprice or call us directly at 1 X800-472 9888 na° � k ACCOUNT ACTIVITY For questions or a report on water uality and information call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CARMEL REDEVELOPMENT COMMISSION,30W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 56.89 12/20 977372 PAYMENT-THANK YOU -10.99 12/22 984145 PAYMENT-THANK YOU -45.90 12/09 0860071059 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 15.16 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 12/31 0864460050 1 OIUFUEL SURCHARGE 2.84 L5745478 RENT 10.99 TOTAL 32.28 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 56.89 — 56.89 + 32.28 = 32.28 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR I. Please INVOICE mayment iiss du by the YS To Pby�datER ea to YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION, PLEASE ensure the smo, CALL I•soo-4n-9ass OR WRITE us AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month in athest dvance.That means ICE MOUNTAIN SPRING WATER CO. your first invoice will include a pro-rated fee for the current month,plus the next month's rental, 6266 6661 DIXIE HWY, SUITE 4 3. Kindly fill in the amount enclosed,include your account number on your check,and do not send cash.If you LOUISVILLE,KY,40258 prefer,you can pay your bill online at service.icemountainwater.com If You think your bill is wrong, or if you need more 4. Never hesitate to call us with comments,questions,or concerns. information about a transaction on your bill,write us on a se sheet of paper. parate We must hear from you in writing no later than thirty(30)days after we sent you the first bill on SAMPLE sohich willthe error or notpreserveroblem yotrtights.alnyouorucan lener,egveushonethus,but efollowing �� ���O��E g Date range of this invoice information: Your name,address,telephone and account numbers. • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is / /"II 6 an error. ourom00-ooroaoD 123A58]890 You are obligated to pay the parts of your bill that are not in question. ' You do not have to a t e eR-oae 1231s67890 Pay h disputed amount while it is being MDN O 29 investigated.During the investigation,we cannot report wco-Nov n Your Account Number as delinquent or take any action to collect the amount in question.unt nE-DEc.e nal:,tic,nt�atua,�muai�amn.u.;as,m CUi[°mer5ervke:1-000-1J39888 GENERAL INFO °M DO° Om4y°°1°r Wl qla M.-yroBoN� RMATION13M'":` •^"' `°' Watch here for a g(INVOICE) I.Payments received after the billin Important 00000 date will appear on personalized account b your next invoice.Past due invoices(not paid within 30 days of news and _ billing date)may e assessed a late fee as allowed ITlaw not to offers ,e °N<t+' u.r; message exceed$20 per month.Additionally,thirda + ;eL+ae�ca�J+,nudNhgc'RPelEgneMrQ » W ly expenses may be assessed arney t a rate not po exceedo100 °/0jon/atto the _ b'c,.`• unpaid balance or the maximum allowed by lawa U Pay electronically x.mwn»m.. b In 2,Each returned check is subject to a service charge subject to the ACCOUNT Arnvm mwl " maximum check return charge allowable in your State. Activity xwprrAe^^•' 1ohnD0e '3M°ns K.c.vsw°00000 Make sure this 3. All bottle and equipment deposits are shown as CURRENT since vmm°ea ACTIVITY. your o°m W1890 raymmom.oE w °.00 amount has been pql, 31J0861aWR 5 6WIl°nN S�SpO Yb+e� 4. Equipment replacement costs will be charged for bottles lost, last invoice " J188"`""" pard in full t0 p9/�l 3,IB861MN 5 ruN 6wrM9 +f 1+.99 stolen,damaged or not returned. 091� t0163081 BM Ir avoid late fees Equipment Lease and/or Service Agreement account ma5.In accordance with NWNA's Terms and Conditions("T&C"),your 1�( y be subject to minimum month Monthly Oil fees. A co IY purchases and/or early cancellation Your new _ Sure ( mpleteversionofthecurrentT& °Nv..nrvs,MEr0+�9°N. — °"'TM" ' harge,Fuel C may be viewed on the •`°'°°""""—'""" RE website listed below)Upon service discontinuationdelivery ACCOUNT SUMMARY �i.99 1,.W ,rent for the ^° — ��" Leased Equipment is charged through the end of the billingc •,,.•-°•~•�» -_ _--- : ""9 urcharge or Delivery calendar. '- --- Fee(see#6 under in which service is discontinued. cycle My Deliveries.rx00 erar r8Je90 6.You will be charged a month] `D'indicates "Genera! Deliver Y Oil Surcharge,Fuel Surcharge or a scheduled Information") Delivery Fee as described in your T&C. Only one of these fees "m6 will apply to each account. delivery •Ile ;,mp „„ rm " The fee that applies to your accoura v >: is stated on the front of the invoice.For further information visit the website listed below service a,o or contact our customer service m m center. m » 7. As a food product, bottled water is subject to the rules and Payment stub regulations promulgated by the Federal Food and Drug - -" ------------- Administration(FDA), p^ YaiM°^�"�'' ACCOUNT NUMBER 0A Br ver Ts'-AMouNT 113.56)090 oo+oa,� Amount due 8,Your first invoice indicates the products delivered on your first NCL06ED INVO+CE NUMBER BILLING DATE delivery,along with any applicable bottle and account deposits, 1334667890 o/WM redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental, bottle 0420096307 0,,282712611 DOU391644 2001VIi'6 Submit your deposits and credits plus charges for any additional products _ '3�'"s` payment by ICE WNT�MwN+M1'ATEB-oMNnl„"A ordered by you. Deliveries are made every three or four weeks,for „ � ory,sl°a 00000 a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximatelyR this date 5 of those invoices u.tn,�.t..+a.�u,.dl.aua.n,a..uu.u,t;,n oRa,°.oMERs.w�cEuu,.°oo�JE.9M° two deliveries, oices will reflect :°N9°r°a.°lE.�+°°..Isg°9R R. ..n onR^•-.•:.. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemountainwater.com Form No.NW 708 5/08 Prescribed 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 Ce loafli6n D 1 reit Purchase Order No. 'Fo. fix a 5 b O Terms Loafs ISI Ile, K Y �Oz 95"— b U6 6 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) I-3-- 0310 2197SS9 va r 3_2 Total 32.2 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 20Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Ice80161n P,; teil-� IN SUM OF $ P. O. box x'56690 �ou,sVjIle, JAY g0285- �6�0 $ 32. 28 ON ACCOUNT OF APPROPRIATION FOR � 8o I/�F3so94d Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or D��olz. �ssg3 5V 32.? 4� 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 20 JL' ignature Title Cost distribution ledger classification if claim paid motor vehicle highway fund