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233769 06/18/14 a �'Fggy CITY OF CARMEL, INDIANA VENDOR: 051125 j; ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*******246.14* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 233769 PO BOX 856680 CHECK DATE: 06/18/14 LOUISVILLE KY 40265-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 14EO11782108 80.95 OTHER MAINT SUPPLIES 2200 4239099 4EO120048525 24.93 OTHER MISCELLANOUS 1125 4350900 4EO120095351 66.91 OTHER CONT SERVICES 1091 4350900 4EO121202766 40.05 OTHER CONT SERVICES 1205 4239099 4EO121776199 3.99 OTHER MISCELLANOUS 1801 4350900 4EO121975593 29.31 OTHER CONT SERVICES service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 04EO120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II I I II I I it 1 1 1 1 1111 l l l l l l l l l l l l l 111 TUE- JUL 06 0120048525 WED- AUG 06 FRI- SEP 05 MON- OCT 06 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT OR JUDY STOHLER Pay your bill online at:service.icemountainwater.com or 1 CIVIC CARVES N 46032-2584 by phone at:1-800-472-9888.It's free! "I.'I�I"IIII'�"II'I"I'll�'I�I'�I'llllllll IIIII"II�I�I����II� (Tryahe Great NEW taste of NESTER NOWT Save$3 off a 12 pack of .2 oz cans for a promoted price 4 $3 99 #� ;¢.;. v k� N SY . a A,. Il 511 ' 07''/A I �a o 9 Lv AND$3 off a 121��ack of Nested 112:liter bottles,fora promoted price'of x$5.99 Ca111.-800-472=9888 or visit p e 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, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 49.26 5/23 EA2420368 PAYMENT RECEIVED -24.73 5/11 745767 PAYMENT-THANK YOU -24.53 5/07 0881753842 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 20.94 6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT �67 .00 6 5 GALLON ICE MOUNTAIN DEPOSIT RETURN_ �C a 00 5/31 E6527908 RENT � /�, �� 3.99 TOTAL - RECEIVEp � 24.93 -M 4 CiTYEA1011V f ;"-zZS�� i BILLING RIGHTS SUMMARy INCASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• Please remember payment is due by the"pay by"date no to ensure the smoothest CALL 1-800-472-9888 OR WRITE Us AT; service, 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.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. #216 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 DIXIE HWY.,SUITE 4 If you prefer,you can pay your bill online at service.icemountainwater.com 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 telephone us,but doing so will not preserve your rights.In your letter, SAMPLE INVOICE give us the following information: • Your name,address,telephone and account numbers. • The dollar amount of the suspected error- Date range of this invoice • Describe the error and explain if you can,why you believe there is an error. 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 1234567890 Xour Account Number 00/00)00-00/00100 as delinquent or take any action to collect the amount in question. E VR- 09 123456789 1 GENERAL INFORMATION MON-ca 79 I.Payments received after the billing(INVOICE)date will appear on Important wEo-Nov z1 Watch here for a NE-OK 19 personalized account your next invoice.Past due invoices(not paid within 30 days of news and ILtlp llhnt;tll}d tIp.6144..... Atdd1� C°ttomer sem e:1A0047b9868 billing date)may be assessed a late fee as allowed by law not to 7ohnD°e lnankyoul•rusinglwMounntnpmdu message exceed$20 per month,Additionally,third y offers n ,nd:en i— partycollection/attome rry,s ies D6oro expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. 2.Each returned check is subject to a service charge subject to theova— Pay electronically maximum check return charge allowable in Your State. --•—~ 3. All bottle and equipment deposits are shown as CURRENT d nane� o1R7e•do Activity ACTIVITY. 4. Equipment replacement costs will be charged for bottles lost, since your ,CCOUWAmvm e � °"""a ' Make sure thisamount has been stolen,damaged or not returned, last invoice a paid in full to ° YDeIHery Address:Jhn Doe,133 Man5°eet Clty,State 00000 S.In accordance with NWNA%Terms and Conditions("T&C"),your avoid late fees Lease paymeno-ThankVou Equipmentand/or Service Agreement account may be p8' ]1100514444 5 3Ga0onNat lSpdyHater nz subject to minimum monthly purchases and/or early cancellation ,,, 3,7885,4444 5 �eMann,answlo.pod, ,a,a tion X11 3„g85,4444 s J. Monthly Oil Moun Ge IReNm fees.(A complete version of the current T&C may be viewed on the o9n2 3,926 6811 u<sWe a 9e i t.Yy t t 7x« website listed below)Upon service discontinuation,rent for the Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle Toru Surcharge or Delivery in which service is discontinued. ? Fee(see#6 under 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge orm.30H "General mRUNrAcnPrrr = PA+ , Delivery Fee as described in your T&C. Only one of these fees Pa Information') Payment Stub ACCOUNT SUMMARY wyF , mmm va Will apply to each account. - --- Thefeethatappliestoyouraccount f•=e.W.="^-- _____________ is stated on the front of the invoice,For -`a-4Po- 1---- ----- P-'BY PAY THIS AMOUM further information please ” .a#°� �n0° P" ACCOUNT NUMOEA o0 00100 visit the website listed below or contact our customer service 123456)690 center, eIw coArE Mr.EH<EoSED �� INVOICE NUMBER 7.As a food product, bottled water is subject to the rules and 1234567690 00/00/00 regulations promulgated by the Federal Food and Drug Administration (FDA). 0420096307 0426273261,9 000391049 200V 36 Amount due 8.Your fust invoice indicates the products delivered on your first ennooe ICE MOUMAIN WACUM 123Ma1n St delivery,along with any applicable bottle and account deposits, ° olyslate 00000 Submit redemption fees,and any dispenser charges.All future invoices [,guy r tp .uat,a 6t 6.6IFI+,p EORCUSTOMMSHMCECAMIA� 7"M your will reflect ch flMtAMOu 90°9 A e5Ae payment by this charges for water delivered and dispenser rental,bottle ❑sicNUPNmEUE4u,oe^"�"OpRro""`dOnperes5"` � date deposits and credits plus charges for any additional products - m4aEameoS-er4 d by ou.Deliveries,are,made eye, three,or.fourweeks„for., _ E6'tiZ + 9Z'6t7 '•''•` . 1N(IOWt/SIH)Abd A11A113V 1143HNn3 1N31M1Snrov/1N3WAVd30Nt/lbr8 S1101A321d aP1s asJan8.1 UO Suual Ol loafgng A21b'wwns 1Nno3'3 f 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 Ice Mountain Purchase Order No. POB 856680 Terms Louisville, KY 40285-6680 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 6/4/2014 04E01 water cooler $ 24.93 Total $ 24.93 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. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF$ Louisville, KY 40285-6680 $ 24.93 ON ACCOUNT OF APPROPRIATION FOR I Board Members P09 or INVOICE NO. ACCT#/TITLE AMOUNT DePT# I hereby certify that the attached invoice(s), or 0 04E01 2200-4239099 $ 24.93 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 6/16/2014 'Signg ure City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund it WIS service.icemountainwater.com ®D ► t ° #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 14EO117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED TUE- JUNIIIIIIIIIII11111111111111111111111 0117821082 THU- JUL 17 FRI- AUG 15 TUE- SEP 16 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at:1-800-472-9888.It's free! CARMEL IN 46074-8267 I��lill�llll�"�'I'I'�Il�iil�nnl��llll�ill��ll�l�����llnlllnl Pr the Great NEW taste of NESTEA NO Sa a$3 ooff a 312 ack of 2 cans for a �jromotedpr771— lceof$3 9... u,'k`&7 'L^u>za ✓a,,r,.d: a� r", ..a,, AtD$3 off a 12` ack of Nestea 1/2I�ter fioties,foq promoted pr�cccbf $5 99! Call 1=$00-472 r a 888 or vlsrt f ..s rervace�cernca' rttnwater�ca tafa +�tararorM Ate ' - r ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountai nwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 11.57 5/23 EA2420369 PAYMENT RECEIVED -11.57 5/02 0881936512 10 5 GAL ICE MOUNTAIN DIRK W/HANDLE _ 34.90 10 5 GALLON ICE MOUNTAIN BOTTLE'DEPOSIT- - 60.00 2 9 OZ PLASTIC CUP 500SLV 6.58 10 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -60.00 5/16 0883299067 5 5 GAL ICE MOUNTAIN DRK W/HANDLE . ' 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE OEPOSIT30.00 3 9 OZ PLASTIC CUP_50C/SLV- -W- ' - '- ,_t, '. 9.87 4 5 GALLON ICE'MOUNTAIN,DEPOSIT RETURN - -24.00 5/31 0886661206 1 OIL/FUEL:SURCHARGE,, 3.16 E6513618 RENT 2.99 TOTAL _ � _ - 80.95 I ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 11.57 — 11.57 + —80.95 = 80.95 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YpUR Bn L OR FOR Y0 VOICE-4 WAYS TO HELP US SERVE YOU SETTER A REPORT ON WATER QUALM'S AND INFORMATION,PLEASE 1•Please remember payment is due by the'Pay CALL 1-800-472-9888 OR WRITE us AT: 2. Remember,if you are rentinge p y by"date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. your first invoice will includa pro-rated feee forour thecturrent month,plus the next month's renantaL That means #216 6661 DDf1EI3WY.,SUTfEq 3. Kindly fill in the amount enclosed include your account number on your check LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at servir a c account n umber ton you k and do not send cash. com Ifyou think your bill is wrong.,or ifmore 4.Never hesitate to call us with tioncomments,questions,or concerns. a transaction on your bill,write vs on a separate sheeinft ofap per.waboe must hear from you m writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In you letter, e give us the following information: SAMPLE INVOICE Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount investigated.During the investigation,we cannot while it is being as delinquent or take any action to collect the amort your account oowoJoo-ooros/oa 123As6ie90 your Account Number oust in question. � a•Y' GENERAL,INFORMATION M-OCT M 12345676 Payments received after the billing(INVOICE)date will appear on Important WU," T r.9 Your next invoice. ANO �' Watch here for a Past due invoices(not paid within 30 da s f n E-oEc,e billing_dafe)_may.be assessed.a.late_fee-as,alto ved, y o news and fill ltl pt•tUlt+F»�tlflJ,l➢4 tUUe'�tldd{7 $oo+n-uses Personalized account exceed SZOper month.Additionally,third byJawnotto__,pfferS_�__ _ John Oce n, �,ailn4laMaanumP,aau4 message expenses may be assessed at a mte not to con oattorn -12TH St exceed 100/of the pti.znre - - �6°•^a' �— -paid balance or the maximum allowed by law. :dad r ar 16„n,ru t n u 6t t to a �� 2.Each returned check is subject to a service ch =e —---- maximum check return charge allowable in your charge to the 3. All bottle and equipment deposits are shown as CURRENT xv Pay electronically ACTMTY Activity 4, Equipment replacement costs will be ch since your Make sure this charged for bottles lost, AccoUNracnvm9 m�.� ^� stolen,damaged or not returned, last invoice 5.In accordance with NWNA's Terms1 amount has been epe(ryPddresc John Dae.121 Main Sbeet Gry,6tate 00000 and Conditions("T&C"),your Pieioa,eawnm ,Dace paid In full to Equipment Lease and/or Service Agreement account may be °vs' 618 Po,n� W- kYou 0 subject to minimum monthly Dux avoid late fees Y Purchases and/or earl n, nml— s ss�N a sPMvwca fees.(A complete version ofthe current T&C m y cancellation n 3' 1q°^• s 0 "'v'"s�1Oepv `° may be viewed on the 0911 elreastaaaa s �Ms� OpIX Monthly oil website listed below)Upon service discontinuation,rent for the osu slezves, wnwaa9e o o9n 1664M5J sem f( j s f.4r' Leased Equipment is charged through Surcharge,Fuel in which service is discontinued. the end of the billing cycle O A If Surcharge F Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Delivery Fee as described in our T&C. y One Of ? Fee(see#6 under trill aPPIY to each account. The fee that applies to your account e fees Pa °"`"°,"°'' -P rraw., + Aam" _PA+1�' t` "General ymentstub AccouNrsuMMAar _ i Irtformation'7 is stated on the front of the in .•,o.—w=-Fa •^e a° voice•For further information please visit the website Listed below or contact our PAYTMSAMOUNT ��' bpd nennbm p.wv^rACCOUNr NUMBER PAY BY center. customer service 113456]890 00 00 7.As a food roduc ,NwICENUMBrR anuN DATE ENaOSED P t, bottled water is subject to the rules and IZMS67890 0aow00 t regulations promulgated by the Federal Food and Drug Administration(FDA). 0420096307 04262712619 000391049 2004 16 s,Your fast invoice indicates the products delivered on your fust 1 AmOun dqe delivery, ICEMOUMAINWATFR COMPANY 1aM along with any applicable bottle and account deposits, °�°" "'" 123 Mate redemption fees,and an d' ecrsence oaaw y dispenser charges.All future invoices Submit your will reflect charges for water delivered and dispenser rental,bottle c a<m a� u d s a G^u6G4 a"p ra c smM°ss""cE`" 'aP°'n-saes deposits and credits plus charges for ally additional products ❑w�w wa^Ps� ti payment by this ordered by you,Deliveries are made evourweeks, _ date a total of 16-17 deliveries per year.Yev will thee receive invoices z _ -_m --_- _. for 12 deliveries. r so.approximately-5 of-those-invoices_wlll reflect two deliveries. ©2008 Ice Mountain Spring Water Comny,a on of Nestle Waters North America Inc. service.icemountainwateccom paDivision - ---_ Form No.NW 709 08112 VOUCHER NO. WARRANT NO. Ice Mountain ALLOWED 20 IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 $80.95 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 2201 14EO117821082 42-389.00 $80.95 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 4kridAlftWO 14 �tl�tC�rtRfl�it�4 'r 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)) 06/04/14 14EO117821082 $80.95 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 service.1cemountainwater.com #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 04E0121975593 / LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTEDTUE- JUN IIIIIIIII111111111111111111 ! III III THU- JUL 10 0121975593 FRI- AUG 08 TUE- SEP 09 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 ar 5rz gip, Tryrhe Great N taste oftTE,A'NOVV�have Sack of�2 oz cansp��a�ra 466- 2,'"A", r err'frs« c a r .r r 3 off a 12 pao c of Nese 1/21ilide tattles,fora pt o#ed pri a of $5 gst ` tl 1-800-4-7 888 or ul = �C'1C!'tOCtOlI !�1MateJ•«GO #Ik aL�CI#Q tf0"Ur orSlP.r� '2� uqs sr aa` y r l ,�'>y, i z�^',wry x.P ,v na,✓f n u'� ,s r 5 .r'rs`✓r '' ,� r'`�: ' r,✓kCf..�,r€ ✓� .d' yzF � rs es ""' �':''<x a''v rl"�� ir 'r t'> / �y �z' '�sy "fir w l -{ i a v�r✓rf"cPPYJ `' Car Ta /"�� s' x�.��sri '� �1'� � z!'�'k'.�. '4 s'.��4 z✓�rw '. � l"'. '��� v,s.+r,.+..xr H��u'� � r�?� � Sfr5'*� '.� a''�it.,��✓i� y��r,,, s��'`r'iin +a! a. Z�,a��,,,�s r � �`�'� ��,,.��.�` ..,e,"�C✓��r � .. ".3`���;. r ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1.800-472-9888 or visit service.icemountainWater.com. Delivery address: CARMEL REDEVELOPMENT COMMISSION,30 W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 66.16 5/23 EA2420367 PAYMENT RECEIVED -29.31 5/11 745768 PAYMENT-THANK YOU -36.85 5/09 0882256209 2 5 GAL ICE MOUNTAIN DRK-W/HANDLE---- 15.16 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 5/31 0886705524 1 OIL/FUEL SURCHARGE n 3.16 E6590186 RENT 10.99 4 � TOTAL 29.31 m r 14 a F. ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THISIAMOUNT Subject to terms on reverse side. 66.16 — 66.16 + 29.31 = '29.31 BILLING RIGHTS SUMMARY '--`-- — IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR VOICE-4 WAYS TO HELP US SERVE YOU BETTER I REPORT ON WATER QUALITY AND 1NFORMATION,PLEASE I. Please remember a CALL 1-800.472-9888 OR P Yment is due by the"pay by"date noted to ensure the smoothest service. WRITE vs AT. 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means I#216CE MOUNTAIN SPRING WATER CO. your first invoice will include a pro-rated fee for the current month,plus the next months rental. 6661 3. Kindly fill in the amount enclosed, include your account number on your cheeky and do not send cash. 6661 DIXIE IIWy,SUITE 4 LOUISVILLE,KY 40258 if you Prefer,you can pay your bill online at service.ieemountainwater.eom 4. Never hesitate to call us with comments, If you think your bill is wrong,or ifyou need more information about a transaction on your bill,write questions,or concerns. must hear from you in writing no ter thanthirtyto sheet ays paper.We sent you the first bill on which the error or problem appearred,after we telephone us b u can owing gformatnotpreserveyomrights.Inyourletter, SAMPLE INVOICE give us the following information: - • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain ifyou can,why you believe there is an error, You are obligated to pay the pars of your bill that are not in question. You do not have to pay the disputed amount while it is being investigated.Durin the investigation, ,,-. ..:: .�.• .`'� During estigation,we cannot report your account Your °0ro0t0° °at�t ro Your Account Number as delinquent or take any action to collect the amount in question. GENERAL INFORMATION IV 12345676 I.Pa Una-oa a Payments received after the billingMOWM z9 Your next invoice.Pas[due invoicesNnOICa(INVOICE) will appear on Important "�N01" E Watch here for a ( P thin 30 days of Ta orc,e billing date)may be assessed-a-latefee as allowed by law of to news and h;tld;ItlaflbllAL4yI11L4aIlw.4nt•fl�Aaail C,ubme,SeMte180W7b9888 6 personalized account exceed$20 per month.Additionally,third offers t°h°0O 1 an4rW m m9 krnw uu w.ew. i message expenses may be assessed ata party 123M•ms3 a aKN� rate not to exceed 100%of the aq.s a a0000 Unpaid balance or the m 2.Each returned check is maximum to]aoservwed bcye ch maximum check return charge allow able in yoursubject to the «a 3. All bottle and equipment deposits are shown as CURRENT Fay electronically ACTIVITY Activity 4. r Equipment replacement costs will be charged for since our � ^aa"�"'°°""'°"° E Make sure this battles lost , acc,iw r cum stolen,damaged with not retuned, Last invoice amount has been 5.In accordance with NWNA's Terms and Conditions("T&C" o�yaee,�rahn OOe 123 Mas)so-°n.°1j'sece awoo Equipment Lease ),your nn w uxx t paid in full to and/or Service Agreement account may belaton avoid late fees subject to minimum month) Deal 3170 m�^l rhe 4 b { Y Purchases andlor earl _ m 3neaslaaa4 s sc�Nalw,Isw�992cn t fees.(A complete version ofthe current T&C may be viewed lon the n' 317�j1" s -- 09n1 31Nfl5144„ 3 �Mdvrca4,5�RQ1Y1° website listed below)Upon service discontinuation,rent for the War 3,e343een 3, Monthly Oil o9n3 ,es,an ae,n P;t€;.j;• il'.'; S Leased Equipment is charged through the end of the billin �- I Surcharge,Fuel in which service is discontinued. g cycle 1mw _ _ -- _;.o;;�- � Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in your T&C. Only one of these fees pa � ^^ —'•• "` 1 `General will apply to each account, Payment stub '°""oVS°"'"""—°1Q1' + — The fee that applies to o accourrr suMMaal a Information") is slated on'he front of the invoice.For Your ______ b tl°s .further info ....................�..°..wK,.ow.+..._--------- s�ckamm�m__ E ma rmation please °,,,,,,,N,��,;,�„� „�, visit the ---------- rarer var3lns aMounr I website listed below or contact our acc12UM7BMsu1 a>s center. customer service 123aw7e90 oa o0 0o t 7.As a food WygCEtJUMsrx uumeDale .r.3aosrn product, bottled water is subject to the rules and 123,M7a90 00MI00 t regulations promulgated by the Federal Food and Dtug a42aa96307 49 2004 36 1 Administration(FDA). 04262712619 a0a391a 8.Your first invoice indicates thei Amount due delivery,along Products delivered on your first ceM«mraMwnlucoMcarn g with any applicable bottle and account deposits, °" " mow" K 123 MA. s 0OM ` redemption fees,and any dispenser charges,All future invoices will reflect ch i Submit your charges for water delivered and dispenser rental,battle t"�L"t,u�.rt.timaleeo,t trate„rt p„°M,osan9 f payment by this deposits and credits plus charges for any additional products ra wra nano wan g°4r �m9^^su• f ordered by you. Deliveries are made eve- weks, _._ _.�_ _ date for a total of 16-17 deliveries per year.You will receive invoices _ _ ....- - - - 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountainn Sp(Ing Water Company,a Division of Nestl6 Waters North America Q service.icemountainwateccom\ - O�i_ Inc. Farm No.NW 709 08/12 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 Te e Purchase Order No. PO Bax 85 660 Terms KY q_0295WO O Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 29.31 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. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ P Q. BOX 9556 U6 I1k� OZ�s-- 66� $ 21.31 ON ACCOUNT OF APPROPRIATION FOR I S0 /t3.W00 Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPTtt# I hereby certify that the attached invoice(s), 01E 01Z 11 7S593 01 Oh 2-9.3/ 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 . Si rtjUUXQaMU4 Cost distribution ledger classification if Title claim paid motor vehicle highway fund Aimservice.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 04EO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIII'IIIIII"IIIIIIIIIIIIIIII TUE- JUL 08 0121776199 WED- AUG 06 FRI- SEP 05 MON- OCT 06 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Pay your bill online at:service.icemou ntai nwater.com or 1 Civic SQ CARMEL N 46032-2584 by phone at:1-800-472-9888.It's free! Irl"IIS'll�"'�II�I'III"'I.II"II'll'll�"III��'III1111�11�'I� -gym�-' ,r,�- T7 it e Great NEW#rite of,NESTEA NQWl ave$3 Off" 12 pack of 12 az cans fir a promoted price of$3 r - ^ r"x`�' a.,Glr x r,y�ii< (r^" y t , NW t off a 12 hack of Neste 1/2 Ill er bottles,far a promoted pace of $5 99 F G6II,1 800-472 9888 or vtsi f v �, x a° r a 1 ,�?ev�xs,��' .d„z ,h x/ z t < e✓F ! R0 ser ce Icemoun v+ ater co`. taadd to ►ur orsle� � b� $x^h= �.vr� j ��„'"� . �, �^�`,;�'�,� '. /��✓ `.ory fit^ a 9�, s :' �/ r '...,a x sl' ;r%x�7`r3'., ACCOUNT ACTIVITY For questions or a report onwater quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: PREVIOUS BALANCE 7.98 5/11 745764 PAYMENT-THANK YOU -3.99 5/31 E6519076 RENT 3.99 TOTAL 7.98 itted To 3 JUN 1-6 2014 + r .j- i .. a CIS Treasurer ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT �_Subject to terms on reverse side. 7.98 _ 3.99 + 3.99 = 7.98 BILLING RIGHTS SUMMAgy IN CASE OF ERRORS OR QUESTIONS ABOUTyp BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALrry AND HELP US SERVE YOU BETTER INFORMATION,PLEASE l• Please remember payment is due by the"pay by"date noted to ensure the smoothest service. CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That me ICE MOUNTAIN SPRING WATER CO, your first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 means 6661 DIXIE HWY.,SUITE 4 3. Kindly fill in the amount enclosed, includeour account number on your check, and do not LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service .icemountainwate'r.com S cash. If you think your bill is wrong,or ifyou need more information about 4. Never hesitate to call us with comments,questions,or concerns. 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 telephone us,but doing so will not preserve your rights, AMP give us the following information: SAMPLE In your letter, VL EINVOICE Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts ofyour bill that are not in question. You do not have to pay the disputed amount while it is being investigated.Duringthe investigation, +rte 3 esfigation,we cannot report your account 123as67a90 •} as delinquent or take any action to collect the amount in question. ' oolooroo-oarooroo Your Account Number GENERX77;, �1�1�j 7�7�,���►*� 7�7 "Pi fJ'141�t9fit r:... AL,"`F Oi��1Hi IO1� TMR_DR pa 123456789 yments received after the billingMo a r9 (INVOICE)date will appear on Important aD N0V" Watch here for a Your next invoice.Past due invoices(not paid within TUE-DEC 18 billing date)may be assessed a late fee as allowed by law not to 30 days of news and exceed$20 Per month.Additionally,third fe 16t1�r ttf(It tNibiwdlltd�a1 wr!}1{7xflwltdd[I: exatome,seMce l4aal7z.saa q} personalized account �.�,� offers Ion"Doe Th kyau iarunag ice MOunW'Fn`ducta message expenses may be assessed of a rate not to w exceed 1Q�o Of the 123 Main 5[ and eMtts. g ._arystat 00000 ontattorney unpaid balance or the maximum allowed by law is ma a qu ntualla 4-6u s ut tiG r u, 2.Each returned check is subject to a service charge subject to the _ maximum check return tum chazge allowable in your State. Pay electronically 3. All bottle and equipment deposits are shown as CURRENT " rtA��66m6 ACTNITY Activity 4. Equipment replacement costs will be charged for bottles lost since your Make sure this stolen,damaged or not re ACCOUNT ACTwIT P Eaw�Ku w'^w "v 6144 '�'°°'M " turned, last invoice amount has been 5.In accordance with NWNA's Te Equipment rms and Conditions("T&C-),your D Lvery Address'lohnDce,iZ3 Main Street Gry,S a e OW00 Prena6aaalan� 1"Dnl .i paid]n full to Lease and/or Service Agreement account may be m mankYou °° avoid late fees subject to minimum monthly °�; 3170051444 3 5G on Na ral5p ngWa er ow purchases and/or early cancellation `� fees,(A complete version of the current T&C maybe viewed on the "' 31768514444 5 Ira Mou rca n S G I pepo 09/11 31788514444 5 IceMountainSGaIR lura f _1 Monthly Oil website listed below)Upon service discontinuation,rent for the 0971 316]638811 1 NNSO A rg w u 09/tz 16640M19> Gent #} l#lis '3�}}l b'S It _� Leased Equipment is charged through the end of the billing cycle Surcharge,Fuel in which service is discontinued - F Surcharge or Delivery ro*u r ..� =, ,� 6.You will be charged a monthly Oil Surchazge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in your T&C. Onl _ will aPP1Y to each account. y one of these fees Payment stub ACCOUM SUMMARY '; "—°"""""/,alai""+ — Ay cUw1FM ACtM7Y P 1x6 MIOVM "` The fee M.. is stated that applies to your account aim _ , Information) 'Gen on the front of the invoice.For "•4•r—_•'•-----OpM----____------------______ era _ her information please visit the website listed below or contact our customer service PAY MUS AMOUNT cen[ec " °vi°"°°""�"°'"'P'""�"� ACCOUNT NUMBER PAY BY 3 1234567890 00 00 00 } INVOICE NUMBR BRUNG DATE .ENCLOSED �� 7. As a food product, bottled water is subject to the rules and 234567890 00/00100 regulations promulgated by the Federal Food an Administration d Dr On(FDA). 04200963x7 04262712619 000391049 2004 la Q S,Your fust invoice indicates the products delivered on your first 1 Amount due delivery; onn ace ry,along with any applicable bottle and account deposits, KE MOUNTAIN WATER COMPANY 133 Main St redemption fees,and any dispenser charges.All future invoices nM 41xw4w mwM xnl Gry,State 00000 Will reflect charges for water delivered and dispenser rental,bottle Submit your }w�n+trJytllnw,{3, {�unat+n„GYt trGtl+�r<tG. w6N5TOMER SERVICE Gt11-000-17a.886 deposits and credits plus charges for any additional Payment by this Ordered b products - ❑nGNuvw6 6EEAlrtowmsa"xv�44edonx4.Aa4sm ' t date y 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 two deliveries. 5 of those invoices will reflect CA: c0 2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc, service.icemountainwater.com Form No.NW 709 08/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ PO Box 856680 Louisville, KY 40258 $3.99 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 104EO121776199 I 42-390.99 I $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 Monday, June 16, 2014 A Director,Administration 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)) 06/04/14 04EO121776199 $3.99 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 service.!cemountainwater.com UW -189102111,111 #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 04E0121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED n- 1411 MON- JUN 23 0121202766 WED- JUL 23 THU- AUG 21 MON- SEP 22 CITY OF CARMEL PARKS DEPARTMENTCustomer Service: 1-800-472-9888 MANDY SPADY Pay your bill online at:service.icemountainwater.com or E 116TH STby phone at: 1-800-472-9888.It's free! CARMEL IN 46032-3455 �II'II.I�I�III'I����"I'ISI'IIII��'III "I'I'I�II�I"I�IIIIII'I�I �Tryilthe Great NEltlf taste of NESTEA NOWlfSaue$3 off a 12 pack of 12 oz:cans fora promoted,price,of$3 99 A14043-off a 124,066 of N6Sldi 1J2 liter battles;for a promoted prlce'ofi $5:991 Ca11;`1-800-472 9888 or Visit- rujcwcemou6f6iiiWater coi6Ao add a iuoder! - ro h µ 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 PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 92.06 5/23 EA2420364 PAYMENT RECEIVED -52.05 5/11 745765 PAYMENT-THANK YOU -40.01 5/22 0884462664 10 5 GAL ICE MOUNTAIN DIRK W/HANDLE— 42.90 BOTTLE DEPOSIT:10 CHARGED, 12 CREDITED -12.00 5/31 0886690213 1 OIUFUEL SURCHARGE 3.16 E6625948 RENT 5.99 TOTAL 40.05 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS,AMOUNT Subject to terms on reverse side. 92.06 — 92.06 + 40.05 40.05 ................ BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONSAEOUTYOLiRBILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER TER REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• Please remember payment is due CALL 1-800-472-9888 OR WRITE US AT: by the"pat by"date noted to ensure the smoothest service. 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance,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. #216 ' 6661 DIXIE HWY.,SUITE 4 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service,icemountainwater,com 4. Never hesitate to call us with comments,questions,or concerns. I IranYOu think your o is wrong,or ifyou need more information about a transaction an 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 telephone as,but doing so will not preserve your rights.In your lette, SAMPLE give us the following information: LE I N VOIC C • Your name,address,telephone and account numbers. G • The dollar amount of the suspected error. Date range of this invoice • Describe the error an error, and explain if you can,why you believe there is You are obligated to pay the parts ofyour bill that are not in question. You do not have to pay the disputed amount while it is being investigated.Duringthe x;1234567__ investigation,we cannot report your account as delinquent or take anOo/oo/oo-aaraaiao 1234567890 Your Account y action to collect the amount in question. Number GPaymenENERAL ,„,-tea,-tea ,23456799 [. ts received after the billing(INVOICE) MOWOCT T9 date will appear on Important Your next invoice.Past due invoices not aid with ME-Nova _ billing date)may be assessed a late fee as by lawn t o news and - ma-occ,9 } etch here for a exceed ptlattt t1Ga11114 111 AG ntlt n,dt�att c°gTe,s� o,]z-9999 personalized account permont. mono y, offers 123M e expenses may be assessed at P co ec o a orney u3M 1 n """ message acw5ut aoao9 unpaid balance or the maximum ate noted bt law.exceed 100%of the i mt t t t lraf v s n,G.6G6i t:t! 2.Each returned check is subject to a service charge subject to the T _ maximum check return charge allowable in your charge 3. All bottle and equipment deposits are shown as CURRENT Y � [ pay electronically w+G rkbo[� ACTIVITY. Activity 4. Equipment replacement costs will be charged for bottles lost, "°°• ` Make sure this since our ," a.e�a ,�••��> stolen, Y ACCOUNT ACTIVI73 damaged or not returned. last Invoiceamount has been 5.In accordance with N ",Aea a.:mnnoce,T3 n,alnsvee oy,swce aoaOO WNA's Terms and Conditions("T&C"),your Pm+l°usPalarrce wx paid IA full to Equipment Lease and/or Service A mankm" ,a.la y subject to minimum monthl Agreement account may be 0831 46'evs ,o<,� i avoid late fees 11 31]80914414 s sG4A9n NatwalSMin9Wa,e� Y f fees,(A complete version ofthe currentT&C may be vies and/or early ewed ion the n,lation 311w, 69m 3v8O.114 s kr Snn+ nsGal9enun >tt'is t Monthly Oil website listed below)Upon service discontinuation,rent for the 09n 3'ez43as" P uw na 9e .f, ,464"19] l,'.(:''+'i``.."s'(t;i` Leased Equipment is charged throw r.ur R,•::z, o_ I Surcharge,Fuel in which service is discontinued. the end of the billing cycle Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge, ra _arge or Fee(see#6 under Delivery Fee as described in your T&C. Only one of these fees "General PPc++ous euAna_vArMumA°rvs,Mwr-t,cuwvxrMnnnr = oanns Nr Will apply to each account. The fee that a payment stub accouNr SUMMARY i61IX ,awc Ia3a is stated on the front of applies to your account Information") the invoice.For further info �,»«••a• •_ ------------------------------ visit ° Iaform ' n rmation please ------'--- ---the website listed below r °aitlitl °"'°"°""`°` ACCOUNT NOM9nl PAY 9Y PAY rx, OUM center. o contact om customer service 1134567890 00l00lW 7.As a food product, bottled water is subject to the rules and NVO W67" 91WNGOM7E FNC OSED 1T34S6]690 00/00/00 regulations promulgated by the Federal Food and Drug Administration(FDA) 042a096307 04262712619 000391049 200V 18 8.Your first invoice indicates the products delivered on your fust i Amount due delivery; CE MOURN ANWA FR COMPANY j°hnDce along with any applicable bottle and account deposits, ^a^" u3Mansc redemption fees,and any dispenser charges.All future invoices ary.su�ao�a will reflect charges for water delivered and dispenser rental,bottle JNda t?•m«tt.tG:,n.Gn.,G.t GGr,.t:a we cu:roM msPxWacA ,bowrz.Peaa Submit your deposits and credits plus charges for an ❑asnwwnN�w�A" uo ���^• ° ry°"" OnPn a de Payment by tbh ordered by you. Deliveries are made eve y additional products date a total of 16-17 deliveries per year.You will only recehree or ive nvoices – – - -- - _.__ ------ - – 12 times pet year,so will 5 of those invoices will reflect t%hib-6 iveries. — ©2008 Ice Mountain S Tin%Water Company,a Division of Nest16 Waters North America Inc. y service.icemountainwater.e0 o'T Form No.NW 709 08/12 service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 05/01/14-05/31/14 04EO120095351 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MMOVIUMM II'I I'I I'I I I IIII'I I I I I I I I'I I I'I 'll MON- JUN 23 0120095351 WED- JUL 23 THU- AUG 21 7JUN ,� MON- SEP 22 CARMEL CLAY PARKS AND REC DEPT. 2014 Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA ay your bill online at:service.icemountainwater.com or 1411 E 116TH ST y phone at:1-800-472-9888.It's free! CARMEL IN 46032-3455 Illlllllll�l�lnl�nlll���nlll�lll�ll��nll�Irllll�llll�ll�llrl Try a Great NEW;taste of NESTER NOWI,Save$3 off a 12 pack of 12 oz cans for a promoted price,of$3.49' AND`$3 off a 123ack.of Nesfea 112.lter bottles,fora promoted price of $5.99i"Cali 1-800-472`9888 or Vtstf r rttc�rceme.eii�as�:Vater-eor�=#s�=ads±e�y�u#�ordert ,.�. _ i »e i F. ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. Delivery address: P CARMEL CLAY PARKS AND REC DEPT.,1427 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 113.04 5/23 EA2420365 PAYMENT RECEIVED -47.75 5/11 745766 PAYMENT-THANK YOU -65.29 5/22 0884462631 9 5 GAL ICE MOUNTAIN DIRK W/HANDLE 38.61 4 9 OZ PLASTIC CUP 500SLV 13.16 BOTTLE DEPOSIT; 9 CHARGED, 9 CREDITED .00 5/31 0886682004 1 OIL/FUEL SURCHARGE 3.16 E6545510 RENT 11.98 TOTAL 66.91 1l 25= 1-=I 3 3�0�00 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 113.04 — 113.04 + 66.91 = 66.91 � BILLING RIGHTS SUMMARY YOUR VOICE-4 WAYS TO IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR HILL,OR FOR HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1 Please remember payment is due b the"Pay b " CALL 1-800-472-9888 OR WRITE US AT: y your e data noted to ensure the smoothest service. 2. Remember,if you are ranting equipment,your equipment rental is charged one month in advance.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. X216 6661 DIXIE HWY.,SUITE 4 3. Kindly fill in the amount enclosed, include our account number on our check LOUISVILLE,KY 40258 If you prefer,you can pay your bill online d at ser Your a c account n umber ter.eom 4. Never hesitate to call us with comments,questions,or concerns. and do not send cash, If you think your bill is wrong,or if need more information about a transaction on your bill,write us on a separate sheet ofpaper.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 telephone us,but doing will not preserve your rights.In your lSAMPLE give us the following information: letter, INVOICE • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain if you can,why you believe there is an error. 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.Duringthe investigation, ctiotool we cannot report question, account 1234567890 as delinquent or take , aorao/oo_oo/oolo° Your Account Number any action to collect the amount in question. 1w , GENERAL INI ORMATION ,,,o-DCT oa 123456789 1-Payments received after the billingateMDN-DCT 29 your next invoice.Past due invoice(sr(ty101paiddwithin130 days of news Important appear on VhDNDY 1' Watch here for a billing date)ma be a d uE-DEC,e Y assessed a late fee as allowed by law not to IhtiyllliiuinSOltJ tlil yll4�duti�V,;tl,tdtl c,�n,c xM�l_000.472-9BBB personalized account exceed$20perm'o`nth:Addffconalg`�lt ua offers inhno ,n1Y°n,wna"y,kMnenG.,nnd.- 't message expenses may be assessed at a rate not to exceed IOD%of the '4 a t 23 Men$c a e 00000. unpaid balance or the maximum allowed by law 2.Each returned check is subject to a service maximum check re charge subject to the _ mob«• m `°"a" turn charge allowable in your State. ' °�" 3. All bottle and equipment deposits are shown as CURRENT Pay eleetronicaIIy ACTIVITY. 1 Activity 4. Equipment replacement costs will be charged for since our Make sure this stolen,damaged or not reg o bottles lost, y accouMArnvrry nm�w�Q^�'°'^-•°'•�'^' " ° , turned, last invoice amount has been S.In accordance with D°;;�ryme•:x. nnnDce,'2BMainsh-aqe-00000 NWor Terms and Conditions("T&C"),your PMmvfBala"� ouu paid in foil to Equipment Lease and/or Service Agreement account may be 1wnkY°n "° avoid late fees subject to minimum monthlyoen, 461B9B Pm•�'• �1n purchases and/or early cancellation n7easl4a.4 s swn°n a'°als°a�wam a a fees.to complete version of the current T&C may be viewed on the W/11 3178851499• 5 I2 MounWn6 Gal Ream website listed below)Upon service discontinuation,rent for the o9n 3'B263BBn we15urt��° «t ' ni nD Monthly e, o9n 16650097 � f,t,; ,i;� Leased Equipment is charged through the end of the billing cycle ? Surcharge,Fuel in which service is discontinued. .�t+r Et'„a,�`"{ > c ! Surcharge or Deliv¢ry mA 6.You will be charged a monthly oil Surcharge, r Fee(see#6 under Delivery Fee as described in y &C. Fuel Surcharge or will a °ar T Only one of these fees PA MDRrAwn2 MD + _ "' cuaBD+rArnMn _ P "General mum 1 apply to each account. The fee Payment stub Pp V O03B"" - xYw that applies to o AccouNr suMMaar ... �,, � i Informetion') xt<3Dc is stated on the front PP Your account of the invoice.For °.—.,�.•°•,°e•°ems,.•------------------- further information please '---"------ visit the w ----oN.mw9mm.dm�.uaa•P•r^�'^ website listed below or contact our ACCOUM NUMBED PAY BY PAY rF 19ODM center. customer service 1IM161110 101MDD 7. As a food product, bottled water is subject to the rules and NY1234 67890 BIWN0100 n4CLOSED 12M66]B90 oDloDroo regulations promulgated by Administration(FDA) the Federal Food and Drug 0420096307 04262712619 000391049 2004 be 8-Your first invoice indicates the products delivered on your fust 1 Amount due delivery,along with anJohn Oce t I ROUMNN WATER COMPANY 123 Main St } Y applicable bottle and account deposits, '"mow"" �y5wre 00p0° redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental,bottle root ^m•'a'•'t'dl 'ur'!`t,t lJ t»u POR CUS DMER SDMCE CALL 1A00)2.9888 ubmit your deposits and credits plus charges for any additional O scNUPr«a wmP"rsg"w � P"" ° 9 ° m` Payment by this ordered by you. Deliveries are made every three or four weeks fotr __-- J date a totalof 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. Q service.icemountainwater.com,, Form No.NW 709 08112 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 051125 Ice Mountain Terms P.O. Box 856680 Louisville, KY 40285-6680 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 6/4/14 4EO121202766 Drinking water&cooler- MCC $ 40.05 6/4/14 4EO120095351 Drinking water Maintenance Dept. $ 66.91 Total is 106.96 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 I Voucher No. Warrant No. I 051125 Ice Mountain . ! Allowed 20 P.O. Box 856680 4! Louisville, KY 40285-6680 I 1 In Sum of$ $ 106.96 l ON ACCOUNT OF APPROPRIATION FOR 101 General fund/109 Monon Center �II` 1 PO#or. INVOICE NO. ACCT#/TITLE AMOUNT I� Board Members Dept# 1091 4E012120276 4350900 $ 40:05 ; 1 hereby certify that the attached invoice(s), or 1125 4E0120095351 4350900 $ 66.91 bills)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 13-Jun 2014 Signature $ 106.96 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund - I