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238126 10/15/14 (9, CITY OF CARMEL, INDIANA VENDOR: 051125 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECKAMOUNT: $*******354.95* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 238126 PO BOX 856680 CHECK DATE: 10/15/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4238900 041012177619 3.99 04I0121776199 2201 4238900 04I011782108 38.30 0420117821082 2200 4239099 04I012004852 24.73 0420120048525 1125 4350900 042012009535 166.38 04I0120095351 1091 4350900 042012120276 91.46 042121202766 1801 4350900 042012197559 30.09 0420121975593 service.icemountainwater.com ' ®D #215 6661 DIXIE HWY,SUITE 4 09/01/14-09/30114 1410 i 17321082 / LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II I I II I I II I'I I HIM I'I I I I I�I�� II WED- OCT 15 01'17821082 WED- NOV 12 MON- DEC 15 TUE- JAN 20 Customer Serjice: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT 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 I�'�I�IIII111�1'III'�II'II..II.. '�111�11111111111111"III��IIII convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Save ntastrc Back to Schon!E s ne traislGet a$1 €+6 ff n y hase(3}zo8 48 �aclk or,(2)92a 24- ck betties[8 raz is lune�a.,ao - r.� ;"� 3t° `' <<a ''tea nr12 az r �uaadt adperfectforteeny,- � ca �� r vrsatser�nee ree ountarnwratercc�ardar E � � F Xi 3 �Fgxn 'a r,� .,.,, &'Y ,.o'. ,,.rr,�+vl✓£,.n �s�r ,..�r.Q ,Y .,wain ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit s.3rvice.icemountainwater.corn. Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131 T ST,CARMEL IN 46074 PREVIOUS BALANCE 109.40 9/16 0901748657 10 5 GAL ICE MOUNTAIN DIRK WIHANDLE 34.90 10 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 60.00 1 9 OZ PLASTIC CUP 50CISLV 3.29 11 5 GALLON ICE MOUNTAIN DEPOSIT:RETURN -66.00 9/30 0905113205 1 OIL/FUEL SURCHARGE 3-12 17165933 RENT 2.99 TOTAL 147.70 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVl-l' PAY THIS AMdUNT Subject to terms on reverse side. 109.40 — 0.00 + 38.30 147.70 P BILLING-RIGHTS SUMMARY " IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR SILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY 1. Please remember payment is due b M',pay US SERVE YOU BETTER CALL 1-800-472-988g OR Q �CORM TION,PLEASE Y p y by"date noted to ensure the smoothest service. WRITE TEAT: 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 LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater.Comr cher 4. Never hesitate to call us With Co k and do not send cash. If frau think your bill is ill ,or if need more information about nlll]ents, a transaction on your bill,write us a se glleSt10n5,Or COnCeIT1S, must hear from you in writing no later than thirty sheet ays afler we paper.We sent you the first bill on which the error arproblem appeared.You can telephone us,but doing so will not pr eserve yourrights,In your lc give us the following inform'a'tion: "'" letter, SAMPLE INVOICE • Your name,address,telephone and account numbers... • The dollar amount of the suspected Date range • Describe the error and explain if you can,why Of this invoice an error. YYou 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.During the investigation,we cannot report Your as delinquent or take any action to collect the amount in question.�t 00/00/00-oN00/oo 1234867890 ' r; Your Account Number GENERAL INFO L Pa RMATION 1„S_OCT S4 123436789 Payments received oiler the billing(INVOICE)date will a M0N OR 29 Your next invoice.Past due invoices no[ appear on Important billing date)may be assessed a late feet allowed by law not to wEo-No921 Hatch here for a ( paid within 30 days of news and TUE-DEC 18 exceed$2�eray be assessed all, 14t( 111 IA fltll l':,11111itiG�1lIl7«pjdl.l�l1' c«aam<r s<nd«:1-eo172-988e # personalized account third offers rna^tr,ro.«0 n9 IceMwWnPn4u message. expenses may be assessed at a rate not two exceedc100°/^of the 123 M s. 55005 a . unpaid balance or the maximum allowed by law. --1..mt a«tib.a�•„u ti tp t e y�,u a4 2.Each returned check is subject to a service ch --- maximum check return ch �e subject to the ^ Y dya, onoa<mn^ ^^a' 1 3. All bottle and equipments depositsbarenshoxv your tate �wu yort Ya nrtc m aawub' .rZ P 9m Pay electronically ACTIVITY. as CURRENT <4r.e aKh Activity # 4. Equipment replacement costs will be ch since your Make sure this stolen,damaged or not returned. charged for bottles lost, AccouNrArnvm 9 m�.�<,<.•��-=��^�a ,. last invoice Equipment WNAs Terms and Conditions("T&C 0<in<nAam<u m^^°°e'23M'^su«caasNt<c0000 j amount has been 5.In accordance with N "),your PmAoua&aiance 0D« paid In full to q Pment Lease and/or Service Agreement sesaccount be mayaa31 ,61895 PI—I-ma^EY99 pa0 subject to minimum month] n1 3va5s14asa s sGaOonNamais9a^8A? ' avoid late fees and/or early fees.(A complete version of the current T&C may be viewed onthe a 31768514494 >oDa 1 *? 09/11 31)t105144M 5 Ice M^un9a(n5G Ifle9um .'- € %% (.;�ntbl website listed below)Upon service discontinuation,rent for the 09n2 31626355,1 1 r«is<rna9 �I ,'4 11 y Oil Leased Equipment is charged through the end of the billing cycle 0913 6645407 Rn9 1 p t Surcharge,Fuel in which service is discontinued. T0" Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Delivery Fee as described in your T&C. Only one of these fees Fee(see#6 under will apply to each account _ Nu 7A^ro M N 1 59EMACM = PAr1xi: M t "General is stated The fee that applies to o Payment stub on the front of the invoice, Y ur account ACCOUNT SUMMARY va xax visit the website For furdter information "a=ate••=>•^• ----'"" - °" " please ------------- - Information) listed ---------------------------- center. below or contact our costo wAd mm 9 w� m a.9m mer service ACCDONr NUMBER O 00 0 PAY THIS AMOUNT ',S 1234567890 50 ENCLOSED q 7.As a food product, bottled water is subject to the rules and twoICE NUMBER BIW NG DATE regulations promulgated b 1234567890 00100(00 i Administration(FDA), y the Federal Food and Drug110420096307 042&2712619 000391049 2004 18 8.Your first invoice indicates the products delivered on your first i Amount due delivery,along with any applicable bottle and account deposits, .OE MOUMAN WATEP COMPANY t12^M4< redemption fees,and any dispenser charges.All future invoices D m dwmlw� �e K 23 Main St will reflect charges for water delivered and dispenser rental,bottle owswl< 00000 deposits and credits plus chargnales 4tn6J«w..tt.as.ts4nint44tdU' roacusloMExscmrcEcwlsm+7zs855 Submity0llr ❑:w OP w aEADOP„�0P5�•�^ ❑PAntAmO^9�0 payment by this ordered by you. Deliveries are made every three ortfour weeks,for _—._ ._____-- — date 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. S©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters R Orth America Inc. Service.icemeuntainwater.com Form No.NW 7o9 02fl4 --- f VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 I $38.30 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members' 2201 11410117821082 I 42-389.001 $38.30 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 A : b f _,..f ,, Thur 14 L 9 e' 1 111 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)) 10/02/14 1410117821082 $38.30 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 3arvice.ic_mountainwater.com ;_ as ' #215 6661 DIXIE HWY,SUITE 4 09/01/14-09/30/14 0410121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 100 Jails MON- OCT 20 0121202766 TUE- NOV 18 FRI- DEC 19 MON- JAN 26 CITY OF CARMEL PARKS DEPARTMENT i ' Customer Service: 1-800�a72-9888 MANDY SPADY ' OCT (3 21'14 Did you torget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 :_ i Your prompt payment is appreciated. For your convenience,pay online:service.icemountainwater.com. I"IIIIIIIII'lllll'I'lll'lllllll IIIII�II��IIII'I'lllllllll'llllll If payment has been made,we thank you. Sane on fantastcBack=to�SchoolEssentiatslGet a $I Qoffpwhen you purcFtaseR(e1 j8o 48pack or(2{j 1r2oz 24-Pack totfiles! 8 oz is lulichbox�frien�tlly�and 12 oz`iserfect�for teens &busy naris Call 1-8t}0-472-9888 vis''ttsenrice.ice►nountainwater:,com to�o�dere! ` � �_ - _ ; .:_...�.�:�.,_T w ACCOUNT ACTIVITY . For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. e v ® e e rvery a ress: 0 0 C ,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 92.10 9/08 404964 PAYMENT-THANK YOU -40.05 9122 0902728831 15 5 GAL ICE MOUNTAIN DIRK W/HANDLE 64.35 BOTi LE DEPOSIT: 15 CHARGED, 12 CREDITED 18.00 9/30 0905142733 1 OIL/FUEL SURCHARGE 3.12 17283582 RENT 5.99 TOTAL 143.51 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 92.10 — 40.05 91.46 = 143.51 BILLING RIGHTS SUMMARY IN CASE YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT Fo>v�WATER RpunLITY AND 1NFo1uvIAT�oN PLEAS 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. CALL 1-soo-an-9ssa OR w1uTE US AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means ICE MOUNTAIN SPRING NATER Co, Your first invoice will include a pro-rated fee for the current month,plus the next month's rental, 6661 3. Kindly fill in the amount enclosed, inc LOUISVILLE, lude your account number on your check, and do not sed cash. 6661 DIXIE EKY,SUITE 4Y 40258 If you prefer,you can pay your bill online at service.icemountainwater.com n ,K Ifyou think your bill,is wrong,or if you need more info4. Never hesitate to call us with comments,questions,or concerns. information about _ a transaction on your bill,write us on a separate sheet of paper.We must bear 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 aze 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 00100100-00100/00 123d56789 or0 ? Your Account Number as delinquent or takke any action to collect the amount in question. 'R_«y 123456789 - 1 GENERAL INFORMATION MON-OR 29 1.Payments received after the billing(INVOICE)date will appear on Important `°EO-"°"21 j Watch here for a NE-OEC IB your next invoice.Past due invoices(not paid within 30 days of news and cu m e s Mme:,eOw7z-9eea personalized account billingdate may be assessed a late fee as allowed b law not to 14tta:111 041�11li:�tltld,lat.itiq"ttidLLIU ) Y Y Additionally third offers i^nD ThakyaularusingN•Mounmmpro8ub message 113 Main 5! „8 ieMus. Y party collection/attorney agsra,e 0= expenses may be assessed at a rate not to exceed 100%of the i_,na a masa+^+ ^t4to L Lbtfd"•u; unpaid balance or the maximum allowed by law. t 2.Each returned check is subject to a service charge subject to the °4e.ae r��`"iys,yn„;aaxeaxrro4l ro 1111, maximum check return charge allowable in your State. �n " e ^e Pay electronically 3. All bottle and equipment deposits are shown as CURRENT URRENT Activity " 4. Equipment replacement costs will be charged for bottles lost, since your pccouNrprnvrrt o �"�"°°"" Make sure this stolen,damaged or not returned. amount has been last invoice p 6 erypdQress.John be,123MaN5 eeL Oq•5ret ^�^ paid in full to 5.In accordance with NWN P eAo,Babn,e A's Terms and Conditions("T&C"),your IV=pa m n,ana Ya• avoid late fees Equipment Lease and/or Service Agreement account may be Ben, 461898 nw SGallon Natural(0poater subject to minimum monthlyn, 3I78R5,4d44 s meMountnmsGamewrc ----- Purchases and/or early cancellation m 3nBBs,4444 s >anc fees.(A complete version of the current T&C maybe viewed on the B9n, me6s,4 a4 s keMwn,nsG IR r F Monthly Oil Bvn 31a263sen wet wrmar9e ri;t, r S4r''-�3 , website listed below)Upon service discontinuation,rent for the R"t u" Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle Surcharge or Delivery Du in which service is discontinued. Fee(see#6 under 6.You will be charged a monthly oil Surcharge,Fuel Surcharge or Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY O a --- Y = ---- ! Information").vmoua.uu+rE_nyMurtrAm4slMet+* ,� will apply to each account. m �. Information >a� The fee that a lies to ___ _--- instated PP Your account my vv.xv vov —v+c.vv."v uc — — _— PAYWISAMOUNT ru• on the front of the invoice.For further information please •a ----- --- -- —_--o°ue�em nw.narewn.aW,an ch*�••t ACCOUNTNUMBER PAY BY visit the website listed below or contact our customer service uxs67e9O 00 a0 00 CentOL INYOICENUMBM BIWNG DATE .ENCLOSED 7. As a food product, bottled water is subject to the rules and 234567890 oorooroo regulations promulgated by the Federal Food and Drug € Administration(FDA), 0420096307 04282?L2619 000393049 2004 LB t Amount due 8.Your first invoice indicates the products delivered on your first ^oce delivery,along with any applicable bottle and account deposits, ICE MOUNTAIN WATER COMPANY OySl nSt redemption fees,and any dispenser charges.All future invoices M�aN"4eB"^ Ate« FORCU9 MS will reflect charges for water delivered and dispenser rental,bottle Submit your 4,a�Wy,mn ,(L„u•Lq„t„LL4t��tMa EORCUSTOMFASDMCEULLI.80N73-9880 payment by this deposits and credits plus charges for any additional products wNBvrORNnEAu OPAh 9^Ba”9 redo”`^sae O A rn° � � date 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 e _y ar,.so.approximately 5-ofthose invoices will reflect _. two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemountainwater.com Form No.NW 709 02/14 r service.icemountainwater.com ®® 10 ISOI sFuuL691i 11 ' I MOM ' #215 6661 DIXIE HWY,SUITE 4 09/01/14-09/30/14 0410120095351 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MON- OCT 20 0120095351 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII _____ _ _ FRE DEC 19 " MON- JAN 26 r i i CARMEL CLAY PARKS AND REC DEPT. O C T — G 2014 Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA _ Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST �.� 4: j Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 Your prompt payment is appreciated. For your I�IIII��I'I�I�' "I�I�III'�I�I"I�I��IIII�I'll��lllll'lll'I�II'll convenience,pay online:service.icemountainwater:com. If payment has been made,we thank you. masse -�� ✓,xs "` r�z��`�S�"' -rx 5au ion fantastcBac�C-toy hoalEssent{a1s4�Geta °COt}off W�en�ou ptirc�iase{1)8oz4 paott<or{2)'I azo, 4 , z�i a� .., �;1 .� �,r,.3�•'1""`dl ,'",,»;:c.;>'.Sg�;.,�, ,:::t" �..�',� '' ;� �`':'y'�� m.m�z..., ,*a:?xH""� �r,. ,,.,;�;,fi�:_ �.,,,,�'c�2s (i a.�>�s.�r�v-e rl�+`:.=Pack bottle 8�oz is llut� h e ox fnertd{y hd 2 oz perfect ford#eens$busy,moms Ca1t 1 800 472 9x8 84 .;✓ Xr " m, ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com.. e nrerya .ress: PREVIOUS BALANCE 83.18 9/08 404963 PAYMENT-THANK YOU -71.20 0901106971 12 5 GAL ICE MOUNTAIN DRK WIHANDLE 51.48 4 5 L NATURAL SPRING WATER-ICE MTN- .00 6 9 OZ PLASTIC CUP 50C/SLV 19.74 BOTTLE DEPOSIT;,"12 CHARGED,13 CREDITED< -6.00 9122 0902728815 10 5 GAL ICE MOUNTAINDRK W/HANDLE ��J V.XAJ�x�� 42.90 4 9 OZ PLASTIC-,CU 50C/SLV, ; 13.16 BOTTLE DEPOSITAO CHARGED, '5I CREDITED ' M17, �� 30.00 9/30 0905128872 1 OIL/FUEL SURCHARGE1 r.� 3.12 17195797 RENT �Z�J— J.7� �C7C7 11.98 TOTAL 178.36 IACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT �_ Subject to terms on reverse side. 83.18 — 71.20 + 166.38 = 178.36 i BILLING RIGHTS SUMMARY i" YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR BILL,OR FOR A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• 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 arerenting equipment, our e ICE MOUNTAIN SPRING WATER CO. your first invoice will include apro-rated fee for the current month,plus the next month's rental: ICE Y equipment rental is charged one month in advance.That means 6661 DIXIE HWY SUITE 4 3• Kindly fill in the amount enclosed include your account number on your Ghee LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater.com and do ttot send cash. If you think our 4. Never hesitate to call us with comments,questions,or concerns. Y 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, SAMP give us the following information: LE INVOICE • Your name,address,telephone and account numbers. G • The dollar amount of the suspected error. an error. Date range of this invoice • Describe the 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.During the investigation,we cannot report as delinquent or take any n Your account \0010010o-00=100 7234567890 your Account Number action to collect the amount in question. 4 GENERAL ` in r R.ara4 ,23456789 1.Payments received aftef the billingMON-.CT 29 Your next invoice.past (INVOICE)date will app a on Important est due invoices(not aid within 30 days of news and WE-Nov 2+ i Watch here for a billing date)may be a late fee as allowed by law not to E-DEC,B exceed�$20 erm- 'It,fl if!n6�41#MFa+I1k1.I1Hb»,Ik1Ck�kjuitaav: eecmn,e,3eMce:1.806472.9BBe personalized account P month—Rdd]rionallythirdpa offers John e�,,,,•„re,•,m91.M9•^vl°p°°°R' message expenses may be assessed at a rate not t exceed 1006/a of the 123M sc aaem«., eY---- .123 sac o99Bo unpaid balance or the maximum allowed bylaw. f aat 1 ut a at n[v t AAtt a a 2,Each returned check is subject to a service charge subject to thea� • - 'a maximum check return charge allowable in your State, � rn� m4ea9ew+xu-..«�k ��"�x�+aprFt�anr 3. All bottle and equipment deposits are shown as Pay electronically Activi ,y�r59 'erro6nn ACTIVITY. CURRENT t3,. 4. Equipment replacement costs will be since your Make sur¢this charged for bottles AccouMArnvnr a 6� a•t ^^w•^^ " stolen,damaged or not returned, es lost last invoice amount has been 5.In accordance with NWNA's Te oeB enaaarea JOhnOce,123A an5beet Gry,Sare 00000 Terms and Conditions("T&C" cre•wmBaia"ce wvx paid in full to Equipment-Lease and/or Service Agreement account may be mankwp w o subject to minimum month! ova+ x6,890 �^�^ a a § avoid late fees /1+ 313086144M 5 SGallan Na lip 9Wa, pl.p( fees.(A complete version ofthe cnrrentT&C maybe viewed Or early Ion the ++ 3ne6s+aaa s mehro nal 6�lO peu k lation 09/11 318263 xII S Ice Mawul SG IR ; website listed below)Upon service discontinuation,rent for the B9nz 3+826380n �cs"nnam `IkL 1 q x as Monthly Otl Leased Equipment is charged through the cad of the billing cycle Surcharge,Fuel in which service is discontinued, ' t` TOtAL ,`{ Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in v.Yv6su u4 r "General your T&C, Only one of these fees w op:a4"N4E >nrMun/wry My "Ae"" w w will apply to each account. Payment stub ACCOUNT SUMMARY a R is stated The fee that applies t your account Information) sutkum mm+^n mmeu6e._ on the e' ' „00-•00010. Ne,e,_a,e.aew�0aee9.+.,.______ -- - -- mvo3ce.For ----------------------- visit the website listed further information please ----n�mw win as reo mw w mm+ 1AY BY IAY.6.1 UNr below or contact Our C ACCOUNTNU0 i center. customer service )23456)890 00 oB i .ENClASED e[ 7•As a food product, bottled water is subject to the rules and INVOKE NUMBED BBLNG OA7F Aq 1234567890 00/00/00 _ regulations promulgated by the Federal Food and Drug Administration(FDA}, 0420096307 04282732619 000391049 2004 18 - + 8.Your first invoice indicates the products delivered on Amount due delive Your first ena Doe ry,along with any applicable bottle and account deposits, CE MOUMAN WATER COMPANY 123 Mal.sc redemption fees,and any dispenser charges.All future invoices aim" ccy,sate OM will reflect charges for water delivered and dispenser rental,battle t a wBcusroMmsEmnauul eaa.n-9ese Submit your Payment by this deposits and credits plus charges for any additional products ❑ "°"`°Wre10nPs'= ❑�^c�� a ordered by you. Deliveries are made every three or four weeks,for I date a total of]6-17 deliveries per year.You 12 times per year,so approximately 5 of will only receive invoices those invoices will reflect two deliveries, ©2008 Ice Mountain Spring Water a Division sion of Nestle Waters North America Inc. service.1cem0untainwater,come - Form No.NW 709 02/14 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 10/2/14 410121202766 Drinking water&cooler-,MCC $ 91.46 10/2/14 • 410120095351 Drinking water Maintenance Dept. $ 166.38 Total $ 257.84 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. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville,-KY 40285-6680 ________ In Sum of$ $ 257.84 l ON ACCOUNT OF APPROPRIATION FOR 101 General fund/109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 410121202766 4350900 $ 91.46 1 hereby certify that the attached invoice(s), or 1125 410120095351 4350900 $ 166.38 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 9-Oct 2014 i Signature $ 257.84 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.1cemountainwater.com ; • ®® ® ' ` #215 6661 DIXIE HWY,SUITE 4 09/01114-09/30/14 0410120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED guy o ® k ` II I I II I I II I I I'II II I I I I I I I I I III I III MON- OCT 06 0120048525 MON- NOV 03 THU- DEC 04 THU- JAN 08 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT OR JUDY STOHLER Did you forget about us? Kindly pay upon receipt. 1 CIVIC SQ 2 2 OU>- q 2 3 q Remember,past due accounts are subject to a iate fee. CARMEL IN 46032-2584 Your prompt payment is appreciated. For your convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. U ...0 Cx¢'I 024 ,,,,: GIC f o2. antas�t��Back��° choo�l�Ess�a�>�al�tGet�a OO�off}wi��nty k p r h��{ }�8 8dpa� 5r ( ) a w'.�:+� � � �, X24-, ackboftslu8 ozlslune oxirlertc�Cy;�lric112 c�zs perfect#o Y�.ns{&£bus r arras` Ca1 �1 8QQ-472 98$or ,."� " � ""r'- ' ` ;i*.;'s.5.�a`" � „,�„,=�' ` : ',�:, ;¢ ;.,ra,'z "r"'�,,`y?�' `e4� 'r:. .f' ,.'.'(� r s ,,4 rx zi'''✓ d �, �' r€ "�, rce�}ce�riounEat�nvl�a �' "�€�r � .`�5'.. 'fr` �✓"�;{� 1✓ �"�" .r^,�, ( ✓ F's .l '�. � i^' �C�^.',� s e"`W ,��," ,;` '�,:„. ..........azf,rrr" w`^x ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. ®� aIng Delivery address: CITY OF CARMEL,1 CIVIC SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 66.71 9/08 404967 PAYMENT-THANK YOU -41.78 9105 0900107061 5 5 GAL ICE MOUNTAINDRK W/HANDLE ,� 4`5S 7,R,9 � 17..45 00 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT �,p 3.29 1 9 OZ PLASTIC CUP 50C/,SLV - 6 5 GALLON ICE MOUNTAIN DEPOSIT RETURN �� .00 RECEIVE[ � 9/30 17179298 RENT 3.99 TOTAL OCT 2014 49.66 CARMEL Qj CITY ENGINEER tea✓ P.Z® ACCOUNT SUMMARY � PREVIOUS BALANCE _PAYMENTf ADJUSTMEMT y CURRENT�CTiVIIYY-'FAY 7Fi16AW d—UN 1 I �r Subject to terms on reverse side. 66.71 41.78 + 24.73 = 49.66 BILLING RIGHTS SUMMARY trr cnsE oP ERRORS ox YOUR INVOICE-4 I A REPORT ON WATER QUALITY YAND��MA IONL P EASE WAYS Tp HELP US SERVE YOU BETTER 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service CALL l-soo a�2,9sss OR WRITE Us AT: 2. Remember,if you are renting equipment, our equipment ICE MOUNTAIN SPRING WATER CO. Your first invoke will include a pro-rated fee for the current month,plus the next month rental. Y qu pmettt rental is charged one month m advance.That means #216 3. Kindly fill in the amount enclose 6661 DDfIE IIWY SUITE 4 If you prefer,you can a d, include your account n LOUISVILLE,KY 40258 p y your bill online at service.icemoun umber on Com check, and do not send cash. if ou think 4. Never hesitate to call us with comments,questions,or concerns. Y your bill is wrong,or ifyou need more,nformation 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 yourletter, SAMPLE give us the following information: LE IN VOICE • Your name,address,telephone and acco The dollar amount of the unt numbers. • 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 actioi ation, *�r4rt 1��3t§"StTt°1 1 i as delinquent or take an g we cannot report your account 00100/00.00/0011, 1234567890 y action to collect the amount n � 1'gnr Account Number question. I GENERAL,INFORMATIONRR-OCT a ,23456789 1:Payments received after the billingMDN-oa 29 Your next invoice;Past.due invoices with nte tl30p ays of n s and important WED-NOV 2, Watch here for a billing date)may be assessed a late fee as allowed by law not to 1E DEC 1. " tl; m utami��ytllanu,iHO"1>,tftdn, Curomer5ervm,1A00i729888 personalized account exceed$20 pet month:-Aiiditionall,third offers °6 D TMn4y"n oru,m9lmMnunWnp oduas message expenses-may be assessed-ar a-r to-not� ceed'100,I torrc- 123 M i sr , City 5tace 00000 q I unpaid balance or the maximum allowed by law, apt ludo �t a ua 6 6wi>u 2,Each returned check is subject to a service charge subject to the l- -- -- - 1l` - maximum check return charge allowable in your State. ° "9"" as�9h ��1 ` 3. All bottle and �k L ry kemw M p:mw°4ea a s � « r `4 - r sem, 1ws a Pay electronically ACTIVITY e4mpment deposits are shown as CURRENT Activity '< 4. Equipment replacement costs will be charged for bottles los[, °"""""°�""8B&1°� �! 1 Make sure this since your Accourrrarnvm � •••n ^�^`•'^•'<'�"' stolen,damaged or not returned. last invoice. amount has been 5.In accordance with NWNA's Te ,I ryAde John Doe,123 Main Street,CIry,S[ate 00000 Terms and Conditions(`T&C"),your p,ne�Bal— �a paid in full to Equipment Lease and/or Service Agreement accountTna^xv"u >ax7 may be oenl 461890 p n^• subject ro minimum month[ n, 317885144M 5 5G OonNamralSpringWatet i avoid late fees fees,(A complete version ofthe current T&C may be viewed and/or early cancellation m 3ve6sw444 5 IceM"un ainSG ID p t g 09/11 31>88514444 5 Ire Mountal SG IR f website listed below U o9n2 318263881 fUe's""19 r I Monthly oil Upon service discontinuation,rent for the 09f1 78404' ^t d s a ,tom; Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle IDTAI _ in which service is discontinued. 1 i 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 °"• N O8 R "General y one of these fees Will apply to each account. Payment stub is stated on the frontThe fee that applies to your account ACCOUNT SUMMARY D n oftheinvoice.Forfurtherin ^.•a•••.••••__—__ Ce^" ---_________ "° °""_" " Information") 1aJoe ease visit the website listed below or contact our customer service o u bm�n�w ACCOUNINUMBER PAY BY PAYT"'SAMOUM CCnter. 1234567890 0000W 7, As a food product, bottled water is subject to the rules and INVOICE NUMBER BIWNC DATE .ENCLOSED 1234567890 00/00/00 regulations promulgated by the Federal Food and Drug Administration(FDA), ,420,96307 04282712619 DaG391049 2004 bE 8.Your F¢st invoice indicates the products delivered on your first `' Amount due delivery,along with any applicable bottle and account deposits, 123 MI( redem ICE MOUNTAIN WA CCOMPANY 123 Main S[ redemption fees,and an D ^aN=4 a ^ y dispenser char ❑rys are 00000 will reflect charges for water delivered and dispenlser rental,bottle t,{ deposits and credits plus charges for an bOW,tnJ�tu.w.t6"at t6,Gn,;u,tr,tbd:�p;- EORcuSroMFRSERWCEGILI�OW72-9608 Submit your i payment by this ordered b Y additional products Cl v�NwTonmae 3�^Bp"�I`aOnReLSPsw ❑anmAroo.a�9e•°aBeeseaae date by Deliveries are made every three or four weeks,for 12 times per a total of 16-17 deliveries per year.You will only receive invoices two deliveries, Y, so approximately 5 of those invoices will reflect ©2008 Ice M I ountain Spring Water Company,a Division of Nestle Waters North America Inc. service .1cemountainwater.com _— Form No.NW 709 02/14 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 9/30/2014 0410120048525 water cooler $ 49.66 Total $ 49.66 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 ON ACCOUNT OF APPROPRIATION FOR 1. Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 0 041012004852 2200-4239099 $ -*r� bill(s) is (are)true and correct and that the materials or services itemized thereon for 23 which charge is made were ordered and received except I 10/13/2014 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund i service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 09/01/14-09/30/14 0410121975593 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® ° II'I'I II I'll ' III 'I I I I I I I"�I I 'II WED- OCT 08 0121975593 WED- NOV 05 MON- DEC 08 MON- JAN 12 CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Did you forget about us? Kindly pay upon receipt. SUITE 220 Remember,past due accounts are subject to a late fee. CARMEL IN 46032-1938 Your prompt payment is appreciated. For your convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. -' urs o"4'd."..r�,` Fys z:,.r av., <•, , s`�',� "S'� "T7 < Sire an fantastl! Back-ta Sclaal Essentials�sGet a,$�t l0 off where ou,purchase1,��iaz;481 -c.ts�. :,�f� �sr. � i Vis,#��a,"�r�.:x 'id a, '`'z a` �vaa.v` "zy f- " �:4.�` E� � ,+a't v;'t✓" ,:�. �"N N ^'��z a y. � k °a" afsf OIL, bottCes #3oaa�s lunbox,friendlU nd<12 oz�lsp�erfect far teems,&bus3�urns Calt -it10-�7298 + r UIS S@NICe ICemauntatnwater Gom to QraIer xf � t� 7w .»"�'�` � '� 'a" .,,,'fi�,f,was` z ✓r la `i r�i .",W e'" ``".z'..z rc'z' ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. NMI Delivery address: CARMEL REDEVELOPMENT COMMISSION,30 W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 92.22 9/08. 404966 PAYMENT-THANK YOU -30.13 9/09 0900421439 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 15.98 2. 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 9130 0905148037 1 OIL/FUEL SURCHARGE 3.12 17243768 RENT 10.99 TOTAL '" 92.18 ACCOUNT SUMMARY _ PREVIOUS BALANCE PAYMENT/ADJUSTMENT~ CURRENT AC T IVITY PAY THIS AMOUNT Subject to terms on reverse side. 92.22 — 30.13 + 30.09 92.18 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUTypUR 13iLL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY AND INFpRMATION,PLEASE HELP y" SERVE YOU BETTER CALL 1-800-472-gggg OR 1. 1'Iease remember payment is due by the`pay by"date noted to ensure the smoothest service. WRITE Us AT: 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 If you think your bill is wrong, out 4. Never hesitate to call us with comments,questions,or concerns, a transaction on your bill,write us on an separate sheet ofmore apapertion bWe must hear from you in writing no later than thirty(30)days after we sent you the first telephone us,but bill on which the error or problem appeared•you can doing so give us the followinginfowill not preserve your rights,In your.letter, will - 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 ifyou can,why you believe there is an error. You are obligated You do not have to pay the parts ofyour bill that are not in question. to pay the disputed amount while it is being investigated.During the investigation,we cannot report your account1 as delinquent or take any action to collect the amount in 00/00!00.00!00!00 1234567890 Your Account Number GENERAL INFO question. AV 1,Payments received after thebilling ION n,A-Oct a 123AS6789 g(INVOICE)date will appear on Important M°r WV 79 Your next invoice.Past due invoices(not paid within 30 days of billing date may be Watch here for a Y be assessed a late fee as allowed b I y new$and UE-DEC 79 exceed$20 per Yaw not[o Na11IU,u.yIlpLlu6 f11UoF1;lIJJtt CusmmerStrvlae:1,800472-9888 personalized account p month.Additionally, a Offers tan o0 Tnankyaarora4my«MaanwnAwam message expenses may be assessed at a rate not to Geed c100°/otto of the 123M n d tMa -- nn su, oaaoo unpaid balance or the maximum allowed by law. ut,,,n -1 2.Each returned oheek is subject to a s -� �I arge maximum check return charge allowable in your State.sect to the •°tea x � -�T-nro w an s Pay electronically 3. All bottle and equipment deposits are shown as CURRENT ACTIVITY. Activity 4. Equipment replacement costs will be charged for bottles lost Since your a, mm,••��daP•21"0°""°°`""" Make Sure this stolen,damaged or not returned. ACCOUNT P 5.In accordance with N last invoice ��n.� i amount has been t•'i YA$•I•C peiivtrypdy¢ss:lohn OaG 333 Main Sneer,�rY.State 00080 Equipment Lease and/or Servr Terms and Conditions C T&C"),your preWau a e AX%K paid in full to Agreement account may be San, 49,898 Pa) %-Th akYau avoid late fees subject to minimum month! m 31]895,4444 s scam N alsnnn9warer y purchases and/or earl aua fees.(Acomplete version ofthecurrent T&C may be viewedlontthe 312 3neesaaa. s ktMWnainzOaioePoc 09/,1 31]99514444 9 IceMountaln SG IAeN ! website listed below)Upon service discontinuation,rent for the 99n: 3,97638811 a lsaanam ry r¢Y Monthly Oil Leased Equipment is c[7arged through the end of the billing cycle �,7 ,8540497 Surcharge,Fuel in which service is discontinued. 1DTPL6. ;s = -.=- Surcharge or Delivery You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(See#6 under Delivery Fee as described in our e Willa I Y T&C. Only one of these PA MouseAuwcs PAM 34oiu Mx a447NPAcmOr _ PAY nuAMaux "General PAY to each account. The fee that app our account fees Payment stub - xw + k,cxk - " 0 is lies to ount AccouNr SUMMARY ay mo-m o m au•. Inform istatedonthefron __________ ( oho t of the invoice. ___ ------ --" • n e.For�.�L - ,r.a4M4..4.o.,..ora.._—.a,a-.•a�..a...,..— -------- +rt our information please Ca$e --------------ACCOUNT NUMBER PAY BY PAY IVIS AMOUNT ! visit the website listed below or contact our customer service � � center. 12345 7990 09 OW i 7.As a food product, bottled water is subject to the rules 2545671190 09)09/110 and NvacENUM0EA BIWNO DANE Mr.ENcwsr° regulations promulgated b Administration(FDA). y the Federal Food and Drug 0420096307 04282712619 000391049 2004 18 8.Your first invoice indicates the products delivered on your first I Amount due delivery, CE MOUMANWATFA COMPANY ahnDce along with any applicable bottle and account deposits, 773 Main S4 redemption fees,and any dispenser charges,All future invoices will reflect charges for water delivered and dispenserN,,,a3e 00000 i deposits and credits plus charges for an rental,bottle bJa,�^t"nw,dl,,as;:.n"t°rt'"aubtJ:a fOACUSTOMFA3NMCEWL1A00{]7-9698 I Submit your ❑P arA yCu� O B at56 payment by this ordered b Y additional products ❑vc wwxm EAumPAn 9 u,A 9 ao a a date y you.Deliveries are made every three or four weeks,for ` _. '.M a total of I6-(7 deliveries per year.You will only receive invoices w_.__ --- --- -- m--' ]2 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestld Waters North America Inc. ~ Q setvice.icemountainwater:com o'er'_ Form No.NW 709 02114 Prescribed by State Board of Accounts City Form No.201(Rev.1995) : ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or.b,ill 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. 1 Payee.' Purchase Order No. / p Terms �pl�ljSV P ' 1\! 4OU 5— 6410 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 0-2 I �ss9 er 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. 20 Clerk-Treasurer VOUCHER.NO. WARRANT NO. Poo , ALLOWED 20 ire W nC - IN SUM OF $ Pa 36 8 56 6 g0 J ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), 190I 2 55 3RIA 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 �3 2Q ig re ki Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.1cemountainwater.com 0 is ' #215 6661 DIXIE HWY,SUITE 4 09/01114-09/30/14 0410121776199 O LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® o II' 111111 II 1'I'III I II"'l l 1111111111111 IIIIIII' I 'll MON- OCT 06 0121776199 MON- NOV 03 THU- DEC 04 THU- JAN 08 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Pay your bill online at;service.icemountainwater.com or 1 CIVIC SQ by phone at:1-800-472-9888.It's freel CARMEL IN 46032-2584 S egos fantas#tc Bac�C ta-Schaof Essenar1si Geta 1 QQ�affdwhen yo purchase(1}Boz 48 hack ori{2}1 giz r <axi .� 24.PackbottEsl B az Is,lun box fnenc}yandX12 oz,s perfect fora teens&busY Moms:Calf1 800-472 98 8 a1 ''2; 3ess'p'p " :�` .r"L',�:��`�"G`mi✓�:�'xi�a_�F�w3d3x',�EE `..t*.s'" ` z*��` "N. �u';Es,'�`�' fs�%<t�"�fi�'.,' ^"�i��;.;� ; I ,��tt. ;ti�5 �' a�,1�� , x � r✓'. V S tCVICEICCnlltlClrtaCnW@r:COn1.0 O f *rl h � :"� �f .,,,; .,, 1« sw:; e:��-°s� a'r � .� '"� '`�` y"` zx✓� ` a.M,`. #' .va `y 5x e'� ear,`,. a ki�.4a ,'*err'¢i ,.a ��'�° �`cr'"k` � ✓ � >.rz z+'wgf'� n�,.�' F r� � °,Ab, ,�_ 'c�''zw+s"r�"$.w�z °�$.� �z2�S*�� x%��9' !�i°� x�'a'..i'r.�:d�, ..�r " ,�4'a� .,� �"✓ s l"��, .;^T� �' '' 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, HUMAN RESOURCE DEPT,CARMEL IN 46032 PREVIOUS BALANCE 8.63 9/08 404965 PAYMENT-THANK YOU -4.64 9/30 17171025 RENT S 3.99 TOTAL ; , 7.98 , p ed To OCT ,e0 2014 c. Mark ,asurer ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURR- AC i 1 TY PAY THIS AMOUNT Subject to terms on reverse side. 8.63 — 4.64 + 3.99 = 7.98 BILLING RIGHTS SUMMARY i INCASE OF ERRORS OR QUESTIONS ABOUTYOURBILL,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 noted to ensure the smoothest service. CALL I-800-472.9888 OR WRITE US AT: 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 apro-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.ieemountainwater"com Ifyoti think your bill is wrong,or ifyou need more information 4. Never hesitate to call us with comments,questions, a transaction on your bill,write us on a separate about or concerns. sheet of paper.We wri must bear from you in ting no later than thirty(30)days after we sent you the first bill on which the error or problem c telephone us,but doing so Wil appeared.You can l not preserve your rights.In your letter, SAM P give us the following information: LE 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 ofyour bill that are not in question. You do not have to pay the disputed amount while it is being i investigated.During the investigation,we cannot re k as delinquent or take any action to collect the amount in question.accoant 001W/00 00J00100 1z3as67s90 g your ' Account Number GENERAL INFORMATION Nq-OC as 1.456789 1•Payments received after the biIlin MON OQ 79 Your next invoice.Past due invoicesb(noottlpa adwithinte 130pdays of news and Important on wEo-NOv n Watch here for a billing date)may beruE-DEc tR ! y assessed a late fee as allowed by law not to Itt7 to pl tltQi;�ilitit[ IAObILjItd1H- cu nmesSe nw;38 04)z.988R personalized account exceed$20 per month:Additionally,third party collection/attorney offers I9h Dae Th ky°uf61using 14"Ount Pmdua4 message -expenses may be assessed at a rate not to exceed 100%-of the- - 1z3M st ,< q,"S.1p G0000 unpaid balance or the maximum allowed by law. _ _ 1„aat a Ati tt it n tt46 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your ` State. ^� _ aR�>a `�aa4nwy ��3z•�R Pay electronically 3. All bottle and equipment de os"s � fir'o � tea}g x — ACTIVITY. A are shown as CURRENT Activity s A" 4. Equipment �+ n••�lMake sure this q pment replacement costs will be charged for bottles los(, Sin your stolen,damaged or not re ACCOUNTAGTYITY . a M9�"�^+�•' °"""`°'na°'returned. last invoice a amount has been 5.In accordance with D<I«vadd non t73Mamstre< oy wt<00000 paid in full to NWNA's Terms and Conditions("T&C"),your P1ennn4eal wc°t Equipment Lease and/or Service Agreement account may be Th kv 4 0 0 ) avoid late fees subject to minimum oRn1 461898 SQII nt- mOn(bl 31)88514444 5 3Gallon Na ISPHn 1 .P 0.0 fees.(AcompleteversionofthecrurrntT&C may beviewedfor early lontiond3e /113,1x04444 s IaM..W3Gl0 O9/11 3,)883,4494 3 11,"nWi SG IR to ". I,= Month website listed below)Upon service discontinuation,rent for the 09/17 31R7aean <Is°Knay z ,} 7 a° Monthly Oil 09/13 1664D49J Rent ,4p 7 l j _t Leased Equipment is charged through the end of the'billing Surcharge,Fuel in which service is discontinued. Surcharge or Delivery g cycle TOPAL _ ^� 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or t Fee(see#6 under Delivery Fee as described in Your T&C. O M.nnsA4°uR "General will apply ee to each my one of these fees Payment stub 'P 0`, . E—`•9M M/o um4Een-�eu9R'Nr.cmrtr , account. The fee that applies accourvr suMMaav a° nt3°c �- is stated on the front � PPhes to your account __ Information') oftheinvoice.Forfurtherinformation °_°^_° `AYTFII nformation' visit the website listed below or contact our customer service °NtlN" `' � ' °" accouNrNUMgEa Pavev ParrNlsaMDUNr 0 omoGJ0' '.)t Center. _ 173436)890 �<" 7.As a food product, bottled NVOICE NUMBER eIWNG DATE water is subject to the rules and regulations promulgated by -ENCEOSED 73436789° oo/Omoo [he Federal Food and Drug Administration(FDA), x420046307 04282712619 000391049 2004 1a ' 8.Your fust invoice indicates the products delivered on yow first s Amount due delive ICE MOUNTAIN WATER COMPANY °hn Doe ry,along with any applicable bottle and account deposits, ow•dNe 1f_tAMC 173 Main st redemption fees,and any dispenser ch atystam OG°oo will reflect charges for water delivered and dispenser rental,bo(tle deposits tnnt>JdU„wib 6.iE;tn.t ewtua„q fORN3TOMER3ERHQCALLIAUinvoicesD 48.9888 '# Submit your P and credits plus charges for any additional ❑3GNu'EOBFREAU GPAn39 OPR 4elrea°R <sa ❑PAM MD 9nO Rertne d• payment by this ordered by you. Deliveries are made every three or four wenvoices eks fotr s w date a total of 16-17 deliveries per year.You will only receive i 12 times per year,so approximately 5 of those invoices will reflect two deliveries, 02008 Ice Mountain Spring Water Company,a Division of tle sWaters North America Inc. service.icemountainwater.com Ne Form No.NW 709 02114 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ PO Box 856680 1 Louisville, KY 40258 $3.99 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 10410121776199 I 42-389.00 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, October 13, 2014 t \ � 1 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 & 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)) 10/02/14 0410121776199 $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 20 Clerk-Treasurer