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239285 11/19/14 CITY OF CARMEL, INDIANA VENDOR: 051125 ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*******199.99* CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 239285 �roN PO BOX 856680 CHECK DATE: 11/19114 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 04JO12004852 20.64 04JO12004852 1125 4350900 04JO12009535 12.55 04JO120095351 1091 4350900 04JO12120276 19.40 04JO121202766 1205 4239099 04JO12177619 20.09 04JO121776199 1801 4350900 04JO12197559 52.07 04JO121975593 2201 4238900 14JO11782108 61.35 14JO117621082 1701 4239099 14J722032704 13.89 14J7220327048 service.1cemountainwater.com #215 6661 DIXIE HWY,SUITE 4 10/01/14- 10/31/14 14J0117821082 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II'I II I'II I'I I I I I'I I I I I I I I II I'I 'I' WED- NOV12 0117821082 DEC MON- DEC 15 FRI- JAN 16 WED- FEB 18 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 Bring In the Hjq" tl '_8"' Celebrations. Enjoy premium brands Including San Pellegrino, . -tiPerrier and;Accyua Patina.,Laok fos speci�il ho{lday savings going onrorilnowuntil the end of the year ,Calix. � $Qa-�;'2 '8S8r co erl ' ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1.800-472-9888 or visit service.!cemountainwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 147.70 10/10 601401 PAYMENT-THANK YOU -109.40 10/26 691003 PAYMENT-THANK YOU -38.30 10/15 0906333968 13 5 GAL ICE MOUNTAIN DRK W/HANDLE 45.37 13 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 78.00 3 9 OZ PLASTIC CUP 50C/SLV 9.87 13 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -78.00 10131 0910212539 1 OIL/FUEL SURCHARGE 3.12 J7330550 RENT 2.99 TOTAL 61.35 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 147.70 — 147.70 + 61.35 = 61.35 BILLING.RIGHTS SUMMARY IN CASE 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 noted to ensure the smoothest seryice. CALL 1-PT ON-WA OR WRITE US AT: Z. Remember,if you are renting equipment, 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 your equipment rents(is charged one month in advance.That means OU DIXIEE,K SUITE4 3, Kindly fill in the amount enclosed include your account number On your check, and do not send LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater,com If ou your_ wrong,or ifyou need more information about 4. Never hesitate to call us with comments,questions,or concerns. cash. Y ,think bill is a transaction on your bill;write us on a separate sheet of paper.We must bear from you in writingno later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You car, telephone us,but doing so will nopreserve your rights.In your letter, t 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 involve an error. • Describe the error and explain if you can,,Shy you believe there is You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputamount while it is being Investigated.During the investigatedion, t . as delinquent or take any action on, we Cannot report your account collect the amount in question. 00100100-00100100 1234567890 �TAV Your Account Number GENE,INFORMATION MB-Ocr00 123456789 y Payments received after the billing(INVOICE)date will appear on Important MON-N T z9 Your next invoice.Pas[due invoices(not paid within 30 days of "�NO°z1 Watch here for a —billing-date)-maybe-assessed-a late fee'as-allow Y news and EGe-oEc w S _ It iiadN Hf#t7It1�klt(.I iElt itllld4l,.tlddtf Curtomer SeMce:l$oo-a72-9888 personalized account exceed$ZOPer month.Additionally,third Party coletion/attorney Jpnnu U,,kYeeJ""119 feeMo°nni°P-1 message offers " z3 M I sl — ,a s expenses may be assessed at a rate not to exceed 100%of the ansa 00000 unpaid balance or the maxim t•t m"a6;iu•at tot G1t,R, R- - um allowed by law. 2.Each returned check is subject to a service charge subject to maximum check return charge allowable in your State. the equipment �Tans�r�agYYo4s4�mz,wW'�1 3. Al] bottle and e sCURRENT deposits are as C Activity Pay electronically ACTIVITY. URRENT � � � _ �� " � � � 4. Equipment replacement costs will be charged for bottles lost, Since youraaP °°''°°" Make sure this stole,damaged Or not re ACCOUNracnvrrY P �n�m 4 turned. last invoice amount has been 5,In accordance with NWNA's Terms and Conditions("T&C"),your DeL cry Addre lohn Oce,123 Main 5tre O%SUle 00000 Equipment Lease and/or Service Agreement account may be °gyp 5B a e x o [ paid in full to es awl 461898 Pd""e",ThankY°v p�.pc E avoid late fees subject to minimum monthly Purchases and/or earl n ;n,7:5 4E44 s 6GaR°nNmprs'T,cZW,',- fees.(A complete version Ofthe cmrentT&C may be viewed ton the "' 3178851—1 S IceMounu nSG ID p u 09!11 31]08614484 5 ke Mountaln6G IP `i. 3 >xxx t website listed below)Upon service discontinuation,rent for the °9112 3182638011 P�swv arae �; A r "a"a 1 Monthly Oil Leased Equipment is charged service o9fu ,W-W 6e^+ '1 z' tJ through the end of billing cycle Surcharge,Fuel in which service is discontinued. O AL 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 UAPfMA[IIYIBY PAYTRiSAMUUNT I "General PPe88°USBNANEE v YMFNBIAUIUSIMFNP•4•e Will apply to each account. The fee that a Payment Stub pC[OUNT SUMMARY pE10, ,ocpc � is stated on the frons of the invoice.For applies to your account visit the website listed further information ------- -- m Information ---- ---- below or c please u.ean uo.-m mw wmPm�s PAY BY PAYrnuAMOUNr center. ontact our customer service ACCOUNT NUMOER ,z3as67e.o 0006!00 „^. 7•As a food Product; INVOICENUM8ER BIWNG DATE ENCEO6E0 P t bottled water is subject to the rules and 1234567890 00108!00 regulations promulgated by the Federal Food and Drug Administration(PDA). - ra _ _--_ _ 0420096307 04282712619 000391049 2004 18 S.Your fast invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, pE MOUNTAN WATER COMPANY _ ohnDce redemption fees,and an IM4and N°NfWe �„„M.x.P� —_C y,5,a sE will reflect charges for water eIv eyed and dispenser rental,bottle C CUi ~ lure invoices Submit your r,41k�,j"SufILqJF 14ntIn4E[a�i�k�i ttaivll Pox euSroMen sEmncE uul�soa+n 9aee deposits and credits plus charges for any additional products P""`""`n:ma xe m payment by this ordered b Cl 61GNUP O4 B£AUOPA Sg UPPM ^RereR sw date y you.Deliveries are made every three or four weeks,for a total of Per y 7 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect rivo deliveries. 02008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemOuntainwater•com Form No.NW 709 02114 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $61.35 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT Board Members 2201 114JO117821082 I 42-389.001 $61.35 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 v Frida r 4, 1 Street Commissioner Street Commissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/05/14 14JO117821082 $61.35 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 service.icemountainwater.com ®d ® ► ° #215 6661 DIXIE HWY,SUITE 410/01/14/14- 10/31/14 04J0121776199 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II'I II I'I"III II"I I I I I I I I I '�II 'II THD- DEC 04 0121776199 WED- JAN 07 FRI- FEB 06 TUE- MAR 10 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 �III��IIIIs��IItnIII�I��IIIIII�InItttl�rlll��I�InI��I�II� r� n th Ho"t S sauulth 3 ark/t C lebrattc�tst En'brtnim brands lncttodtn Sa"n Pellegrtn Bngnl 9 -f Perrier antl Aclqua Panna Look for speclai hobday samgs going on<frorn:nahw unto the end of the year Gall , QQ I�" l .as+ t atear.�s.,r�tauat -srtl ! „f meg - r sr J:l rd .4 r Ufa' s i 4t � r y � r� Jn ,y P - __ � + 'Z,+�,,.�"i "4, .*' ✓vim �N/hx xi f G,i .vlk & / lyr Y'4. �y r. ai a�. ..�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 SO, HUMAN RESOURCE DEPT,CARMEL IN 46032 PREVIOUS BALANCE 7.98 10/10 601403 PAYMENT-THANK YOU -3.99 10/26 691008 PAYMENT-THANK YOU -3.99 10/06 0904697372 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 6.98 BOTTLE DEPOSIT: 2 CHARGED, 1 CREDITED 6.00 10/31 0910242940 1 OIL/FUEL SURCHARGE 3.12 J7335525 RENT 3.99 TOTAL �submitted To 20.09 NOV 17 2014 Clerk Treasurer ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PA�THISOU T Subject to terms on reverse side. 7.98 — 7.98 + 20.09 = BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOB VOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT 72 WATER QUALITY AND 1. Please remember payment is due by the"Pay y CALL 1-800-47Z_WA OR WRITE ALA FORMATION,PLEASE p y b ']date noted to ensure the smoothest service. US AT, 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means ICE MOUNTAIN SPRING NgTER 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 LOUISVILLE,KY 40258 ifyou prefer,you can pay your bill online at service.icemountainwater.comr check, and do not send cash. If ou bink 4. Never hesitate to call us with comments, Y your bill is wrong,or ifyou need more information about questions,or Concerns. a transaction on your;bill,write us Ona separate sheet m paper;We must hear from you in writing no later than thirty(30j days after we sent you the first bill on which theerror or problem appeared.You can telephone us,but doing so will not preserve your rights• c give us the following information: In your letter, SAMPLE INVOICE • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range • Describe the error and explain if of this invoice an error. You can,why you believe there is You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being investigated.During the investigation,we cannot report as delinquent or take an Your account 00/00100-90!00100 1234567890 Your Account Number y action to collect the amount in question. GENERAL INFORMATION F I.Pa TNR-OCT oa 123456799 Payments received after the billing(INVOICE)date will appear on Important MON-OCT 29 Your next invoice.Past due invoices(not paid within 30 days billing date)may be assessed a late feet allowed by law not to wEUNov 21 Watch here for a y of news and NE-DEC 10 t exceed$20month. uaiaditalnnti;,aii.t.mGat±it„iu`a_iaan C��me1$ee:,9ow]:99e9 Personalized account Per month.gdditionally,third orneyoffers 123M.Ie Thenklo°r°.ulln9loo MO-o"nPr°E°ti Message expenses may be assessed at a rate not to exceed c100°/otof the 123 Maur sr °rysro, 00000 ^dam°•:. unpaid balance or the maximum allowed by law. i.m,>„i t i tt,:t1�1 un t.u6tua„p --2.Each_returned check is subjectto.aservice_charge subject to the maximum check re ank am¢sg mjmwc®�xye ""d1 tum charge allowable in your State. 3. All bottle and equipment deposits are shown as CURRENT pay electronically ACTIVITY Activity - 4.Equipment replacement costs will be charged for bottles lost, since your pccouMAcrnm ° ua •r• u' "m ” Make sore this stolen,damaged or not returned• last invoice amount has been 5.In accordance with NWNA's Terms and Conditions(„T&C'),your Dern �s John Doe,123 M310 °rys ale 00000 Equipment Lease and/or Service Agreement account may be P��l Ta"« paid lII full to Pryment Thank You avoid Late fees SUI7j¢C[to minlmnm m oenl 46Ib98 lowc �y onthly purchases and/or earl nI 3190lau4 5 S6a0o"Nawral5PrfIP— Yt a a DIP— fees.(q complete version of the current T&C may be vtewed'olntthe ” 31.51d14 s Ia Mo"mm scal Dewno _—- mnl 3naes14444 s IceMov"ramswtn• _ 1VIOItthly Oil website listed below)Upon service discontinuation,rent for the 091 3's¢s3ee" Him Leased Equipment is charged through the end of the billing cycle "2 191 "` Surcharge,Fuel in which service is discontinued. *D1^L a ° ftT{{ �''' 1°C1p` 6.You will be charged a monthly oil Surcharge,Fuel Surcharge or Surcharge or Delivery Delivery Fee as described in our T&C, Fee(See#6 under Your Only one of these fees APS M +�•. Arn m _ •.Yuri: o0M "General stili apply to each account. The fee payment stub is stated on the front that applies to your account ACCOUMSUMMARY -------------- - x ah of the invoice.Forfn-her information "°�"°'°"'"°'°"—° `°""`"°" ` °k"°^""°"AMOU` r Inform visit the website listed below or contact O please p,ymum.aNWnu.n wM>m°MK^� ACCOUNT NUMBER PAY BY PAY nIis AMOUNT center. our customer service 0 00 00 ± /234561890 NG DATE ,ENCLOSED l 7. As a food product, bottled water is subject to the rules and NVOICENU8N BIW100100 regulations promulgated b 123+56]890 ooroo 00 Administration(FDA), Y the Federal Food and Drug 0420096307 04282712619 DOD391049 2004 18 8.Your first invoice indicates the products delivered on your first11,111=11 S Amount due delivery,along with ana ICE 11,111 INWAIFACOM14 Loh" Y applicable bottle and account deposits, .oMa„a xww u„Nmn"nx.u" 123 Mam s1 redemption fees,and any dispenser charges.All future invoices °n slake 00000 Will reflect charges for water delivered and dispenser rental,bottle Submit your 1„.N,4,d.N..yJE...11.�I1.:Lp..L"GtC,lidaa- N)R NSTOMER S[aVtCE ULL13W-1]3-988a deposits and credits plus charges for any additional products ❑skNw]Dx]x E 4mc nsy"uPk awreao°x Sus k ❑DwArocw 0"°"�" '°` Payment by this ordered by you. Deliveries are made every hree or four weeks,for ___.- - date a total of 16-17 deliveries per _.._.. - _-.._,---.-----__.. -_. _ ve _.__ only ces 12 times per year,so approximately 5 of hose invoices lwill effect two deliveries. ©2008 ice Mountain Spring Water Company,a Division of Nestle Waters North America y seniice.icemountainwater.com - --— Inc. Form No.NW 709 02/14 VOUCHER NO' WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ : PO Box'856680 Louisville,'KY 40258 - $20.09 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board MemberS`. hereby certify that the attached invoice(s), or -1205 04JO121776199 42-390:99-' -$20.09 - 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, November 17, 2014 h Director, Administration Title Cost distributionledger 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, of hours, rate er hour, number of units, P y P 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)) 11/05/14 04JO121776199 $20.09 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.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4o 10/01/14-10/31/14 04J0121975593 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIII111IIIIIIIIIIIIIIIIII IIII 08 FRI- AN DEC 09 0121975593 TUE- FEB 10 THU- MAR 12 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 CARMEL IN 46032-1938 by phone at:1-800-472-9888.It's free/ Br g n the Holiday Season with Sparkling CdIebratlorlst Enjoy premium"brands Including San Pellegrino,' + °a Perrier antl Acq a Panna Lo6k,,for peciat Iholi ay saVings-going on from now untwthe end o#the yearf�CalE" 00-472 98titrr visitrv�ce:Icetxraun �sivaater tori to of� � x ° Al 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 92.18 10/10 601398 PAYMENT-THANK YOU -62.09 10/26 691007 PAYMENT-THANK YOU -30.09 10/08 0905015103 4 5 GAL ICE MOUNTAIN DRK W/HANDLE 31.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 24.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 10/31 0910251990 1 OIL/FUEL SURCHARGE 3.12 J7407089 RENT 10.99 7471270 RENT FREE TOTAL 52.07 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 92.18 — 92.18 + 52.07 = 52.07 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUTyOUR BILL,OR FOR YOUR VOICE-4 A REPORT ON WATER QUALITY AND INFO 1. Please remember a WAYS TO HELP US SERVE YOU BETTER CALL 1-800-4729888 OR WRITE US AT: RMATION,PLEASE Payment is due by the" a ICE MO 2• Remembe,if p y by"date noted to ensure the smoothest service. MOUNTAIN SPRING IVATER CO. you are renting equipment, our e #216 Your first invoice will include a Y equipment rental is charged one month in advance.That means 6661 DIXIE H 3, Kindly pro-rated fee for the current month,plus the next month's rental. WY„SUITE 4 y fill in the amount enclose LOUISVILLE,KY 40258 If you prefer, d include your account number on you can pay your bill online at 1 Youce,ic account n umber ton your check, If You think o 4. Never hesitate to and do not send cash• Y ur bill is wrong,or if you need more information about call us with comments, a transaction on your bill,wiite'dsquestions,or concerns. must hear from on a separate sheet of paper.We sent you the first bill on which the error or Problem g no later than a30)days after we telephone us,but doing so will not preserve appeared.You can give us the following information: Y0�rights.In your letter, • Your name,address,telephoneand account numbers DSAMPLE INVOICE • The dollar amount of the suspected error, • escribe the error and exp You can, Date range of this invoice an error. lain if y 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 i[ is being investigated.During the investigation,we cannot report your account as delinquent or take ,i any action to collect We amount in question. ' 00100/00-00,00,00 134567890 GENERALINFO i XourAccount Number I.Payments received after the b 11�TION Your next invoice.Past due in e�OICE)date will a 1N6-0cr a u3as67s9 bYourillin _ appear on Important MDN-CC119 g date)ma be ( Paid within 30 days of n_eWS and TUE-DEC 18 Y assessed a late fee as allowed b �ateh here for a exceed$20 per month.Additionally,third - - _ T1'a UI I11 IDd!4L'!t n 1 ut dtlGnll:tiJaE1' y taw not to e4awmersorv(co:1-e0a47z-9866 personalized account expenses May Pare ceedCtion/attorney Utters 12 — __ Thom you for uAng 1.Moonffi"p.d.. Y be assessed at a rate not to exceed ]00%of the 133 M sE ane aM a message unpaid balance or the maxim o y 5�, �� 2,Each re um allowed by law. i•aut,r„tu�fu,�.n;,n�4a"t i.64trdau turned check n subject to a service charge subject to the maximum check return charge allowable in your State, { 3. All bottle and equipoient de YW pndl86: VC Odta/FR;e.Xw yOurWc ACTIVITY. Posits are sholw as CURRENT .. `'� }� J Pay electronically Activity 4. Equipment replacement costs will be charged for bottles lost, 10 stolen,damaged or not re since your 5.1n accordance fumed. last° ACCOUNiACnVnY r mus 'emm°vnm.wm aMvm , Rsaeamf2N I with NWNA's Terms and invoice Make sure this Conditions Dor 1yAEdress:lonn0oc.113W!n Street OrASt 00000 ! amount has been Equipment Lease and/or Service Agreement ac oust may be paid in full to subject t0 minimum monthly purchases and/or early cancellation �1 361696 Paynlent•7Aank fees,(A corn ]e m 3veasl,aaa 5 SGallonNaNralSpdngWan complete ma m 3l7aes,.a+ s aaA°Woalnscal0.no0 avoid late fees website listed below Y be viewed on the mn1 3" 51a s la Mwn ms W,6e m Leased E ui )Upon service discontinuation,rent for the o9n7 3M7636Bn wets°aw9: ',''-7""” } Monthly 9 Equipment is charged through the end of the billing cycle o9n7 ,66,0091 �" l i I Oil in which service is discontinued. 'y1r t i y o« Surcharge,Fuel 6.You will be charged a monthly Oil Surcharge, Surcharge Or Delivery Delivery Fee as described in g Fuel Surcharge or Fee Evift aPP1Y to each ac oar T Y of these (se under Y &C. Only one a#6 count The f ese fees Payment stub is stated on the front f fee that applies to your account ACCOUNT SUMMARY vpmous�cE—P"yMENrl�wl�umaENE+�""piT0.CNR1' _ I General visit the o the invoice,For further info, Information') website listed below or mationplease "'""'«°'°°°"° °°""""°""`"�"` " °" f center, contact o ------------------------------------------------------ on°� our customer service ACCOUM NUMBER PAY BY PAY TNIS A�MOUNr 7.As a food 1234567890 0000 00 product bottled water is subject to the INPCIICENUMBFA MUING DATE ENCLOSED regulations promulgated by the Federal Food rules and 113,567690 -01" /00 Administration(FDA), and Drug 8,Your first invoice indicates the products delivered on 0420096307 04282712619 000391049 20a4 18 delivery,along with an Your first Amount due redemption fees,and anyapplicable bottle and account deposits, .[E MOUMANWATE COMPANY 123 main Et,NJonmNmRW°Ie,N°An A,nulo trr. orysane 100000 Will reflect charges for w terlde!vered apenser nd dis enAli ser rentalture ,lbotte y deposits and credits plus charges for an P P ma..,i.n6M m.,al.n tn..4"ttG4;t„n' F06NS OMEA SERNCE CALLI-0Ob171A898 Submit our ordered by you_Deliveries�re made ever y additional roduct5 ❑SIGNUP OP P E UOMNSg UpPryWr 60 MaxSMt ❑MntAM 6 9a�Ma • payment by this a total of 16-17 deliveries peryear. y three or four weeks,for -. - date P You will on! recei a invoices 2 times per year,so approximately pr5 Y ° _---.__ two deliveries, °f those invoices will reflect — - 02008 Ice Mountain Spring Water Company,a Division of Nestle W Q servtee•icemountainwater.com o eters North America Inc. - - - Form No.NW 709 02/14 Y — - Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE-VOUCHER CITY OF CARMEL rl itemized must show: kind of service where performed, dates service rendered b An invoice or bill tb be roe e properly Y . � P Y whom,::rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee, ce �lI A h��.�n. D 1 rE� r Purchase Order No. p`U v 0 y &F6 6 6 S10 Terms Le k l s VI I I� I�) L V 2 gJr—6 0�0 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) -5—� OftJOIZ 975393 e►r S2.°7 Total 52•�7 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 IClerk-Treasurer VOUCHER NO. WARRANT NO. - ALLOWED 20 � U11?Aft I�Z°�/' IN SUM OF $ YO I ,� 9566-96. . Louisville . KY '-n2�s; 8o $ 52. °7 ON ACCOUNT OF APPROPRIATION FOR 18d t/�+�so9oo Board Members PO#or D PT.# INVOICE NO. tA11CCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), ��D121�'15S f3J d 5 °7 or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except r r I l-17- 201 ignature Cost distribution ledger classification if Ttle claim paid motor,vehicle highway fund service.icemountainwater.com ; #215 6661 DIXIE HWY,SUITE 4 i LOUISVILLE KY40258 10/01/14-10/31/14 04J0121202766 ADDRESS SERVICE REQUESTED ACCOUNT;UPCOMING DELIVERIES TUE- NOV 18 0121202766 II I I'I II I I I"I I I I II I I I I I I I I I II I 'II FFRI- DEC 19 RI- AN 23 11/04 �F,IV]F,D TUE- FEB 24 CITY OF CARMEL PARKS DEPARTMENT NOV ® 201 Customer Service: 1-800-472-9888 MANDPADY 1411 E SETH ST : __ ay your bill online at:service.icemountainwater.corn or 1411 E L I 116TH 03 y phone at:1-800-472-9888.Ifs free! CARMEL IN 46032-3455 Bring in�fihe Holiday Seasonwith�Sparkl ngC�elebrat�o�nst Enjoypremium brands Including San Pellegr�ino, : �9Perr�erandA►cryua Panna:�Look�fors ectalhollda �sa��tn s "�o!n onf or m�noinr�unttl�the end of the�'e�ar. Calf - - 1=8QQ-X72-98i3�or�tsit�snrvace Icerrtot�ntatnv♦aterr..o„i to ord�r� ' r +.° = `tee r4�. .'", ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1.800.472-9888 or visit service.icemountainwater.com. 12 NTE.-—RERE P S Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 143.51 10/10 601400 PAYMENT-THANK YOU -52.05 10/26 691004 PAYMENT-THANK YOU -91.46 10/21 0908537871 1 5 GAL ICE MOUNTAIN DRK-W/HANDLE - - — '4 4.29 BOTTLE DEPOSIT: 1-CHARGED„0 CREDITED ” 6.00 10/31 0910244821 1 OIUFUEL SURCHARGE �r °a (�`� 3.12 J7446522 RENT .� -i .K�' ^n �� VV �� 5.99 7474033 RENT C �'� ' i FREE f ;F]( t ; ,' PorF TOTAL 19.40 Date �,reval Data ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY_PAY THIS AMOUNT Subject to terms on reverse side. 143.51 — 143.51 + 19.40 — 19.40 i BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL OR FOR YOUR INVOICE-4 WAYS To A REFORT ON WATER QUALITYHELP US SERVE YOU BETTER CALL 1-800.472- Ar.. RNIATION,PLEASE l Please remember payment is due by the"Pay uses OR WRITE lis AT; 2. Remember,if p Y by"date noted to ensure ICE MOUNTAIN Sp you are renting equipment, our a he smoothest service. #216 RI1YG WATER CO. Yom•first invoice will include a pro-rated fee for the current month, Y equipment rental is charged one month in advance.That means 6661 DIXIE FIWY SUITE 4 3. Kindly fill in the amount enclose plus the next month's rental, LOUISVILLE,KY 40258 prefer,you can a d,include your account number on p y your bill online at service,icemountainwater.comom check,and do not send If YOU think Your bill is 4.Never hesitate to call us with comments, cash.If You information about a transacfion on ong' or if you need more questions,Or COnCertiS. sheet of Your bill,write us on a separate writing no later than th' We must hear from you in Which the error or problem(130)days after we sent you the first bill on c so will not preserve your rights.appeared.You can telephone us,but doing SAMPLE INVOICE informationIn Your letter,give us the following Date range of this invoice • Your name,address,telephone and account numbers. • The dollar amount of the suspected Describe the error and error. • explain if you can,why you believe there is an error. „ .. You are obligated toaY the ' 00100100•,orooi0o u3asara90 You do not have to Parts of your bill that are not in question. investigated.Durin Pay the disputed amount while it is being mR-o°oa 1234567990 } as delinquentg he investigation, cannot re MON ocr:9 or take an we° Port Your account `"mNOV 21 Your y action to collect the amount in question. IDE-1Ec,6 - Account Number GENE adi�n s�n sa nd 1ti a n tt nd iR Cu ,pale,=, 00 72-9809 1.Payments L INFORMATION I i 12 : Thart4 vuf"u n91aM"vnWnpmtl m { received after the billing(INVOICE Important °ry 5 to°0p°° entl ry V' Watch here for a }[Our next invoice)?est,due_' )date will a t tga.d„In it 0.i144,d[Idt,t>atl. tavoices-(not- appear news and personalized account billing date may be Paid within30_d�y�o� Y assessed a late fee as allowed by law not to offers-- 4 exceed$20 per month.Additionally, x aME _ message expenses may be assessed at a rte not to exceed 00%of thcollection/attorne M aa1W `" 3aA`nom; �.yrua unpaid balance or the maximum allowed by law 2.Each re tamed check is subject to a service charge subject to the AccouNracnvnr " " " "P maps Pay electronically I maximum check return charge allowable in your State. 3, All bottle and equipment Activity DMN Addresx John 1ue 123M inS me Ury,5 areO6W 4 pment deposits are sho P"9rou:eaw a °x Make sure this ACTIVITY. Own as CURRENT Since your sen, 46,e9a 9 m pt-want w xra 4. Equipment replacement costs WA WWI— 5 Bsallm Na"a18p gNOK, p�q i amount has been stolen,da will be charged last invoice a�s+a.4 s k M"untainswloapom _ a xxR ; waged or not returned, g ;for bottles lost, ovn almil— s '�"""pbinswlam o,x { paid in full to S.In accordance with N 69112 3,82638011 , 9N:ls fi n � q a a WNAS Terms and Conditions(°°T&C" ( Ig avoid late fees Equipment Lease -' and/or Service Agreement account may be MAL oco subject ie minimum month] � ' fees.(A complete version of he current T&C may be viewed on the ases andlor early cancellation Your new Monthly Oil website listed below delivery ACCOUNT SUMMARY "" +`� o a Surcharge,Fuel Leased )Up service discontinuation, - 9N944,ANa Equipment is charged through the end of the billing cycle " " N" Surcharge or Delivery in which service is discontinued. calendar. —"` "—----- ------ ---- --- _ ___ __— Gy�Q„��.i00P4)2.9000 6.You will be charged a "indicates My Delivenes A N M , 9PR " ""^ '° ""� F ee(see#6 under Deliverymonthly Oil Surchar e,Fuel a scheduled Fee as described in your T& g Surcharge or "General will apply to each account. T C. Only one of these fees delivery ° Information is stated he fee that applies to n o ° om a n nn n on the front of the invoice.For Your account nn m nm visit the website furherinformation.please a listed below or contact o ' center. w customer service 7. As a food Product, "O� ao ° Pr bottled water Payment Stub ° oav is subject to inn; "n' "s HH- Promulgated mnm°1 :i;ann u regulations promulgated b the rules and Administration(FDA). Y the Federal Food and Drug _ __-------_-_ . S.Your first invoice indicates '!i� VAY 6Y VAY THIS AMOUNT the products delivered on your first 101"` Amount due delivery,along with any applicable bottleNCEO9E1redemption fees,and any dispenser cha andaccount deposits, oolooloo `l`--`-"reflecf-charges-.for-water-delivered-ande.All dispenser invoices wili- _ _ _ deposits and credits plus charges for an _ 1411,16307 04282712619 000391049 20040']011 ordered by you.Deliveries are made eve Y additional products - "hnoce Submit your `--KE MOUweeks,for �r NW ATER OM�PH• 123 Man't _ payment by a total of I6-17 deliveries per year.You willOnl oreceive in oices this date 12 times per year,so Ycm,s "00000 two deliveries. approximately 5 of those invoices will reflect I�.est,u,1.•tw,...0,n„lu,ast:.t„uta.u�t„a wR�,,,mMPa,Emla�tE,�""+n-9aR" ,- �9GNNP900FRF£AUNPFv,919nUp8epuiedOn FevexSde. ❑Pun,M,O"n9e,on Bereretde c 2008 Ice Mountain Spring Water Company,a Division of Nestle Wate service.icemountainwater.cors North America inc. in —--- Form No.Not/708 08112 serviceAcemountainwater.com � #215 6661 DIXIE HWY,SUITE 4 10/01/14-10/31/14 04J0120095351 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIIIIIIII1111111111111111111TUE- NOV 19 0120095351 DEC FRI- DEC 1 FV-ED FRI- JAN 23 TUE- FEB 24 NOV 10 2014 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWAi ; Pay your bill online at:service.icemountainwater.com or 1411 E 116TH ST -- - — by phone at:1-800-472-9888.IYs free) CARMEL IN 46032-3455 I��I�il��l��l�lllllllr�l�l��llll�ll�l��l�l�ll�ll��llllll�� NBr i g In the HoIldajr Season wRKSparkiing Celebratlo>A Enjoy premium brandsµrnciuding Sanl,_Hegrino, exec and Atjua Panna Look for special°halttlay sau�ngs going,,,.,,' from now until the end af4the,ysar°Cali „ —---- %1t5tftfd9 TYtS�[ £r17 C 't�C11il11iit11n8tir v t �;Idert - f'r r . , 'y'i ti '—"m K4;4, �.v lC s i b y' f r ra�am iN a r � f za jr1,9e s y itx 'gY " ;r �°"G` 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 CLAY PARKS AND REC DEPT.,1411 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 178.36 10/10 601399 PAYMENT-THANK YOU -11.98 10/26 691005 PAYMENT-THANK YOU -166.38 10/20 0907017081 5 5 GAL ICE MOUNTAIN DRK W/HANDLE 21.45 BOTTLE DEPOSIT:,5 CHARGED,,9 CREDITED -24.00 10/31 0910230242 1 OIL/FUEL SURCHARGE -ase YV�- ,f/',IV l 3.12 J7359800 RENT �'1tlon I { 11.98 �.# TOTAL P or F 12.55 ` 4-Ini Date 'i Dv ro - ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 178.36 — 178.36 + 12.55 = 12.55 i BILLING RIGHTS SUMMARy YOUR INVOICE-4 IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND FORMATION,PLEASE 1• Please remember payment is due b the" a b " CALL 1-800-472-9888 OR WRITE USAT: Y P Y Y date noted to ensure the smoothest service. 2. Remember,if you are renting equipment,your epment rental is charged one month in advance.That means WATER CO. your first invoice will include.a qui ICE MOUNTAIN SPRING Wfpro-rated fee for the current mon #216 3. Kindly fill in the amount enclosed include your account numberonyour hecknand do not send cash. 6661 DIXIE HWY.,SUITE 4 the next LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater.com Ifyou think your bill is,wrung,or,if you need more information about 4. Never hesitate to call us with comments,questions,or concerns. a transaction on your bill;'write must hus on a separate sheet of paper.We' ear 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, SAM P give as the following information: LE INVOICE • Your name,address,telephone and account numbers. INVOICE • 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 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, as delinquent or take any action to collet the amounts inquestion,cannot report your ant oD/oolDo-oolootoo 1234567890 Your Account Number 10 GENERAL INFORMATION TNR-0a m 123456789 I.Payments received after the billing(INVOICE)date will appear on Important mo�oawu,NOV 29 Your next invoice.Past due invoices(not paid within 30 days of news and TUE.Mo,n Watch here for a billing date)may be, UE-DEc,R Y assessed a late fee as allow btlatll pblli6duiidli9tlb.illtl t6Sltdalt�. Cunam=r5mke:L80047b98R0 personalized account exceed"$20Per month�;dditiotra(l',-ffiiid—azt by law not[o Offers ^ D Tnamy°",°,°,ro91uM°°"w'per°� message expenses may be assessed at a rate not to exceed cI wanUlthe i23 M i n ��., lT' —--crv.slat 00000 unpaid balance or the maximum allowed by law. "dud d ub dtw11:•t�En E•tu 61ua 2.Each returned check is subject to a service charge subject to the maximum check return ch — arge allowable in your State. 8 Pay electronically 3. All bottle and equipment deposits areshown as CURRENT Y � *,�' �t"' u�R*�rwtyot�ipet"Tu.at..�6 roach'hwa 3, ACTIVITY. RRENT Activity ) �� 4. Equipment replacement costs will be charged for bottles lost, since your Make Sure this stolen, ACCOUNT ACTIVITY P ¢um damaged or not returned, last invoice s ai<00000 amount has been 5.In accordance with NWNA Dei enAae.e ,n"D°e.123Mamsuee ey. paid in full to s Terms and Conditions("T&C"),your a l°�Rala"" an Equipment Lease and/or Service Agreement account may be T nw y°u nw 1 461890 `�""`" aD avoid late fees subject to minimum mon „ 3,)88514449 5 BGaIIOn Nawrai Sptln9 Wa r monthly purchases and/or earl fees'(A complete version Of the c Y cancellation on the m 3p8es14949 s I�Mo°R,amsG lO z« urrentTr4cCmaybeviewedonthe 09,N 3vsss,4aa s IceMnuOwRSGa1R '' >� Monthly Oil website listed below)Upon service discontinuation,rent for the 09 t 3+Riwae" w°Is Rnar9° z �l� >� Leased Equipment is charged through the end of the billing cycle 2 ,660999 { I Surcharge,Fuel r in which service is discontinued. Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery flee as described in your T&C. O PA+"+sAMpuN "General will apply Fee each a my one of these fees Payment stubP"E"10OaPaANEE b account. The fee that applies to your account ACCOUNT SUMMARY 0 0 ` Information') is stated on the front of the invoice.For further information "— p�IS�- matlo • ' n' visit the website listed below or contact our c Please '--o�N u ws m"� �aPm ^+ ACCOUNT NUMBER PAY BY PAY THIS AMOUNT center. ustomer service 23456]890 DDD 00 INVOICENUMeER afaING DATE .ENCLOSED 7.As a food product, bottled water is subject to the rules and 23456]890 0mooro0 ; regulations promulgated by the Federal Food and Drug ± Admmistratim,(FDA). 0420096307 04282712619 n00391049 2004 18 8,Your first invoice indicates the products delivered on your first # Amount due delivery, roR0�• along with any applicable bottle and account deposits, 'CE MOUNTAIN WA ER COMPANY 123 Main St redemption fees,and any dispenser charges.All future invoices oMi°^a"'D w° N«a tel^ clty,swte 00000 will reflect charges for water delivered and of rental,bottle fi to I. ar„ a n n xrl'"tttt t"tT EORNS OMERSERVKEG 11 800>T2.9888 Submit your deposits and credits plus charges for any additional products ❑slGNup OR R FAU 0PA sl,^UPn°4mredD R xva. ❑P MAm ^�O"NN Sd" payment by this ordered by you. Deliveries are made every three or four weeks,for _ _---•--."-" ,— t 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. —- _ ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemountainwater.com Form No.NW 709 02114 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. P per er 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 11/5/14 4JO121202766 Drinking water&cooler- MCC $ 19.40 11/5/14 4JO120095351 Drinking vgater Maintenance Dept. $ 12.55 Total $ 31.95 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 i Voucher No. Warrant No. 051125 Ice Mountain ; Allowed 20 P:O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 31.95 l ON ACCOUNT OF APPROPRIATION FOR 101 General fund/109 Monon Center I I PO#orBoard Members INVOICE NO. ACCT#/TITLE AMOUNT '! Dept# i 1091 . 4J0121202766 4350900 $ 19.40 I hereby certify that the attached invoice(s), or 1125 4JO120095351 4350900 $ 12.55 ` 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 j 13-Nov 2014 j II Signature $ 31.95 I Accounts Payable Coordinator Cost distribution ledger classification if y( Title claim paid motor vehicle highway fund, I j I City of Carmel Engineering Department One Civic Square Carmel, IN 46032 Remit to: Ice Mountain POB 856680 Louisville, KY 40285-6680 Invoice Date Invoice# Project Name Amount Paid 11/5/2014 04JO120048525 water cooler $ 20.64 Check Total $20.64 Prepared by City of Carmel 11/14/2014 service.1cemountainwater.com ° b #215 6661 DIXIE HWY,SUITE 410/01/14- 10/31/14 04J0120048525 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTEDTHU - DEC 04 0120048525 VVE WED- JAN 07 FRI- FEB 06 TUE- MAR 10 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 SQ by phone at:1-800-472-9888.IYs free) CARMEL IN 46032-2584 Brtl g n the;Halrtlay Season with Spar 1ht g Celebrations! Enjoy premium brands Including an Pellegrino, I,e!�rler and Acij is Panna L; cSk for special holiday savings going on from now uintll the end of the year — t77 OSv - ! �>t&+fir-��{'9fitt!nL!l1ttNdBteGnm to nri34t) r U77'�_�,�rv, .ems':,,,a. r✓ 3a "'✓r3 2 �" r rr,N' f a2 ✓' r I �� acX „ �, t - Ar��N ,✓✓l'rmg' ,� � ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.leemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 49.66 10/10 601402 PAYMENT-THANK YOU -24.93 10/26 691006 PAYMENT-THANK YOU -24.73 10/06 0904697331 1 5 GAL ICE MOUNTAIN DRK W/HANDLE �� 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 7 .00 4 9 OZ PLASTIC CUP'50C/SLV ��✓� ��p 13.16 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 10/31 J7343660 RENT "e RECEIVED 3.99 TOTAL NOV 2014 20.64 e _ CARMEL ° E CIN ENGINEER �� ,le f 2200 — 423q OG �1 I ACCOUNT-SUMMARY -PREVIOUS BALANCE_ PAYMENT?ADJUSTMENT- CURRENT'ACTIVITY —PAY THIS AmO-UNT rSr Subject to terms on reverse side 49.66 49.66 + 20.64 20.64 BILLING RIGHTSSUMMARY INCASE OF ERRORS OR QUESTIONS ABOUT YpUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY AND INFO HELP US SERVE YOU BETTER j CALL I-800-47p_ggg8 OR WRITE US AT: �ATTON,PLEASE 1. • Please remember payment is due by the"pay by"date noted to ensure the smoothest service. 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance. ICE MOUNTAIN SPRING WATER CO. Your first invoice will include a pro-rated fee for the #216 P current month,plus the next month's rental. That means 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 at service.icemountainwater.om 4. Never hesitate to call us with co and do not send cash, Ifyou think your bill is wrong,or if you need more information about 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,In your letter, SAMPLE 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 an,why you believe there is an error. if you c .. 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 an P Your account s o0/oo1oD-oolooroo 1234567890 your Account Nu y action to collect the amount in question. tuber GENERAL INFORMATION 123416769 I,Pam 1HR-�� Payments received after the billing(INVOICE date ppMO"OCT 19 Your next invoice.Past due invoices(not paid within 130 days of news and Important "'�N0C 11 Watch here for a billing date)may be assessed a late fee as allowed b 1 uE-OEC la i exceed$2o per by no[to n.n«;tit m ttlgi lNil,Iiu :munp;,ua,ln' c0„0”°f$a,u;,,g001,1.9B8B personalized account p month.Additionally,third offers in6�d00 Tnanlr9nmt9smgleMnunmmPmdum message expenses may be assessed at a rate not lona exceedc100°/°/Btof the 1Z3M'msc Ona Fam«a. i "-d ggs>as 00000 , unpaid balance or the maximum allowed by law. 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. TomuuO rW awn+Y RnedaY " °""a r�gh at __,_-- 3. All bottle and equipment deposits are shown as CURRENT 0_ 1 `o-e adoroax =e a m09 9v Pay electronically ACTIVITY Activity i 4. Equipment replacement costs will be ch Since your m�.ate �m^a°" Make sere this stolen,damaged or not returned, charged for bottles Inst ACCOUNT AR{v{n ' 5.In accordance with N last invoice WNA's Terms and Conditions DA- Add,—lOenl)-123Ma1WO Cirysum 00000 ; amount has been Equipment Lease and/or Service Agreement (��T&C"),your _ o,°,n Ulanoa -I)` '� paid in full to subject to minimum month! g ment account may be 0801 401898 Payment-Thanty ,a o y purchases and/or early cancellation m 3vees14a4 s swnmNaromsPnn9w4ut N � Y=N avoid late fees fees.(A Complete version ofthe currentT&C may be viewed on the 1 308851°°44 s aeMwntamse 1DePP Rr f 09111 31re8414aM 3 la MwnGtnSGa1RN website listed below)Upon service discontinuation,rent for the B9n= 310=6388,1 emerges�r +.1'€ t Monthly Oil Leased Equipment is charged throe o9n= 16MDI17 S Surcharge,Fuel through the end of the billing cycle in which service is discontinued- Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or .__. Fee(see#6 under Delivery Fee as described in o 1 to ea your T&C. Only one of these fees `General w'lll apply each account. Payment stub PRFvrom BAwsF_v vMvrryAorvslMFHr}cuaRFM vRv c PAvvxO rsl is stated The fee that applies to our c ACCOUNT SUMMARY Information") on the front Y account p -- aho ofthe invoice.For further info •°'°° "^•^'—°"`°----"------ '°`° "° nform ------------- v1s1t the website listed enation please --'"O UAW NAW MNR^P ACCOUNT NUMBERns7 Br PAY THIS AMOUNT center. below or contact our customer service 0 00 123456)890 7. As a food product, bottled water is subject to the rules and INVOICE NUMBER BILLING GATE ENCLOSED 1234s6TB9000/00 regulations Promulgated by the Federal Food and Drug Administration(FDA), 0420096307 0426 000391049 2004 16 8.Your first invoice indicates the products delivered on your first Amount due delivery, ICE WATERCOMPANY J. ry,along with any applicable bottle and account deposits, d"� 0 "^*"° 1redemption fees,and any dispenser charges.All future invoiceswill reflect charges for water delivered and dispenser rental,bottle o0000ER SFICACEtALL 1.8001)2.9808 � Submit your deposits and credits plus charges for any additional productsgOflM �" Payment by this ordered b date Y You. Deliveries are made eve ---•- a-' ry three or four weeks,for _______-.� ._-- a total of 16-17 deliveries per year.you will only receive invoices 12 times per year,so approximately 5 two deliveries. of those invoices will reflect ©2008 Ice Mountain Spring Wafer Compan`y,`a-Divisiori of-Nestld-Waters North America Inc.`z service.icernountainwater.com _-- - - - ------ - _ - _._ Form N.. NW70907J14 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 11/5/2014 04J0120048525 water cooler $ 20.64 i I Total $ 20.64 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 $ 20.64 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#rrITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 0 04JO1200485 2200-4239099 $ 20.64 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 11/17/2014 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwatencom N #215 6661 DIXIE HWY,SUITE 4 10101/14- 10/31/14 14,17220327048 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 'I'I I ll I'I IIII I'III I l I I I I I l ll I I 'll THD- DEC 04 7220327048 WED- JAN 07 FRI- FEB 06 TUE- MAR 10 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 ANN DAVIS 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 I�II�II"III�I��IIIIIIII�II�I��III�I�I��III�I��III�II��J��,I �Bang in the F#olrtlayrSeasonSwlth Sparkling Ce[ebrattar>is! Enjoy premium brands Including San Pellegrino, Pe riernd AccuaxPanna I_akgfor speciT hallday sau ng`s going an from now untll the end of the year Gall .s.,A -sAQO.IS,w 4_.+ aanu ,a t r� l r -C►�*7�t1 �vvv `ir i iS«aci va0 E�G;.i `r2 'k''rd Cy`�4ug ��j✓�y � z ,s,r� r`�` �/� T-?�,yr y-. -� ��,� � Awa t-. t��`✓°� ,z'a� ''x r�"s per!/ y r� ✓rte s�'�� ,i ark '�,-,. `s ., .� ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL 1N 46032 PREVIOUS BALANCE 17.18 10/26" 690336 PAYMENT-THANK YOU -17.18 10/06 0904697646 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 10/31 0910324953 1 OIL/FUEL SURCHARGE 3.12 J7373749 RENT 3.99 TOTAL 13.89 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT!ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 17.18 — 17.18 + 13.89 = 13.89 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR BILL,OR FOR YOUR INVOICE-4 A REPORT ON WATER QUALITY AND INFORMATION,PLEASE WAYS TO HELP US SERVE YOU BETTER 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. CALL t-soo-47z-9sss OR WRITE us AT: 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance. ICE MOUNTAIN SPRING 1VATER CO. Your first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 That means 6661 DIXIE HWY.,SUITE 4 3. Kindly fill in the amount enclosed, includeour account number on LOUISVILLE,KY 40258 4, If you prefer,you can pay your bill online at service.icemountainwater.e 0/r check, and do not send cash. Never hesitate to call us with comments, Ifyou think your bill is wrong,or if you need more information about a transaction on questions,or concerns. Your bill,wr to us on a•separate sheefof fraper.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, give us thefdlloivinginformation: 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' question. You do not have to pay the disputed amount while it is being investigated.During the investigation,we cane as delinquent or take an of report your account 234567890 y action to collect the amount in question, 3 00100/00-00/00100 Your Account Number GENERAL INFORMATION 723456789 1.Payments received after the billing(INVOICE)date will appear on Important MON oc 2y Your next invoice.Past due invoices(not paid within 30 da s billing date)may be assessed a late fee as allowed by law not to 2 Watch here for a y of news and NE-DEC IB exceed$20 per month:Additionally,-third- a ItdlEdiltilll�ditlLLptltLidUt�dtitt�tb�tl.idlt cn,am<r ser,,re:,-aoas,z-yeas personalized account expenses may P rty-collectior>/attorney__off_-Cf$— lohnoce r,,,„krp,,,a,,,�„y„aMounulnprodum [ y be assessed at a rate not to exceed 100%t the u1M-NSt message unpaid balance or the maximum allowed by len -�rys�te Iwo .na=<m<e,. I:dtid,t of H,..dl.d1 LU,L..LLLLd.,U l 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. 3. All bottle and equipment deposits are shown as CURRENT I'aY electronically ACTIVITY. Activity 4. Equipment replacement costs will be charged for bottles lost, Make sure this since your ACCOUM ACIIVRY r dam+n^ • •° b p” stolen,damaged or not returned. -• " 5.In accordance with N last invoice been WNA'sTermsandConditions Der nAee.eaa John Doe,121 MainStreeCGry,State00000 amount has Equipment Lease and/or Service Agreement account mayyour be xx paid in full to subject to minim 083, 96,e5e Payment-Th nkYoo avoid late fees um monthly purchases and/or early cancellation n, 3nees,aaa s sGanonNaturalsP��wwaler u� fees.(A complete version of the c n, 3naas,4 9 5 I eMaunWlnSGalD posR � F urren[T&C may be viewed on the o9m anea5,<^a4 5 keMoumalnSGaleetum Month website listed below}Upon service discontinuation,rent for the "'1'2 31e263�" E<elsnmh r9< M« Monthly oil Leased Equipment is charged through0/n i669P 97 in which service is discontinued. 03e end of the billing cycle ' Surcharge,Fuel " Surcharge or Delivery TMAL 6.You will he charged a monthly Oil Surcharge,Fuel Surcharge or T Delivery Fee as described in your T&C. Only one of these fees Fee(see#6 under will apply A� ,�,"a +Nae A<Am _ ••*» ��M "General pply to each account. The fee Payment stub eamnu5a 4ANEE P _ "" that applies ACCOUNT SUMMARY IX - kxxz is stated on the front PP s to your account of the invoice.For further information '.""ae• "`"11C.MOUMr""` ""°2T "'""""" Information") cult a website listed below or contact our Please ------------ IXt•dW.awbWrcam.�AN•'P.Yme`t ACCOUM NUMBER PAY BY PAY 7a1S AMOUNT center. customer service 1239567890 000000 7.As a food product, bottled water is subject to the rules and NY12C 567-90 BIWN 010. ENCEOSEO regulations 234567090 00/00/00 Promulgated by the Federal Food and Drug Administration(FDA). 0420096397 0428271RL19 000391049 2004 as 8.Your first invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, aCOE MOUMAN WATER COMPANY 123 i redemption fees,and any dispenser charges.Al]future invoices Mp NceEW NW M c 23M"'n sc Will reflect charges for water delivered and dispenser rental,bottle GgCuu, 00000 deposits and credits plus charges for an Jqa„J„qL,•..n„dL.,pwLa„L.LLLr,aAn: fOACUSTOME05EBV CE GN1180002.5800 Submit your ❑SIGNUPfOREProducts RFEAUIOpAYI5lgnUpR¢puvetlOnOexneSide ❑PrNtA,ryWnSeannRemne6Ne E payment by this ordered by you. Deliveries are made every three or four weeks,for ony receive idate two deliveries. a tots of 16-17 deliveries per year,you will lnvoices - 12 times per year so approximately 5 of those invoices will reflect �serv©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. ice.icemountainwater,com Form No.NW 709 02/14 Q 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)) i� LS 8 . 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. ALLOWED 20 N SUM OF $ MOO $ p, ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), (t-1 �°f 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 20 Cost distribution ledger classification if Tltl claim paid motor vehicle highway fund