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240322 12/16/14 CITY OF CARMEL, INDIANA VENDOR: 051125 ® ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $*******177.51 :9I=a CARMEL, INDIANA 46032 PROCESSING CENTER CHECK NUMBER: 240322 PO BOX 856680 CHECK DATE: 12/16/14 LOUISVILLE KY 40285-6680 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 04KO12004852 10.97 04KO120048525 1125 4350900 04KO12009535 53.67 04KO120095351 1091 4350900 04KO12120276 3.97 04KO121202766 1205 4239099 04KO12177619 34.59 04KO121776199 1801 4350900 04KO12197559 30.05 04KO121975593 2201 4238900 14KO11782108 44.26 14KO117821082 service.icemountainwater.com • ' *b ® ► ' #215 6661 DIXIE HWY,SUITE 4 11/01/14-11/30/14 04K0121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIII'IIIIIIIIIIIIIIIIIIIII 'll WED- JAN 07 0121776199 FRI- FEB 06 TUE- MAR 10 Access your delivery calendar at WED- APR 08 service.icemountainwater.com CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Did you forget about us? Kindly pay upon receipt. 1 CIVIC SQ Remember,past due accounts are subject to a late 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. Bringer the�Hol tlay Season w th SparklingArCelebrationsi Enjoy,premium-brantls'tncludmg San Pellegrino, a. :, 3Pe,rfer aAcquaPanna ok for pedal h�tiliday savings going onTfrom now until the end of the year Call 9880 KVisit service i .66 diaifitwtmdeer+ _ - 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 20.09 11/03 0909236853 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 20.94 2 9 OZ PLASTIC CUP 50C/SLV 6.58 BOTTLE DEPOSIT: 6 CHARGED, 6 CREDITED .00 11/30 0914463419 1 OIL/FUEL SURCHARGE u 3.08 K7502676 RENT 3.99 TOTAL Submitted To 54.68 DEC14 Clerk Treasurer ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT URRENT ACTT PAY THIS AMOUNT Subject to terms on reverse side. 20.09 — 0.00 + 34.59 = 54.68 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR ypUR INVOICE-4 WAYS TO A REPORT ON WATER KELP US SERVE YOIj BETTER QUALITY AND INFORMATION,PLEASE l• Please remember payment is due b the" CALL 1-800-472-9888 OR WRITE US AT: Y pay by"date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. 2• Remember,if you are renting equipment,your a vi #216 your first invoice will include a pro-rated fee for the current month,plus the next month's rental. equipment rental is charged one month in advance.That means 6661 DIXIE Hwy„SUITE 4 3• Kindly fill in the amount enclose include our account number on LOUISVILLE,KY 40258 if you prefer,you can pay your bill online at service icemou t inwater•com check, and do not send cash. Ifyou think your bill is wrong,or if ou need 4• Never hesitate to call us with co a transaction on Y more information about comments,gIICShOnS,Or COrieerl]S, Your btll,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 letter, C give us the following information: your lSAMPLE 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 dis ,puted amount while it is being investigated.During the investi anon g we cannotthe am report as delinquent or take an a P rt Your account 00)00(00.00/00/00 12345fi7890 y coon to collect the amount in question. � Your Account Number GENE : +. �r - 1, Payments FORMATION l R_OC,pq 123456789 yments received after the billing(INVOICE)date will appear on Important MON or z9 j your next invoice.Past due invoices(not paid within 30 days of billing weo-Nov n Watch here for a g date)may be assessed a late fee as allowed by law of to news and I& DEC 18 exceed$20 per month.Additionalltoracyy, n,aa.R1P01lIIglytl¢IJBLP•lltpPt4aAd[l, Cuaro 1,M, 1.80"72-9888 personalized account y third Offers John Oce123 ThanByPP r"r Pang Be MPu a,np odPm IRBSSage expenses may be assessed at a rate not toa exceed 100%tof the CitySUns, •ndaeM¢c �4 Gry,5late 00000 - - unpaid balance or the maximum allowed by law, k t0,t t ttt iL»,antt ua d ast r,t+nu 2,-Each-retumed-check.is-subjeet_to a-service_charge.subject to the maximum check return charge allowable in your State- 3. All bottle and equipment deposits u.mnu a Ywo03 r� ¢ pay electronically Po are shown as CU ry T mPh ACTIVITY CURRENT Activity 4, Equipment replacement costs'will be charged for bottles lost ,.4.»4aa•m d — since your ACCOUNracnvnY . �a� PP am»,.a.Pte» v -Make sure this— -- stolen,damaged or not returned, tt, S.In accordance last invoice as been with NWNA's Terms and Conditions("T&C", DN�raddau >ah^Doe•1z3Ma'"soeel.an.s,•,e 000ao amount h Equipment Lease and/or Service Agreement acco )your Pe oP.a wove i paid in full to ant may be oen, 46,890 Pa ment-Tha Y. subject to minimum monthl m 3,7895,4444 'S SGallonNamrol$pdngWate, ,x.,x avoid late fees Monthly purchases and/or early cancellation V. fees.(AcompleteversionofthecurrentT&C may be n, 317BBs,4444 s Bella^wnswio.Poa, F _ ___ Y viewed on the 011 3,78 9 514 4 4 4 s ,ceMPPnroi^sw,ne,Pn, 1o<fo< Monthly website listed below U o9nz 3,83638811 welsPnhare• y Oil Leased Equipment is)chargedshrough the end ofion -nt for he billing cycle "2 "x°099 Ren, C "N U a i `i t} Surcharge,Fuel in which service is discontinued, ro a ;`'tr=":^``' 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Surcharge or Delivery Delivery Fee as described in your T&C. Only one of these fees _ Fee(see#6 under win apply to each account. P^ — "' is stated on t The fee that applies to Payment stub ACCOUNT SUMMARY Y9E14oP:P4wla_. wow,om+wrcPP9,„TArnYDY — Information') he front of the invoice.For Your account "" PSA°^" General visit the website listed further info �»�^_••••w^P."' --- -- _ °• ^^" "5. ma'on' Tomer please -'--"----'-- below or contact `bbei4'•m"•A"'�'•P"��' ACCOUNTNUMBER PAY 9Y PAYTNIS AMOUNT center our customer service 1234567890 DD DD ,ENCLOSED 7.As a food product, bottled water is subject to the rules and INVOICENUMBER BIW10NG DATE regulations promulgated by the Federal Food and Drug 12MS67890 oo7ovoo Administration(FDA). 042009630"7 042827126b9 000391049 2004 18 8.Your first invoice indicates the products delivered on your first Amount due delivery,along with an �c1MMOO11 T11NWA COMPANY t^hn 0ce I emPtion fees,and Y applicable bottle and account deposits, anmu W m A�uA w4 123W s1 spenser charges. ture invoices ill effect charges fora waterSubmitand dispenlsfr oral bottle o cry,s,a,e Go" deposits and credits plus charges for any additions[ productsa"tt 6o»t4r,taa a wBcusTDMEnsERWauu+ero+n.9se8 Submit your ❑P <A ryCM 9 D R m•d payment by this ordered b ❑SGNUP DR P EAUR PA 9nUP9 re^D"M�S°° date Y you. Deliveries are made every three or four weeks,for - ---.„,..,._� a total of 16-17 deliveries per year.You will only receive invoices l2 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.corn Form No.NW 7pg py14 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ PO Box 856680 Louisville, KY 40258 $34.59 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 104KO121776199 I 42-390.99 I $34.59 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, December 15, 2014 r Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 12/03/14 04KO121776199 $34.59 hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer service.icemountainwater.com p ' #215 6661 DIXIE HWY,SUITE 4 11/01/14- 11/30/14 04K0121975593 LOUISVILLE KY 40258 ADDRESS,SERVICE REQUESTEDlimp 111111 IIIIIIIII1111111111111111111111111 N 0121975593 FRIAN 09 TUE- FEB 10 Access your delivery calendar at THU- MAR 12 service.icemountainwater.com CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Did you forget about us? Kindly pay upon receipt. SUITE 220 Remember,past due accounts are subject to a late fee. CARMEL IN 46032-1938 Your prompt payment is appreciated. For your convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Bring In the�Hol day hS,eason with sSparkling Celebratlans!Enjoy premium brands includtng:San PellegrmQi Pe ler and1%% qu ,Panna Look for special holiday saylr>Igs going,on-from now until the end of the year Call, _,_— 1:-:SQD-47�2._9�8$�ritisit�etyice a�mouratatnwaZer cQ.�j to orders `9 c wae,".,.. ., •-, rte.-. ;, '°.� 5�- . ,,,, - 9 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 52.07 11/05 0909565988 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 11/30 0914466974 1 OIUFUEL SURCHARGE 3.08 K7572753 RENT 10.99 TOTAL 82.12 I ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 52.07 — 0.00 + 30.05 = 82.12 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-q WAYS TO A REPORT ON WATER QUALITY AND INFORMATION,PLEASE �'I'P US SERVE YOU BETTER CALL 1-800-472- 1.Please remember payment is due by the-pay 9888 OR WRITE US AT; p Y by"date noted to ensure the smoothest service. ICE MOUNTAIN SP 2• Remember,if YOU are renting equipment 6661 RING WATER CO. your first invoice will include prated fee for the current month,plus the next month's rental. Y quipment rental is charged one month in advance.That means #216661 DIXIE ffWE,Ky SUITE 4 3. Kindly fill in the amount enclosed include LOUISVILLE,KY 40258 If you prefer,you can a your account number on Pay your bill online at service,icemo_untainwater.com . 4. Never hesitate to call us your check, and do not send cash. Ifyou ran think your bill is wrong or ifyou need more information about a transaction.on with comments,questions,or concerns, your bill;write us on a separate sheet ofpaper.We must hear from you in wilting no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can I us,but doing so will not preserve your ri giveusthefollowinginformation: Phts•InYour lett er' SAMPLE 1N • Your name,address,telephone and account numbers. 'INVOICE • The dollar amount of the suspected error. • Describe the error Date range of this invoice 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 as delinquent or take any investigation,we cannot report your account y action to collect the amount in a 0010010°-00f Niao 121as67e90 GENE question. Your Account Number 1.Payments�AL ved GENERAL the billing • ` Your next invoice-past due invoices�OICE)date will a e 1NR-OCT Ba 123456789 pp ar on Important MON-OCT 19 billing date)may (not paid within 30 YfD NOV 21 Watch here for a y be assessed a late fee as allowed by law not to news and TUE-°e le exceed S20 per month.Additional), tttl.:;in�liii ntn«tWi U[n Rluat iLidtl. Customer Sella:1.800-/R-9888 personalized account Y third Party collection/attomey offers tan^toe Th ky"I,?sln9l"M°uNalnProd message expenses play be assessed at a rate not to exceed t00%of the unpaid balance or the maximum allowed by law. 23 Mann so Gq 6ta[ 00000 and sellar. " i.Ja i J Ut e:il..,d1 IbAO-.1,•4ttt d a _ 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 �navxrom��� ENSN..�ewraR Pay electronically ACTIVITY, 'c*°—oa°re ny "w ,"a— 4. Equipment Activity 1 q pment replacement costs will be charged for bottles lost, since Your .°6.,:vaeea 6a stolen,damaged or not re accourrrarnvm ° w« °<� � �- >a Make sure this 5,In accordance with N turned. last invoice Rr WNA's Terms and Conditions("T&C", DeO eryAddre 7ohnDce.i]3Main5 ett GrySrote OOOOO amount has been Equipment Lease and/or Service Agreement account may be flp d Ball" ] paid in full to subject to minimum month) 6831 461898 9aymenoIDankY y purchases and/or earl m nTeas144a 5 SWIbAN—'IsOn9k'°[N avoid late fees fees.(A complete version of the current T&C may be viewed onthe n 3veasl4w4 s kaMwn ons Gal°e96u[ website listed below)Upon service discontinuation,rent for the o9+n 3neesla4e ' ImMw°alnsGalne[°m _ i °�"� B9nr 3362638811 1 w�eiwrrnay p?t i t l f it r >a�oc Monthly 0i1 Leased Equipment is charged Through the end of the'billing c 12 1664oa9r !t in which service is discontinued, s Surcharge,Fuel g Ycle TOGV. ' =!_' 'r� ,ctioc i 6.You will be charged a monthlyOil S Surcharge or Delivery DeliveryFee Surcharge,Fuel Surcharge or Fee(see a under each described. your T&C. Only one of these fees will apply to each account. payment stub The fee that aSUM ,emouse6[6Na va]Maniaorv6nau,3 cuaeENrarnnrr _ armisarnoura is stated on the front of the applies to your account AccouNr MAaY — + — oco era) invoice.Forte visit the website listed below further informationplease "°.a•.°'°° "°'°'—°'<a°"<..°°.ru.— — ems Information') 6 or contactcustomer ----------- --- ------------------------------------ center. our oxvn 8°+mbmerzaun MrA your P>i>nm' ACCOUNTNUMBER PAY BY PAYTNIS AMOUNT service 123456]890 OHIO 7, As a food product, bottled water is subject to the NPacE NUMBER BfWNG GATE ENCEOSEO regulations promulgated b rules and IZM567690 DO/Woo Administration(FDA). y the Federal Food and Drug 8•Your first invoice indicates the 0420°96307 04262712614 000391049 2a04 la delive products delivered on your first Amount due ry,along with any applicable bottle and account deposits, CE MOUNTAN WATFACOMPAN 123 Main redemption fees,and ° "tlNetl"'""N"" "` otyswe St 00000 any dispenser charges.All future invoices Will reflect charges for water deliveredanddispenserrental,bottle 1:.ma t"pt•,at. ll.t6nat,^6t Yedutt MRCUSrOMASFMCEUlL1$06415.9688 Submit your deposits and credits plus charges for any additional products �"�'�0 ordered by you. Deliveries are made eve (]s4NuvroemEaonn:ye,nwlaaRM�ve< payment by this a total of 16-17 deliveries per n three or four weeks,for __._._ .a. :, date 12 times P Year.You will only receive invoices __ __ Per year,so approximately 5 of those invoices will reflect I two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Q service.icemountainwater.com o Inc. 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 Df ted Purchase Order No. 0, �g 95 b b D O Terms iA15 ����� ► o ��-S "' �O6 �o Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 2-3-� Koiz Ingo ° Total . OS 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 � Ce AttA+a) reed IN SUM OF $ l' D Box 954696 1 rigJ5 01 L, ICY 4 02856( 6 $ 30ob5 ON ACCOUNT OF APPROPRIATION FOR 1901 / / 50106 Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), 93 5 " .oS 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 12-/5-201 Si 6iure Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com ' ®t! E ' #215 6661 DIXIE HWY,SUITE 4 11/01/14- 11/30/14 04K0120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II'I II I I'I l I I'I'lI II'I I I l l I II' I 'll WED JAN 07 0120048525 FRI- FEB 06 TUE- MAR 10 Access your delivery calendar at WED- APR 08 service.icemountainwater.com 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 22-00 Remember,past due accounts are subject to a late fee.. CARMEL IN 46032-2584 o+v,, Your prompt payment is appreciated. For your ""II'IrI��'lll' 'lll��"""I.IIIIIII�II'lll'�II�II�II��II�'ll rr,�NC. convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Bring inn the H tl Y SeasonwithSparklm�'Celebrations! Enjoy premium brands including San Pellegrino, Perrier a_nd�Acqua` ,anna*look for speciial holiday savings Ooing'on from now,untiCtlie end of the year Call �— T Q 4, � e Jo"A' f �E ACCOUNT ACTIVITY. For questions or a report on water quality and information,call 1.800-472-9888 or visit service.icemountainwater.com. !9 s s 9 ® e 6 Delivery address: CITY OF CARMEL,1 CIVIC SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 20.64 11/03 0909236804 2 5 GAL ICE MOUNTAIN DRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN . $� ®a'� .00 11/30 K7510635 RENT �N 6 �,�� 3.99 TOTAL �1 �� 31.61 0 2014 v pE �, � CACtME� � ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 20.64 — 0.00 + 10.97 = 31.61 BILLING RIGHTS SUMMARY INCASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 1• Please remember payment is due b the" CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,if you are renting Y pay by"date noted to ensure the smoothest service. equipment,your equipment rental is charged one month in advance.That means ICE MOUNTAIN SPRING WATER CO. Your first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 3. Kindly fill in the amount enclose include 6661 DIXIE HWY,SUITE 4 If you prefer,you can a d Your account-number on your check, and do not send cash. LOUISVILLE,KY 40258 pay Your bill online at service.icemountainwater.com If an think 4. Never hesitate to cal]us with comments,questions,or concerns. Y your bill is wrong,or if you need more information about a transaction on 91 write us on separate sheet ofpaper.We must hear from you in writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared,you can telephone us but doing so will not preserve your rights.In your letter, give us the following information: SAMPLE INVOICE • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. ' 00/00/00.00IODJ00 1234567890 i GENERAL INFO ! t Your Account Number 1.Pa RMATION T1+n-Dcr oa 723456789 i Payments received after the billing(INVOICE)date will appear on Important Your next invoice.Past due invoices(not p Mwboc z9 billing date)may be assessed a late fee as allowed by law not to wmNov2, Watch here for a (o aid within 30 days of news and TDE-DEC,4 exceed$20 per month.Additionally, ILtJr;")Ig[11 11111-'JIVGl IUI Ii111nU�dtel,ld' a:minerse�wua.eoo-ax-9888 personalized account expenses may be assessed at a to noa� exceed]008/0 of the offers 123Maie Thenky°ufarualgf°eM9unWnpodu f message t ty Main St aM 4e1 , unpaid balance or the maximum allowed by law. G y.snm 00000 1.,aLl f a6 li dl.,,lt+.n! LLLI I„a 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in ch State. r }'r` ary� p z�avma�� eary •�°*•” -- { Pay electronically 3. All bottle and equipment deposits are shown as CURRENT a0N a�T p � ACTIVITY. Cul a&x�Nl'm`mB�^aYF �*'m m�A i Activity 4. Equipment replacement costs will be charged for bottles lost, Since your "°'g" a Make sure this stolen,damaged or not reaccouNrarnvm m' 0p4 5.In accordance with NWNA Tams and Conditions("T&C" last invoice amount has been Delivery addrezr.John Doe,173 Main SureE Gry.5We 00W0 Equipment Lease ) Your P ,oeoBalana x a paid in full to and/or Service Agreement account may be °�" dfi1896 PaY,n Jta°aY°° � � avoid late fees subject to minimum monthly purchases and/or early cancellation m 3neas14a4 5 Io,aa°n Nai,56pnnn Water fees.(A complete version of the current T&C may be viewed on the n' "10fl51H01 s e"'°WosQlcep�n � celll 31TBBsiKH s N MOun+aln3l'u1R I website listed below)Upon service discontinuation,rent for the o9nx 3+ez6 a4n Rensu w 9= y aaa`,'0a` Monthly OII 0911 1661019) Pent {i(}v' . 1�,...1 i;*y Leased Equipment is charged through the end of the billing cycle - Surcharge,Fuel in which service is discontinued. t o t r,: B 4 1O'A` r - = � Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge, _e or Fee(see#6 under Delivery Fee as described in your T&C, Only one of hesegfees11 General will a campus palAna_aA.MurtamuaaMun i,a _ r PA Tr+r1AMOUNr PPIY to each account. Payment stub peC — °° The fee that applies to accouNr SUMMARY ,a,ot �,��,„°„,� ; is stated on the FP Your account Information") front of the invoice.For -'---- visit the website listed further information ------------------------ n ----oepN pY rtu6eMrtwm�.e�)�°'Y"'^'+ PAY BY PAY 11115 AMOUNT t below or contact our customer service ACCOUNT NUMBER center. 1234561e90 000000 ENCLOSED 7.As a food product, bottled water is subject to the rules andrug INVOICE 567890 00/00/00 NUMBER BIWNODATE i 1234 regulations promulgated by the Federal Food and D Administration(FDA). 0420096307 04242712619 000391049 200V 19 8.Your first invoice indicates the products delivered on your first Amount due delivery, ICE MOUNTAIN WATER COMPANY John Doe along with any applicable bottle and account deposits, n wdNMlWm NPU.Unita IM 123 Main St redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental,bottle Gq,swte,00000 deposits and credits ]us ch I,N,�,.aeN-.n.p,0 ta.,h„LLtt,�:n fO0.CU5 0ME0.5FAV CEGUL 6 80 0 111-98 0 8 Submit your ❑P ttA Moa 9 0 a nuSde Payment by this ordered b P charges for any additional products ❑9cNwwB ttEw pPAnv9°uPB w 4o x u a date Y You. Deliveries are made every three or four weeks,for ____ ._--• ---_.____.__. --- a total of 16-17 deliveries per year.You will only receive invoices t --� —” 12 times per year,so approximately 5 two deliveries. of those invoices will reflect ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service.icemountainwater,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 12/3/2014 04K0120048525 water cooler $ 10.97 Total $ 10.97 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. Ice Mountain :. ALLOWED 20 POB 856680 IN SUM OF$ Louisville, KY 40285-6680 $ 10.97 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or DEPT# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or 0 041<01200485 2200-4239099 $ 10.97 bills) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and (received except I 12/15/2014 Sig ature City Engineer i Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.1cemountainwater.commallp �" Igkyg'WON #215 6661 DIXIE HWY,SUITE 4 LOUISVILLE KY 40258 11/01/14-11/30/14 .14K0117821082 ADDRESS SERVICE REQUESTED IIIIIIIIIII11111111111111111111111 M 0117821082 FRIAN 16 WED- FEB 18 Access your delivery calendar at THU- MAR 19 service.icemountainwater.com Customer Service: 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 �Illillrin���'ll"I"II�IIII'IIIII�I�L1"�nllll�llllll�lll�l„ convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Bring in the Holiday Season with Sparkllrig Celebratlonsl Enjoy premium brands Including San Pellegrino' Perrier antl A'- Panna Look for'specibi holiday savings going on from now until the end of the year Cali BC Q Z2 9888 or�is�iLservtc�.tc+�rnourifa n-WA><e`r o►ili to oraiert — a r W J. �OVAU'A'lw 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 STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 61.35 11/12 0910486729 10 5 GAL ICE MOUNTAIN DIRK W/HANDLE 34.90 10 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 60.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 10 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -60.00 11/30 0914437579 1 OIL/FUEL SURCHARGE 3.08 K7497787 RENT 2.99 TOTAL 105.61 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 61.35 — 0.00 + 44.26 = 105.61 BILLING RIGHTS SUMMARY A EPOASE T ERRORS OR QUESTIONS ABOUTYOUR BILL,OR FOR YOUR INVOICE-4 WAY'S TO A REPORT ON WATER QUALITY AND INFO 1, Please remember payment is due b the"Pay p 'S SERVE y0U BETTER CALL 1-800-472-9g88 OR WRITE US AN RMATION,PLEASE Y y date noted to ensure the smoothest service. 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means ICE MOUNTAIN SPRING WATER CO, Your first invoice Will include a pro-rated fee for the current month,plus the next month's rental. aI2I6 6661 DIXIE ,K -,SUITE 4 3. Kindly fill in the amount enclosed, include your account number on your cher LOUISVILLE,KY 40258 If You prefer,you can pay your bill online at service.icemonntainwater.com k and do not send cash. Ifyou think your bill is wrongor if you need more information about 4. Never hesitate to call us with comments,questions,or concerns. , a transaction On-your-bill,write us bn a'separate sheet ofpaper.We must hear from you in writing no later than thirty(30)days after we sent you the first bill On which the error or problem appeared.you can telephone us,but doing so will not preserve your riYour lSAMP ghts,In etter, e 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 explai an error n ifyou 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 any action to collect the amount inyquestion.ant ' ooroo/oo•oaooloo 1234s67e90 your Account Number GENERAL FOIMMENMEMN RMATIONF 12345678 1.Payments received after the billingTNR-oc o4 Your next invoice, (INVOICE)date will appear on Important MOwOCT 29 Past due invoices(not paid within 30 da s of wEUNov2 billing date)may be assessed a]ate fee as allowed by law of o news and W,-OECte Watch here for a exceed date) may$20 per b rise sed alute fie !t!d^iG qt 18V t!"tJ11`�dt t"'1811^tt;utaap cn�mtt$eMu,4pp,n-per personalized account expenses may be assessed ata partycollection/attorne _°hers t•h�o ,u,^k,nt„n m9 meM"n^wnpn6•m �Inessage 123 M.1-s1 aneae,.Nea. y��� — --Ory,St t 00000 unpaid balance or the maximum rate noted bt laexceed 100%of the 1.ap;4 a n R;ivana G t r,aGti -- 2.Each returned check is subject toalloa service charge subject to the maximum check return charge allowable in your State. 3. All bottle and equipment deposits are shown as CURRENT ttn1tMa—"—'�yj'P`e^meg pay electronically ACTIVITY n9"nw •t n uhn�r Activity 4. Equipment replacement costs will be charged for bottles lost, since your mom. w••wm dam �° Make sure this stolen,damages]or not return AccouNrnc3,vltY . 5.In accordance with last invoice Equipment L NWNA'sTermsandConditions(' &C DeINery0.ddmcJOhnO^e123MainSreetary•Sate000OJ amount has been ease and/or Service u )'yOW Pm pu BaI•^Ce paid.in full to Agreement account OB + 461B9B Prymmt-Tha^kYou °s avoid late fees subject to minimum monthsPurchases may be 3„aa5,,,,a 5 SWIImNawral5pdngWaer woa fees.(A complete version ofthe current T&C may be viewed cancelontion 3vees,aaa s ,teM�n amsGalOepo� -`, oua 03/11 31788314444 5 lu M"unlainBG IR website listed below U 09n 110M3.11 eeesnau9e 7 l 1# aY Monthly Oil upon service discontinuation,rent for the 03” 16fia009 R"t {�-''`' a e Leased Equipment is charged through the end of the billing cycle Surcharge,Fuel in which service is discontinued. O A` Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Delivery Fee as described in your TSur Only one of these fees Fee(see#6 under will apply to each account is stated on the The fee that applies to our payment stub AccouNrsuMMARr Informah front of The invoice y account ” �n em t "General visit the website listed e.For further information "'"""°'°°°”'°'°^° E- .•o�---- ----- - { a below or contact our c please ----o mp a•P ^ ACCOUNT NUMBER PAY BY PAY TNI3 AMOUNT center, customer service 23456]890 000080 7.AS 8 fOOd INVOICE NUMBER BIWNG GATE EN[LOSEO product, bottled water is subject to the rules and 1234567890 00100100 regulations promulgated by the Federal Food and Drug Administration(FDA). o9eoa963a7 ovaaanas>9 a0a39 ov9 aaav as 8.Your first invoice indicates the products delivered on your first Amount due delivery,along with any applicable bottle and account deposits, ICE roh^� redemption fes,and,anpMJ°n elabtlEW.b.Nnp�M>sk.6r, 123 Main St will reflect ch y dispenser charges.All future invoices a ys are 00000 charges for water delivered and dispenser rental,bottle lwa{a.J N ,g.,.at:aiw+a«l ul c'a„e concusroMERSEmrcEuu,eoo+n.9BBe Submit your deposits and credits plus charges for any additional products � ""pppEAnOP""sgnOnP°"dOnPN `A" � Payment by this ordered b date y you. Deliveries are made every a total of per year, deliveries per year.You wi will ly re e'ive n oices weeks,for - 12 times per yea, 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 02/14 i VOUCHER NO. WARRANT NO. Ice Mountain ALLOWED 20 IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 $44.26 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 14KO117821082 42-389.00 $44.26 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 ua"Thursd' 014 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)) 12/03/14 14KO117821082 $44.26 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 4 11!01/14- 11/30/14 04K0121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIK---- PCE FRI- DEC 0121202766 FRI- JAN 23 TUE- FEB 24 Access your delivery calendar at ' WED- MAR 25 service.icemountainwater.com CITY OF CARMEL PARKS DEPARTMENT DEC -8 2014 Customer Service: 1-800-472-9888 MANDY SPADY Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST BY: Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 Your prompt payment is appreciated. For your I'll'IIII'IIII'I'IIII'IIII'II'll'IIIIIII'II'IIIIIIIIIIIIIIIIII'I' convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. — - ,�, ,. �,�.�,�,,.;.,��r Fav �"s�� 'r,srw �. .x,`& - `. 3. Briicln theHdldaySeasawtthSparkingCQelebrattons Enjoy premtuin brands tnclutling San Pellegrino, Petrter andAcgaParria Lrodkfior special holltlay saungs;going on°ffrom now iinttl the end of the year. Call dd7 9RftR r�wSilfnSRW. err Qm�rintalpwater cnm tnt4�derl _- — — - -- ACCOUNT ACTIVITY For questions.or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 19.40 11/18 0911651883 10 5 GAL ICE MOUNTAIN DRK W/HANDLE 42.90 BOTTLE DEPOSIT: 10 CHARGED, 18 CREDITED 48.00 11!30 0914456587 1 OIUFUEL SURCHARGE 3.08 K7611566 RENT P 5.99 t!rchase TOTAL 23.37 P.O. PorF I• 35��1 �iJ F"ud-et i_i le reser Purchaser Date— ACCOUNT SUMMARY PREVIOUS BALANCE_ PAYMENT/ADJUSTMENT CURRENT ACTIVITY —PAY THIS AMOUNT �_ Subject to terms on reverse side. 19.40 0.00 + 3.97 23.37 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO •• A REPORT ON WATER QUALITY AND�O HELP US SERVE YOU BETTER CALL 1-800-472-9888 OR WRITE US AT: RMATION,PLEASE 1 Please remember payment is due by the"pay by"date noted to ensure the smoothest service. RING NATER CO, 2 your fiRemerster if you are invo ce w II include equipment, prp ated f e forour thecurrent month,plment rental is usethe next montIt h s advance.That means ICE MOUNTAIN SP tl216 666]DIXIE HW.,SUITE 4 3 Kindly fill n the amount enclosed include your account number on your cher rental, LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.icemountainwater.com k and do not send cash. If you think 4. Never hesitate to call us with comments, u Your bill is wrong,a Ifyou need more information about 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, give us the following information: SAMPLE INVOICE_ Your name,address,telephone and account numbers. • The dollar amount of the suspected error. Date range of this invoice • Describe the error and explain an error. Ifyou can,why you believe[here is You are obligated to pay the parts ofyobill that are not in question. You do not have to pay the m disputed amount while it is being investigated.During the investigation,we cannot report our x.,.rTsa 7!89D i as delinquent or take any action to collect the amount in question. account 00/00100.00/00 00 123466789D 'questionYour Account Number GENERAL INFO . RMATION 1•Payments received after the billing(INVOICE)date will appear on Impo[tant TD =0crW 72345b789 Your next invoice,Past due invoices ❑ MO9 OCi M billing (not paid within 30 days of Y"o-�21 ! Watch here for a g date)may be assessed a late fee as allowed by law of to news and TM-DEC la exceed$20.permon[h.Additionally,thirdxon7123 tdildWllibtltl4.;JtIu(fdldAtl' CusmmuServarLBOOi719888 personalized account offers ThankyouforusingleMounninproduN message e 6e assessed at c'r`atee not P c`eed C100°700 e—— St in sc ,d rcmw. 9 ary,s,, 00000 unpaid balance or the maximum allowed by law, i_m u a pt"`n It ru to t Gtit.ua.n; 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in our �0 .w °a°—="•"ri` "sa "- 3. All bottle and equipment deposits are shown aseCURgENT �Y m� Pay electronically ACTIVITY. " m ta a ar�wRea a A� Kn Activity s 4. Equipment replacement costs will be charged for bottles lost, sPa,Am d stolen,damaged or not re since your Make sure this oda ACCOUNT ACTMTY a dua +seu'"¢`Aa'"°""w""°°' rc,ma+ 5.In accordance with fumed. last invoiee NWNA's Terms and Conditions D6N,jAdd—3eh,DM 113M•tnsveet Cus—owm amount has been Equipment Lease and/or Service Agreement your pmnane 1— o o + paid in full to es subject to minimum month) greement account may be avoid late fees /11 3178851gM4 5 SGaAon Natural5pdn9 Waur y% fees.(A complete version of the current T&C may be viewed cancellation on the t i /11 317885,44N 5 Ke Mauntaln3 WlOeposn _ W/1 31)13 11 s Ke M.m.tai.swin.mm f. > Monthly Oil website listed below)Upon service discontinuation,rent for We 09n1 3,81638811 its�9e fr , r4 -gf ; Leased Equipment is charged through the end of the billing cycle 197 f Surcharge,Fuel J in which service is discontinued. TD"E ` 0 0 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Surcharge or Delivery Delivery Fee as described in o — f Fee'(see i{6 under Your T&C. Only one of these fees Will apply to each account. Payment stub "0N0°:"" —PpeMN + _ is stated on the The fee that a cuRw,rArnPm PAYTnuAMnurn• "Gen e front of the invoice.For applies to your account ACCOUNT SUMMARY ... Information,) laxx � ! es visit thefiutherinfo ....,>....._.._.,•....�..---- n � � information please `---`------- / website listed below or contact our customer service ACCOUNT NUMBER 6Y PAYr USAMOUNT center. ono 11305678900 00 7.As a food product,.bottled water is subject to the roles and NvolcE NUMBERG DATE ENCLOSEDregulations promulgated by theFederal Food and Drug o/ooAdministration(FDA). 0420096307 o42a00039ID49 2004 1R8.YourFust invoice indicates the products delivered�on our Amount due delivery along with any applicable bottle and account deposiLst I,MoUNA1NWATERCOM111 roredemption fees,and any dispenser charges.All future i❑voicesp a•.NmW,�N mA. 1will reflect charaoaggges for water delivered and dispenser rental,bottle RSFRVRCALL,ROW71"PBRB Submit your deposits and credits plus charges for any additional products Payment by this ordered b reaa�R•�+• t date veries are made e a total of 16-17 deliveries per year.YoverY three or four weeks u will only receive invoices for 12 times per year,so approximately 5 of two deliveries. those invoices will reflect 2008 Ice Mountain Spring Water Company,a Division Ot Nestle Waters North America Inc. Q service.icemountainwater.com o---- Form No.NW 709 02(14 Q service:icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 11/01/14-11/30/14 04K0120095351 LOUISVILLE KY 40258 I FAR ADDRESS SERVICE REQUESTED IIIIII III FRI- DEC 19 0120095351 II IIII II II I I HIM 11111111FRI- JAN 23 TUE FEB 24 Access your delivery calendar at WED- MAR 25 service.icemountainwater.com YXT CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA DEC 2014 Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 BY- Your prompt payment is appreciated. For your "III'I"IIIIIIII'I�I'Illll��lll���l��ll�l��ll'�III�I�IIII�'ll'I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Bring IntheHo11d�aySeasonwlth SparkllnCelebratlor►st Enjoy premium brands_mcluding San°Pellegrino, Perrier and Ac ua Panna Look for special holiday savings going on from now until the�entl ofI a year Call q n �. _ 0-47 9888 o", istt;sett rite Icemountainwater com to orders -fit 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 12.55 11/18 0911651867 9 5 GAL ICE MOUNTAIN DIRK W/HANDLE 38.61 BOTTLE DEPOSIT: 9 CHARGED, 9 CREDITED .00 3.08 11/30 0914452156 1 OILIFUEL SURCHARGE' Description UN- WUTEIC MO 11.98 K7526406 RENT TOTAL P.O.. # tPoorr F 66.22 . � � t,a:1c?at !Jt-le Dp3cr "'urchaser Date r rcval_tQt� Da'a I ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 12.55 — 0.00 + 53.67 = 66.22 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE CALL 1-800-472.9888 OR WRITE US AT: 1• Please remember payment is due by hC"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.That means #ZI6 ICE MOUNTAIN SPRING WATER CO. Your first invoice will include a pro-rated fee for the current month,plus the next month's rental. O DIXIE HWY.,SUITE 4 3• Kindly fill in the amount enclosed include our account number on our check, and LOUISVILLE,KY 40258 If you prefer,you can pay your bill online at service.ieemountainwater.com 4. Never hesitate to call us with comments,questions,or concerns. do not send cash. Ifyou think your bill is wrong,or if you need more information about a transaction on your,bill write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, C give us the following information: SAMPLE INVOICE • Your name,address,telephone The and account numbers, Describe • ribe amount of the suspected error. Date range of this Invoice an error, the error and explain ifyou 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 investigated.Duringp amount while it is being the investigation,co we cannot report your account as delinquent or take any action to collect the amount in question. ' Doroo/oo•ooroaoD 1234567890 GENERAL INFO n— parr- rmnr Your Account Number I.Pa RMA TION TMP.00T od 12345679 Payment received after the billing(INVOICE)date will appear on Important MO OCT 29 Your next invoice.Past due invoices(not paid within 30 days of billingNED-0 Zl Watch here for a date}may be assessed a]ate feet allowed by law not to news and me-DE<,B j exceed$20 14f1tinUl IIIA lo�lilll aIL"ltltl•tt.�tl,ldli CustomerSeMa:1.900172-9896 personalized account per month.Additionally,third art offers attomey 123M.41 T,k�uta,u,nykaM9untalnPm4 message xpanses-may be assessed at a-rate-not to exceed.100%of"the--------____- _ 1zBMaw41 .na:amaaa. Gry,Stat 00000 ;.. unpaid balance or the maximum allowed by law, I:tph t m'u„it;awEu 1 1Et I,J a 2.Each re turned,check is subject to a service charge subject to he - maximum check return charge allowable in your State. eP Aa v om.maget«aaame t +lar« m.smwbipm;on. irow omPre 3. All bottle and equipment deposits are shown uMtcm a1 mm.ou a tlu kww. Bu Pay electronically ACTIVITY, as CURRENT aawa:•aer o °^ '"`rata .w� ^"e Activity ? 4.Equipment replacement costs will be char since your ACCOUNT b° �«n a "°° Make sure this stolen,damaged or not returned. Ted for bottles lost, °�°"" ` I last invoice amount has been 5.In accordance with N WNA's Terms and Conditions( our Deinenaaam:,<>onn DRe.121 Mom so-eet.Cm.state a0000 Equipment Lease and/or Service Agreement account may be PredGu°B 1l «x.' i paid in full to 08,3, 49,899 =ry ,-ThankYRu .p, avoid late fees subject to minimum monthsandn, 317asla 5 SGaMnNa nl$pring Water fees.(A complete version of he current T&C may be vieor early wed lontthe "' 31�141A s ke MounNm sGamaP9an _ axx 0991 3t7985141I4 5 ke MounralnS Gal Retum i ion website listed below)Upon service discontinuation,rent for the mn2 81829388,1 rRawmwye Monthly Oil Leased Equipment is charged through the end of the billing cycle i Surcharge,Fuel in which service is discontinued, ` s Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or y ._ Delivery Fee as described in your T&C. Only one of these fees Fee(see#6 under will apply to each account Payment stub - AT vaenousawNa_vpMwnAPrv9Mnn.}ma9Danan9lr • The fee that a ACcourrr suMMaar ,� >� E ,MIaAM00N7 I 'Genrenrah Is stated on the front of the invoice PPhes.to.your account. _sm aeun a _ information') visit the website listed oice.Forftrrther_information •a---°---- ..M� please ---------------------------- center, below or contact Pum�'�o4 o m� ACCOUNTNUMBER PAY BY PAYTHISAMOUNT our customer service 0u 00 00 "0 111a N 890 ,ENCLOSED 7.Asa food product, bowled water is subject to the rules and NvaCE 679890 BILLING regulations promulgated by the Federal Food and Drug 1z11s97990 o0�00100 I Administration(FDA), 0420096307 04282712614 DOU391049 2004 18 8.Your first invoice indicates the products delivered on your first Amount due delivery,aloe CEMOUNraNWATERCOMPANY Jahn Doe g with any applicable bottle and account deposits, a te ^ ^""" 123 Main St redemption fees,and any dispenser chtureinvoices ary,uale 9G000 will reflect charges for water delivered and dispenser rental bottle j Submit Your deposits and credits plus charges for any additional products t^:l°4"t ui,a(�aL.aluEa G..hLLI t»n FO0.CUSTOMER 50MCEW 1a0oJRA88B C3 sGNVPEORRN Ew�Ans9 0PB o ��RM�a H. ❑o�tH O 9 O P �. payment by this ordered by you. Deliveries are made every three or four weeks,for date a total of per 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. Sr service.icemountainwater.com . Form No.NW 709 02/94 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 12/3/14 4KO121202766 Drinking water&cooler- MCC $ 3.97 12/3/14 4KO120095351 Drinking water Maintenance Dept. _ $ 53.67 Total $ 51.64 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 Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 57.64 ON ACCOUNT OF APPROPRIATION FOR 101 Genera!fund/109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 (14KO121202766 4350900 $ 3.97 1 hereby certify that the attached invoice(s), or 1125 4K0120095351 4350900 $ 53.67 I 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 I 11-Dec 2014 j Signature $ 57.64 ; Accounts Payable Coordinator Cost distribution ledger classification if Title 1 claim paid motor vehicle highway fund I I�