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189834 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $195.06 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 8566BO CHECK NUMBER: 189834 LOUISVILLE KY 40285 -8880 CHECK DATE: 9/14/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4350900 00HO12009535 98.08 00HO120095351 1091 4350900 00HO12120276 47.27 00HO12120276 1205 4239099 00HO12177619 33.97 00HO121776199 1701 4239099 0OH722032704 15.74 0OH7220327048 e 941171TA "�A service.icemountainwater.COm 0 D 215 6661 DIXIE HWY, SUITE 4 08/01/10 08/31/10 0OH7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED LL 10101 e SET 24 7220327048 MO N- OCT 25 TUE- NOV 23 MON- DEC 27 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1 -800- 472 -9888 ANN DAVIS Thank you for choosing Ice Mountain Home Office 1 CIVIC SQ Delivery! We value your business. CARMEL IN 46032 -2584 Illllll 'lllllll'lllllll'I'lllll 'III "II'I��IIIIIIIIIIIII "I'I' t)rd�er Arizona Beverages by take delivery byv9130f;1;0 to be entered Intotl e "Getaviray' Sweeps f a� chance,to, win great prizes +.No Purchase_Necessary.:lnds 8131110 LIrniti30 entries /personlrr►onth ,Official' V"- ales at servrceicemo n tal wat er omVold wherehibite T. d p.^ ACCOUNT ACTIVITY ay your bill online at: service.icemoun amwa er.com or y p one a s ree. PREVIOUS BALANCE 25.58 8/08 384807 PAYMENT -THANK YOU -12.79 8/31 502897 PAYMENT -THANK YOU -12.79 8/2.5 0687150201 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 3.49 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 8/31 0688984095 1 OIL/FUEL SURCHARGE 2.28 H9631854 RENT 3.99 TOTAL 15.74 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 25.58 25.58 15.74 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER W CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2 Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 -600- 472 -9988 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer, you can pay your bill online at service. ice mountain.com, 6661 DIXIE HWY., SUITE 4 r LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. 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 SAMPLE INVOICE telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. 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. lzTaseraeo Your Account Number You do not have to pay the disputed amount while it is being eoroNtno- ootooioo investigated. During the investigation, we cannot report your account lz3 +56789 as delinquent or take any action to collect the amount in question. TNR oLT moN -Del =9 Watch here for a wfr}NOV GENERAL INFORMATION nE of ,a personalized account 1, billing received after the Payments INVOICE date will ap on Important 800 12 Y g pp (►f lmuhnF ,utOd "A1pti11L1i,Nttl�Nt41Jdq c"scomvs�c" mes a e your next invoice. Past due invoices (not paid within 30 days of news and billing date) may be assessed a late fee as allowed by law not to offers izs M.i. 51 exceed $20 per month. Additionally, third party collectionlattomey nrv's`a`a p;,alJ.Ito.u. p I.JR.1'J OA rtt expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. Pav electronically r T°° 9P r3� ,,nm reufO narxYa a` t<"' f1 fro 2. Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ti m aid °J0° z sea amount has been ACTIVITY. since your AccouNUrnvrr v. c S �a,< 'OW paid in full to 4. Equipmem 18St InVU1Ce replacement costs will be charged for bottles lost, oaimery Aaare Do ,zR N. s n� stolen, damaged or not returned. FrMau R e zns avoid late fees Paymre, rTa11F 500" 5. In accordance with NWNA's Terms and Conditions "T &C your mss abre9a scaib "Natwal5 a9w ri, 3i'a°s,aW s ,ce>a "scat pap°rc aza ui ment Lease and/or Service Agreement account may be eRSi s 5G sa Monthly Oil E q P g Y o ni w<t Sn<x o9n r ee°s,w« s subject to minimum monthly purchases and/or early cancellation Rm, zAr°°n L r Su rChar e, FUCI 091�� t 31 P+ fees. A complete version ofthe currentT &C may be viewed on the P Y Surcharge or Delivery website listed below) Upon service discontinuation, rent for the T °TAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle `General in which service is discontinued. 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge m�NSM "a e w Information') a Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY will apply to each account. The fee that applies to your account w eccouNr NUMBER r rRr 57+0 "uOi1"° 0pjp000 MT.fNCEe is stated on the front of the invoice. For further information please ,2,E1C90 °,w., OATE N,IMAER visit the website listed below or contact our customer service 00100100 1 =Tascra9 center. P 0420n963a7 114262712639 llnaa91945 2004 1E 7. As a food p r oduct, bottled water is subject to the rules and Amount due regulations promulgated by the Federal Food and Drug pn" Administration (FDA). ICC..UNruNwATfRComml+ Tz3M alosE o w" c7,x 000QO Submit your 8. Your first invoice indicates the products delivered on your first Ec ru °owrz 9°Ra delivery, along with any applicable bottle and account deposits, pgCpyTO p5r a ment b this �aaa"±pa.,•a• au.tl6nM6 t.�uta6o N,rAa"4.,onaa....a :F,< P Y Y redemption fees, and any dispenser charges. All future invoices date ❑sNN °•a+,wEEau.oana sq will reflect charges for water delivered and dispenser rental, bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16 -17. deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 11108 service. icemountain.com S Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) r 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)) f Total 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. ALLOWED 20 2 ,41 IN SUM OF U Isin iLk- K q 285- 8() I 4 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. n 1 hereby certify that the attached invoice(s), or 03 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except A. q 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund service. icemountainwater.com 19, e 215 6661 DIXIE HWY, SUITE 4 08/01110 08/31/10 00HO120095351 0 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MON- SET 20 0120095351 TUE- OCT 19 WED- NOV 17 MON- DEC 20 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1- 800 472 -9888 AUDREY KOSTRZEWA Thank you for choosing Ice Mountain Home Office 1411 E 116TH ST Delivery! We value your business. CARMEL IN 46032 -3455 �I iill��liilil��l�lllll�liln��llil�lln�llrir�llillllllll�ll W 0►cie rizona erages by 8/31/10 !take delivery by 9/301.10 to be entered lti o tfii Getav►ray "�Svveeps for a chance to vuln ^great prizeslSi�o Purchase NecessaryPEnds 8131!$90: Limlt 30e�ntrleslpersonlmonth Offtcial W'fia i 9 rul'es at service icemountainmiteir.com �Vtild Where prohlbltec� A ti Si rp m a ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1- 800 -472 -9888. It's free! e rvery a ress: e_ 415 02 PREVIOUS BALANCE 135.37 8108 384804 PAYMENT -THANK YOU -88.18 8/31 502894 PAYMENT -THANK YOU -47.19 8/19 0686167313 14 5 GAL ICE MOUNTAIN DRK WIHANDLE 55.86 4 9 OZ PLASTIC UP 50C/SLEEVE 11.96 BOTTLE DEPOSIT: 14 CHARGED, 11 CREDITED \nA 18.00 8/31 0688900158 1 OILIFUEL SURCHARGE 4 2 H9620637 RENT 2 �EC t TOTAPurchase t)RIN I N 67 WKtT�k 6C 98.08 Description —e, e, CO0 L0Y2, N A I Nrt P.O. P 40K G.L..# -I IAA 4' aCQb Bud Lute Descr �j -�1PP' 1 �Yl �1Gcj Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CUR VITY PAY THIS AMOUNT Subject to terms on reverse side. 135.37 135.37 98.08 98.08 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BEf TER IN CASE OF ERRORS OR QUESTIONSABOUT YOUR BILL, OR FOR I. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A RL'PORT ON WATER QUALITY AND INFORmdaiON. PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1- 800 -472 -9988 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6216 6661 DIXIE HWY., SUITE 4 1 f you prefer, you can pay your bill online at service.icemountain,com. LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we sent you the first bill on which the error or problem appeared. You can SAMPLE INVOICE telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. 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 r 00100100 00100100 1134567890 Your Account Number investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. Tap ocr txs +s6�a9 MoNoa z9 Watch here for a wed -aov i� GENERAL INFORMATION personalized account I. Payments received after the billing (INVOICE) date wilt appear on Important r ^�+5e"^�W�ngpO message your next invoice. Past due invoices (not paid within 30 days of news and r ,,,,,E o9m ^9' billing dale) may be assessed a late fee as allowed by law not to offers izi ace s, .,d 1ry g•• exceed $20 per month- Additionally, third party collectionlattorney cft5 0 Xw 1.daa.,l m, Il.ab.tl 611 t„bLL1.J�n expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law, aa x amxaar 6 2�zwa Pay electronically tomN,4ge5'q mrsa.' P �45'mtmu�v^` bw 2. Each returned check is subject to a service charge subject to the maximum check return charge allowable in our State. g Y Make sure this 3 All bottle and equipment deposits are shown as CURRENT Activity M amount has been ACTIVITY since your AreO "c Ttv ry n99 paid in full to dd,ess. lolin WC. 123 Mdn 5 +sect "YS 4. Equipment replacement costs will be charged for bottles lost, last invoice stolen, damaged or not returned. �,�i ^4= s ow avoid late fees 5. In accordance with NWNA's Terms and Conditions T &C our ma "EVE Y Darn 46,s9a swu" ^Nmwasrm ^9 sam i„ rir°as�+aa 5 �4i¢.wsn Monthly Oil Equipment Lease arrWor Service Agreement account may be y m s,�aena s °rs °'m r 1'_( subject to minimum monthly purchases and/or early cancellation a a�, Surcharge, Fuel fees. (A complete versn io ofthe curreutT &C tnay be viewed on the '�4oi9 5740 40 S urcharge or Delivery website listed below) Upon service discontinuation, rent for the .ornt Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 5 6. You will be charged Y b 6 e or ed a month) Oil Surcharge, Fuel Surcharg a„oasa6rw^•_°"'""`yiss mn Information Deliver Fee as described in our T &C. Only g one of these fees Payment stub Ao ouN „•w i.99 Tar TN,9 AMOUNT will apply to each account. The fee that applies to your account .�ww -^g ACCOUM 00 Y NUMBE0. PAY By 5140 0a T. is staled on the front of the invoice. For further information please 13345673 ,�oicE NUMeE3 3nuNC Onr ENCLOSED e visit the website listed below or contact our customer service ,33456rea3 eolomoo center. 7. As a food product, bottled water is subject to the rules and 0,200ae11a osa62n1z619 ¢¢¢a91vvg1 a¢a9 16 Amount due regulations promulgated by the Federal Food and Drug Administration (FDA). ,'ysiaies`oo9o0 8. Your first invoice indicates the products delivered on your first t S 99a 4 R 934e Submit your 0.5fm'K L delivery, along with any applicable bottle and account deposits, so. p ayment by this Jnt J.0 Jt is n to t l61 u r redemption fees- and any dispenser charges. All future invoices ,no —ms: ,w date Mill reflect charges for water delivered and dispenser rental, bottle "urvoe +off" deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16 -17 deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect t wo deliveries. 2008 ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 11108 service. icemountain.com 10 service. icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 08/01/10 08/31/10 00HO121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED e M O 0121202766 TE- OCT 19 WED- NOV 17 MON- DEC 20 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1- 800 -472 -9888 MANDY SPADY Thank you for choosing Ice Mountain Home Office 1411 E 116TH ST Delivery! We value your business. CARMEL IN 46032 -3455 IIIIIIII' I' IIIIIIIIIIII"' IIIII�III�IInIIIII "II'I'IIII "IIIII'I Order AnzonaBeverages kijr_ 8131110 8 _fake delivery by.9130110 to be °entered Into`the 'Getaway Sweepsfffor a dh to win great p�iieslaNa Purchase Necessary �Ends� Lirnit, 3.0�entriaslpe`rsonlfnonth 4 fftclal rules at se JgeficemoU ,7 61hi+vater:dom Vntd where rahlb tei! a t° p ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at: 800 -472 -9888. is ree. e very a reSS: PREVIOUS BALANCE 131.75 8108 384805 PAYMENT -THANK YOU -77.86 8131 502895 PAYMENT -THANK YOU -53.89 8/19 0686167388 8 5 GAL ICE MOUNTAIN DRK W /HANDLE 31.92 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 1 5 L NATURAL SPRING WATER ICE MTN 5.99 1 BOTTLE DEPOS TM 1 8 CHA 9 CREDITED 014 -6.00 8131 H9689273 068881818 1 RENT EL SURCH Purc %ase 5,99 Description C D E rylCG TOTAL 1. k 47.27 P.O. Wor i acll I. 45 09po Budget Line [3escr K� ��nP r (tY: TICS Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT t ADJUSTMENT CUCVWT AT4,VITY PAY THIS AMOUNT Subject to terms on reverse side. 131.75 131.75 47.27 JJ II 47.27 BELLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR I. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment your equipment rental is charged one month in advance. That means CALL 1 -800- 472 -9889 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 9216 if you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAMPLE INVOICE 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: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. 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 I ooIDDIDD 00100I0D 1734567990 Your Account Number investigated. During the investigation, we cannot report your account 7 as delinquent or take any action to collect the amount in question. nn a 123,56789 6�ox -cacz ze Watch here for a wEo- Na+ 71 GENERAL INFORMATION NE -DfC' personalized account 1. Payments received after the billing INVOICE date will appear on Important 6dcltl lli6Lltl�:atln•In "ttdan a�+ Y g pA message your next invoice. Past due invoices (not paid within 30 days of news and ,a+o °•I� billing date) may be assessed a late fee as allowed by law not to offers �i�i s `n a,a,.+�•a C,ry.Stat 00000 exceed $20 per month. Additionally, third party collection/attorney „]n,twA [)M „11 „76„t1:6i1 4.61 l6d °u. expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. Pay electronically 16 2. Each returned check is subject to a service charge subject to the "'"ou tSY x p aiN.elrgm6el( fi maximum check return charge allowable in your State. w Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your ACCOUNT ACTIVITY r 4. Equipment replacement costs will be charged for bottles lost, 5 "'e 0°0°° paid in full to last invoice stolen, damaged or not returned. avoid late fees S. In accordance with NWNA's Terms and Conditions (`•T &C your r ,61698 W b ai c ew 1 "w !rl 3L]� 5 I =e B,puMaln eGal DewU Equipment Lease and/or Service Agreement account may be r 6es4.w s kerno ^s 6 p Monthly Oil subject to minimum month) p urchases and/or earl cancellation 09 31 `l sub ,_,,.F,� J Y P Y Surcharge, Fuel ns roe„ ae ^c ...,i. n� s�aa fees. (A complete version of the current T &C may be viewed on the a9l,7 19] �r v Surcharge or Delivery website listed below) Upon service discontinuation, rent for the tt AL Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. a "TM 1AptlN 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or ,ee„u„sw.var "vsµ "`""mss' ,,,,,,,,m,.m Information Delivery Fee as described in your T &C. Only one of these fees Payment stub AccouN'rSUMMARY s9� PAV1nISAMOUI+r will apply to each account. The fee that applies to your account ACCOUNT NUMaEa s1.a9 is stated on the front of the invoice. For further information please 121456 M s. Eyaaosca IIN MME BILLING D: 123456 visit the website listed below or contact our customer service ,21 +567699 00/99106 center. Y2C2�1261 9 09039}049 2004 16 7. As a food product, bottled water is subject to the rules and os2on963ot c Amount due regulations promulgated by the Federal Food and Drug e Doe Administration (FDA). uN wAr 'g s�;�3'�oD your 8. ltwr first invoice indicates the products delivered on your first. Submit =viro Mear6vlcewE+� j19Bee delivery, along with any applicable bottle and account deposits. ,06 ue payment by this a tit pt .a6.au., „6.4661 a .n a 1 a redemption fees, and any dispenser charges. All future invoices date �N erEev,oa>nsg °1+•a"^'^°"` y�^- will renect charges for water delivered and dispenser rental, bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16 -17 deliveries per year, You will only receive invoices t 2 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. Form No. Nvd 709 11108 service. icemountain.com 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 913110 00HO120095351 Water cooler lease 98.08 913110 00HO12120276 Water cooler lease 47.27 Total LEE1 5.35 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 i` Voucher No. Warrant No, 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285 -6680 In Sum of 145.35 ON ACCOUNT OF APPROPRIATION FOR 101 General 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept ept 1125 00HO120095351 4350900 98.08 1 hereby certify that the attached invoice(s), or 1091 00HO12120276 4350900 47.27 bill(s) is (are) true and correct and that the materials or services itemized thereon for which "charge is made were ordered and received except 9 -Sep 2010 Signature 145.35 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i service.icemountainwater.com Al I I "I.' A O B O 215 6661 DIXIE HWY, SUITE 4 08/01/10 08/31/10 00HO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 1 FRI- SEP 24 0121776199 �I II"I'1I I III1� t I l I I II I �II I z�5 TU NOV 23 MON- DEC 27 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1 -800- 472 -9888 JIM SPELLBRING Thank you for choosing Ice Mountain Home Office 1 CIVIC SQ Delivery! We value your business. CARMEL IN 46032 -2584 Ostler Arizona Beverages Eby 813'1/10 &take tlellvery by 913Q7'f0 to be t k 4he "Getaway" Sweeps for a C to5w�n great prizes.'No:Purchase Necessary !Ends 8131110 WLlmlt 30 enIn Wper on lmonth$Offlcial rules at servrce.icemountalnwater.com Vold where proh ibited ACCOUNT ACTIVITY ay your bill online at: service.icemoun ainwa er.com or y p one a s ree. PREVIOUS BALANCE 21.25 8/08 384808 PAYMENT -THANK YOU -3.99 8131 502896 PAYMENT -THANK YOU -3.99 8/13 HA1400820 LATE FEE -15.00 8/17 0686349531 4 5 GAL ICE MOUNTAIN DRK W /HANDLE 13.96 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 BOTTLE DEPOSIT: 4 CHARGED, 3 CREDITED 6.00 8/25 0687150011 1 5 GAL ICE.MOUNTAIN,DRK•W /HANDLE 3.49 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99 BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED D .00 8131 0688893346 1 OIL /FUEL SURCHARGE 'P 1 3 2010 2.28 H9599679 RENT 3.99 TOTAL B Y 33.97 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 21.25 22.98 35.70 33.97 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1- 800 -472 -9989 OR WRITE US AT your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. 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 nu later than thirty (30) days after we SAMPLE INVOICE 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: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. 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. 127456789/ Your Account ]Number You do not have to pay the disputed amount while it is being 0.100100 00,1011' investigated. During the investigation, we cannot report your account A 3456789 as delinquent or take any action to collect the amount in question, Mon 1�a 4 Watch here for a GENERAL INFORMATIONa'a p ersonalized account L I y a*atio4 dnn d. ill6l.ItR allpaq:aWdO a +w B' 800 Pfle6 Payments received after the billing (INVOICE) date will appear nn Im P ortant message your next invoice. Past due invoices (not paid within 30 days of news and billing date) may be a late fee as allowed bylaw not to Offers �i exceed $20 hi l, ddi h er month. Additionally, third a collectioniattorne atYSml 1000° LLLLd'A11' uw-- P Y p Y 1p„,dL„d4dl:La U• t:d8and unpaid balance or the maximum lowedlby l ay Iced 100 /0 of the I Pay electronically 2. Each returned check is subject to a service charge subject to the maximum check return charge allowable in our State. meaaanf1O4n« g Y Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your AccouNrernvm `a„ ronno «.111- '^5I— lcrosu „9s paid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice IxuVSn yes,. 9 stolen, damaged or not returned. r P a e lam .41 avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C y our wt>roe P'Y N rwn.rW 6-I)1 sGallan NaNraI SPA 4w 4 -80.00 ftl 3,]BBS, s keMwntalns WlOeC�' a.vb Equipment Lease and/or Service Agreement account may be r a.a4 Mw n,ahssa Be i r n.99 Monthly Oil o9l,t ),rMS Fie, surtluryaf z{Y'Ft subject to minimum monthly purchases and/or early cancellation wf11 Surcharge, Fuel fees. (A complete version ofthe currentT&C may be viewed on the p9nx b0 9J J p-vX' -P Surcharge or Delivery website listed below) Upon service discontinuation, rent for the mrnl a Fee (see 6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or ^'N"+ Information') Deliver y our Y Fee as described in ourT &C. Only one of these fees Pay ment stub ACCOUMrSUMMARY ^o. TNISAMOUN will apply to each account The fee that applies to your account ACCEro NUMB"' 8]46 is stated on the front of the invoice. For further information please 123456]- B 00 DATE r. ENcaosra ,W.,{E NUMBER visit the website listed below or contact our customer service 17, 61. center. P J 1r2uns0n] "2P2 26 1vo3 as9 2019 LB Amount due 7. Asa food product, bottled water 1s su to the rules and regulations promulgated by the Federal Food and Drug lo h n 0a Administration (FDA). {r MOUNrNN wAirxoM° ary s Submit your 0 d m 8. Your first invoice indicates the products delivered on your first Wfl SEPVKr delivery, along with any applicable bottle and account deposits, cU -TQMr6 payment by this Vdpd,u:Lti„F "1.t.LLdwa. „a sd• mniNn redemption fees, and any dispenser charges. All future invoices �N OYFOR uE "Ow N n 1P �•��flM date will reflect charges for water delivered and dispenser rental, bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16 -17 deliveries per year. You will only receive invoices 12 times per 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. Form No. NW 709 11108 service.icemountain.com VOUCHER. `!O. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF S PO Box 856680 $33.97 ON ACCOUNT OF APPROPRIATION FOR Carmel Administration PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1205 100HO1217761991 42- 390.99 I $33.97 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, September 13, 2010 r Director, Administration y 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 P,4) ABLE VOUCHER CITY OF CARMEL =::ice cc bill to be preper!y shovj: kind of service, where performed, dates service rendered, by om, 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)) 08/31/10 1 00HO121776199 I I $33.97 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