190311 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $52.64
o CARMEL, INDIANA 46032 PROCESSING CENTER
i
PO BOX 856680 CHECK NUMBER: 190311
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LOUISVILLE KY 40285 -6680
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4239099 00GO12220610 -19.97 OTHER MISCELLANOUS
920 4239099 00GO12220610 19.97 00GO122206105
2200 4239099 00HO12004852 23.93 00HO120048525
920 4239099 00HO12220610 28.71 00HO122206105
V
service.icemountainwater.com
Q 215 6661 DIXIE HWY, SUITE 4 08!01110 08/31/10 00H0120048525
0
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED IM
SET 24 0120048525
MO
I I J I MON- OCT 25
TUE- NOV 23
MON- DEC 27
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 Remember, past due accounts are subject to a late fee.
CARMEL IN 46032 -2584 Your prompt payment is appreciated. For your
1111'11'1'1 11 1 '1' 111 '1"' convenience, pay online: icemountainwater.comiservice.
If payment has been made, we thank you.
Order Arizona Beveragesby 8131110 taltetleltdgry by 9 /3 to be °enteretllnto ;the "Getaway' Sweeps #oraa
chanceto win great P N;o PuPChaseVecessary Ends813'1110: «LImIt3D eritt=ieslperson /t»antM Ofi total w r
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ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1- 800 -472 -9888. It's free!
Delivery address:
PREVIOUS BALANCE 68.30
8108 384806 PAYMENT -THANK YOU -40.88
8125 0687149872 4 5 GAL ICE MOUNTAIN DRK WlHANDLE 13.96
4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN
2 9 OZ PLASTIC UP 50C/SLEEVE Zg1lJ 1'2,.71 5.98
8131 H9607452 RENT S� 3.99
TOTAL 1 N RECEIVED 51.35
e� 80
CARMEL
gZgzv
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT I ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 68.30 40.88 23.93 51.35
BILLING RIGIITS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN 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 I -800- 472 -9888 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 IIWY., SUITE 4
LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns.
It you think your bill is wrong, or ifyou 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 S AMPLE IN VOICE
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.
S i
You are obligated to pay the parts of your bill that are not in question. 123456739Q Your Account Number
You do not have to pay the disputed amount while it is being f pat00tvo- oalo
investigated. During the investigation, we cannot report your account i
as delinquent or take any action to collect the amount in question. Yaa ocr 123 +sn�e
l i
M« oer n Watch here for a
GENERAL INFORMATIONS a personalized account
ili6tdni:aun. o;Aiaaa rtq e a
1. Payments received after the billing (INVOICE) NVOICE) dale will appear on P message
your next invoice. Past due invoices (not paid within 30 days of news and tWl ".,IN "gl,dltltd g
billing date) may be assessed a late fee as allowed by law not to offers '23M i s
exceed $20 er month. Additionally, art an. sme°
R Y, party A,d�. n ut,.tt.J.n,d.dlt`ua.9
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. :•s '¢a„ fiexrs+H Pay electronically
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. Make su this
3. All bottle and equipment deposits are shown as CURRENT Activity
amount has been
ACTIVITY. since your ACCOUNr ACTIVITY •e;cys,a,e oBroB
4. Equipment replacement costs will be charged for bottles lost, ,�ypaare: w ^•t'3M, s n." paid in full to
last invoice
stolen, damaged or not returned. avoid late fees
Pay"+ent Thank ao.oA
5. In accordance with NWNA's Terms and Conditions "T &C your aern w,PVP s scai �„aas ^,.i soa g w sopo
Ill 3,raB5, ke MOUntainaW OeP"T t�
Equipment Lease and/or Service Agreement. account may be r 3nsas,°+P+ s swiP Monthly Oil
avaasi++°^ ire MOU ^n^ y t;..
5 N
subject to minimum monthly purchases and/or early cancellation (f�t. ..r arr;. Surcharge Fuel
nt n.o
fees. (A complete version of the current T &C may be viewed on the osn= ��16441 g 1�. Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the roT•a F¢¢ (see 46 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued.
vfa" ^sMa °P rt si a
6. You will he charged a monthly Oil Surcharge, Fuel Surcharge or nw ,,,�•��•^'^^"i
Relive y our Payment stub Fee as described in ourT &C. Onl one of these fees Pa AcmuNTSUMMAPr Information
c.•o
PAV 1N45 AMOUNT
will PAY BY apply to each account. The fee that applies to your account �:�^�^^^^Y°""'""`°' pccouNTNUMBEn �w sr.w
is stated on the front of the invoice. For further information please °•°""h'"6 ,z3asa7a .W DATr Mr. ENaosry
MVOKENUMBEP Wmgo
visit the website listed below
,or contact our customer service S%780
center.
7. As a food product, bottled water is subject to the rules and ,4e0r19630? Ontaznatr9 oa039i°49 21101 su Amount due
regulations promulgated by the Federal Food and Drug n ^oce
Administrution (FDA). icE MOUrnuNwAn P "r„�, yMtd1
Submit your
8. Your first invoice indicates the products delivered on your first am
delivery, along with any applicable bottle and account deposits,
k ...Rnll +6a.L ,hNdd +a
ayment by this
t.daI,.a:a
redemption fees, and any dispenser charges. All future invoices �Swr�F�EA�Mragnuna °�••dOnflPe"' 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 1 1108
service. icemountain.com
Prescribed by Stale 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.
P.O. Box 856680
Terms
Louisville, KY 40285 -6680
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/03/10 OOH Rent and Servie August $23.93
Accntol2b04852
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
Ice Mountain IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
$23.93
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PQ# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
uum zN(3 4239099 "23t3 bill(s) is (are) true and correct and that the
nia
materials or services itemized thereon for
A cnt 0120048525
which change is made were ordered and
received except
20
/07
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
service.icemountainwater.com ®p
215 6661 DIXIE HWY, SUITE 4 08/01/10 08/31/10 00HO122206105
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED g
0122206105
FRI- OCT 15
MON- NOV 15
THU- DEC 16
CITY OF CARMEL ENGINEERING /1ST AVE Customer Service: 1- 800 -472 -9888
KATIE NEVILLE 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
Jill '1""11'1. 11111111' III"' 1 1 111111111111111111 11111111111111 11 convenience, pay online: icemountainwater.com /service.
If payment has been made, we thank you.
1Based:on customer feedback; we have 663 ed Nestea Lemonade, Citrus Tea and i�txed °•Berry to;a f2e
count box with new list price of $499 per box tid�prI in g as low as J9 when you add 2.or6more,:boxes ori.
"My_RegularOrder',
ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1- 800472 -9888. It's free!
ffig
e wary a ress:
PREVIOUS BALANCE 49.73
8108 384802 PAYMENT -THANK YOU -29.76
8117 0685551749 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47
2 9 OZ PLASTIC UP 50C /SLEEVE 5.98
1 .5 L NATURAL SPRING WATER ICE MTN ;I j2' 5
rt BOTTLE DEPOSIT: 3 CHARGED, 3 CREDITED .00
r
8131 0688949262 1 OILIFUELSURCHARGE� w r 2.28
H9597060 RENT 3.99
HECEMEO
TOTAL i d 48.68
CARMEL�
CITY R ti
ENGlNEEh
ACCOUNT SUMMARY R PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 49.73 29.76 28.71 48.68 1
r escriueu uy oIdte ouaiu ui nuuuwns -ty rurm rvu. cu i �nev. iaao1
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 Direct Purchase Order No. NA
PO Box 856680 Terms
Louisville, KY 40258 -6680 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/17/10 00H01 22206105 Keystone Reconstruction Project $28.71
Miscellaneous
Project 07 -08
a
Total $28,71
I hereby certify that the attached invoice(s), or bills(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 N0, WARRANT NO.
Ice Mountain Direct ALLOWED 20
PO Box 856680 IN THE SUM OF
Louisville, KY 40258 -6680
28.71
ON ACCOUNT OF APPROPRIATION FOR
Ice Mountain Direct
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
DEPT.#
dX 00HO122206105 4239099 $28.71
NA I hereby certify that the attched 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
2 Se p 20 10
21�
.7,
Total 28_.7 1 Signature
Cost distribution ledger classification if City Eng ine er
claim paid motor vehicle highway fund Title