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192113 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $143.04 O CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 192113 LOUISVILLE KY 40285 -6680 CHECK DATE: 11123/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 OOJO11782108 18.99 00JO117821082 2200 4239099 00JO12004852 13.96 00JO120048525 1125 4350900 00JO12009535 11.23 OTHER CONT SERVICES 1091 4350900 00JO12120276 64.86 OTHER CONT SERVICES 920 4239099 00JO12220610 15.25 00JO122206105 1205 4353099 00JO12177619 18.75 00JO121776199 service. icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 10/01/10 10/31/10 00JO121776199 p LOUISVILLE KY 40258 6 ADDRESS SERVICE REQUESTED TUE- NV 23 H H H U MIl I Holt I I I f l i I ON Ell MON- DEC 27 0121776199 1 WED- JAN 26 THU- FEB 24 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 nllll�lllll�lllllllnllll��unr��lll��ll��llll��llnl��lllllll RIOBN AVAILABLE Homemadelgoodness in a ",l ottlel "100 rv G egainic S AO L.ea� -Tea iti-`Original Sweep Tea and Lemtnade�6ox glass bottleS12 per case'Call SQO- 72 =9888 or vlsitasery ce "tcemountainw►ater com for our $2offrvspeclall Oar exp�cesA1,0131f10. e �x M v r� ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntainwater.com or by phone at:1- 800 -472 -9888. It's free! Delivery address: CITY OF CARMEL, 1 CIVIC SO, HUMAN RESOURCE DEPT, CARMEL IN 46032 PREVIOUS BALANCE 18.75 10124 780962 PAYMENT -THANK YOU -18.75 10125 0695576728 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 BOTTLE DEPOSIT: 1 CHARGED, 0 CREDITED 6.00 10/31 0697585271 1 OIL /FUEL SURCHARGE 2.28 J9878425 RENT 3.99 TOTAL LZ 18.75 D k �U J 2 2 2010 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT I ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT r Subject to terms on reverse side. 18.75 18.75 18.75 18.75 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 -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. 4216 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 I NVOI C E 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 bill that are not in question. o 12a456 Your Account Number You do not have to pay the dispsputed uted amount while it is being t ooloolRO-p investigated. During the investigation, we cannot report your account 1 3456789 as delinquent or take any action to collect the amount in question. a+oNon =9 Watch here For a GENERAL INFORMATION wB6.a ,ve- ort 1a ersonalired account I. Payments received after the billing (INVOICE) date will appear on Important tG@ �iV1tpa�tlllht ,.11ad,110.•alllt ^11;;gJJ4 a „p,,,a,sa•a�� g0 +'z sera p message your next invoice. Past due invoices (not paid within 30 days of news and m ..,Ryo� o•�ar ^a billing date) may be assessed a late fee as allowed by law not to offers h2, M.M11 "w,a••3�•s exceed $20 per month. Additionally, third party collection/attorney ms`01e r000R I• JaJ,,,l aL VI »V4.Ar..4d L F.r II.J.:O expenses may be assessed at a rate not to exceed 100% of the _....W.. 7 ;-r mat- unpaid balance or the maximum allowed by law. nay t m Pay electronically 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? ACTIVITY. since our AaourrACrvm amount has been 4. Equipment re replacement costs will be charged for bottles lost, y ceu�rvnda w "0o' paid in full to p g last invoice stolen, damaged or not returned. „a.w° +Bala 1e m avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C your mnl 6 5 Ga110n Natu,al Sp•�R9 Ill 1116051eda6 la Mw ^rains Gal Dc0^ut Equipment Lease and/or Service Agreement account may be 3veas�4444 s k•mn� ^u osGalR n?a Monthly Oil +?sni n; laBSia4a+ 5 r�atzu subject. to minimum monthly purchases and/or early cancellation o9nz Surcharge, Fuel fees. (A complete version ofthe current T&C may be viewed on the wn 1 ,u>noas' .-,,_j 17 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the lout 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 Y g g ed a month) Oil Surcharge, Fuel Surcharge or 4s1 nw M^ Information v9 a K„ u_ fT-- Deliver ee as described in our T &C. Only one of these fees Pa stub ACCOnHT S UTAM ry y our Payment Bny BY VA TH55 AMOVNt will apply to each account. The fee that. applies to your account AaouNTNum.E is stated on the front of the invoice. For further information please 1.345610.9° a,roNCOA,B Mr.e.c,Ws 11,V UNUMBER a1001W visit the website listed below or contact our customer service 1j3456169 center. 6429096307 514262,12619 006391049 2004 15 7. As a food product bottled water 1s sub to the rules and Amount due regulations promulgated by the Federal Food and Drug Ipn�o« Administration (FDA). Ice MOUI+uiN urn *r r Qy s�a�eS10 -M a aw.^• Submit your 8. Your first invoice indicates the products delivered on your fast caS,oMrR 55 a•'K r r .aaee delivery, along with any applicable bottle and account deposits, roR 4. a meet b this I. J141.. 3„ pl „,1L.,.1L.d1„ta.,4.Mr.41.J,.a ,sssaa v^ y payment Y redemption fees, and any dispenser charges. All future invoices F• fi° a sg „upR.a�4.ao�BaK. date will reflect charges for water delivered and dispenser rental, bottle vGrypeloRr 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 11/08 service. icemountain.com Sw VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF PO Box 856680 Louisville, KY 40258 $18.75 ON ACCOUNT OF APPROPRIATION FOR Carmel Administration PO# Dept. INVOICE NO, ACCT #(TITLE AMOUNT Board Members r 1205 100JO121776199 I 43- 530.99 $18.75 1 hereby certify that the attached invoice(s), or 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 Monday, November 22, 2010 Directo Administratio 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)) 11/03/10 00JO121776199 $18.75 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with 1C 5- 11- 10 -1.6 20 Clerk- Treasurer hd ii 7 A service.!cemountainwater.com 215 6661 DIXIE HWY, SUITE 4 10/01/10 10/31110 00JO122206105 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MON- NOV 15 0122206105 THU DEC 16 WED- JAN 19 WED- FEB 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 �I��l�ilillillll����llll�illll��l��ll�l��l�ll 'I'llllllu�ll�,llll convenience, pay online: icemountainwater.com /service. If payment has been made, we thank you. —4- NOW AVAILABL "E r Homemaclegoodness In a bottler '100 %mOrganlcSweet LeafTea to `Ortglnal Sweet Teayj a and Lemonade, ;16oz glass bottles, 12 per case Cai1800= 472 -9888 or vtstt servlc iceni'ountainwater, com fore our 32F ff.s peclafl offer ex pi�es�90 /31110 v_ e a r t e ti s +"E. "5< Y.- ✓r "e ...,w° =azy„ ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at:1 -800- 472 -8888. It's free! Delivery address: CITY OF CARMEL ENGINEERING, 1301ST AVE SW, CARMEL IN 46032 PREVIOUS BALANCE 53.93 10108 706698 PAYMENT -THANK YOU -28.71 10115 0694077546 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 1 .5 L NATURAL SPRING WATER ICE,MTN 5.99 10/31 0697652196 1 OIL /FUEL SURCHARGE 2.28 J9875897 RENT 3.99 TOTAL 40.47 N OV A Mae t% J ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY RAY THIS AMOUNT 0,. Subject to terms on reverse side. 5193 28.71 15.25 49 4'715 a6 -&—ueu uy J19 ouaru ui Auuu W nB —y ico. cu 000) 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)) 11/03/10 00JO122206105 Keystone Reconstruction Project $15.25 Miscellaneous Project 07 -08 r yr Total $15.25 I hereby certify that the attached invoice(s), or bills(s), is (are) true and correct and I have audited same t in 'accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. Ice Mountain Direct ALLOWED 20 PO Box 856680 IN THE SUM OF Louisville, KY 40258 -6680 15.25 ON ACCOUNT OF APPROPRIATION FOR Ice Mountain Direct PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members DEPT.# NA 00JO122206105 4239099 $15.25 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 22 -Nov 20 10 Total $15. 2 5 Signature Cost distribution ledger classification if Cit En claim paid motor vehicle highway fund Title service. icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 10/01/10 -10/31/10 00JO120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED amfiv B Il i t ll 1 1 ll l I I I I II I I I I I I I I II I I TUE- 23 0120048525 DEC MON- DEC 27 WED- JAN 26 THU- FEB 24 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 �I II��1' IC I�III1I11' I "'l�I'�I�'1'I1I' convenience, pay online: icemountainwater.comiservice. If payment has been made, we thank you. NOW AVAILABLEHomemade goadnesstn a bottle! 100% Organic Swee# LeafTea In:Orlgmal Sweet Tea and Lerl�anaae bottEes, per`case :Call SUQ -<t72; -9888 or vlslt service Icernaurltaltwa +ef.com for our $2 off;speciallOffer expires 10131110, v 4 �q� m° �s r 0 w ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1 -800 -472 -9888. It's free! e e D elivery address: CITY OF GARMEL, I CIVIC CITY ENG INEERING DEPT, CARMEL IN 46032 PREVIOUS BALANCE 47.86 10108 706697 PAYMENT -THANK YOU -23.93 10125 0695576603 2 5 GAL ICE MOUNTAIN DIRK W /HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT -00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN 1 1 9 1 �jj� 00 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 10131 J9885994 RENT L�>? 3.99 TOTAL MED 37.89 NOV 210 ;aPiEL CO ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 47.86 23.93 13.96 37.89 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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. Ice Mountain Payee P.O. Box 85 6680 Purchase Order No. Terms Louisville, KY 40285 -6680 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/03/10 001 Rent and Servie Sept $13.96 Accnt 01 2004852� 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. B ox 856680 Louisville, KY 40286 -6680 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering b� 4 Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT n I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the n/a 00J FNG 4239099 materials or services itemized thereon for A cnt 0120048526 which charge is made were ordered and received except Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund service. icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 10/01/10 10/31/10 00JO117821082 LOUISVILLE KY 40258 B e ADDRESS SERVICE REQUESTED IIIIIII III111111111111IIIIIIIIIII TU E NOV I- DEC 16 0117821082 FR THU- JAN 20 THU- FEB 17 Customer Service: 1- 800 -472 -9888 CITY OF CARMEL STREET DEPATMENT YOUR ACCOUNT IS SERIOUSLY DELINQUENT and is 3400 W 131ST ST subject to additional late fees. You must make immediate CARMEL IN 46074 -8267 payment to avoid collection action. For your convenience, you can pay by phone. Please call today! a {VoW AVAILABLE Homemade goodness In a botklel -1l)0 %Organic Sweet LeafgTea In 0rtgirpal Sweet Tva and Lemonade, l6ortsglass bottles; '12 per 11;,80,0 472-9888 or visit tervic8 tcemountdinwatbr.c' for our' $2'.off specialf Offer�exp�r�es 1013'1110. R M° m ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntainwater.com or by phone at:1- 800472 -9888. It's free! 11 e e e Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074 PREVIOUS BALANCE 136.54 10124 0696557347 1 LATE FEE 15.00 10/31 J9873728 RENT 3.99 TOTAL 155.53 5 Lam, "i- U-) be 6 L- ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT r,,,, Subject to terms on reverse side. 136.54 0.00 18.99 155.53 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $18.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members 2201 00JO017821082 42 389.00 $1899 1 hereby certify that the attached invoice(s) or bills) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday, N& Member 18, 2010 Stre t Commiss oner Street �ornr ,sg,nr, 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)) 11/03/10 00JO017821082 $18.99 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer NO "I A ".1 service.icemountainwater.com ®D 215 6661 DIXIE HWY, SUITE 4 10/01/10 10/31/10 00JO120095351 M LOUISVILLE KY 40258 M- ADDRESS SERVICE REQUESTED II I I II I I II I I IIIIII I l l i I I II II I I III WED- 17 0120095351 DEC MON- DEC 20 FRI- JAN 21 It f 3 ,p FRI- FEB 18 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 CARMEL IN 46032 -3455 Delivery! We value your business. OW AVAIkAB Hom�eritacle "goodness m .61 '100% Organic Sw,eet Leaf Tea m Orlgin-al Sweet and Lemonade, 1601 glassebotties; 42 pe' r:,case Call 800 472 988 1"S ICe Icemountainwatorcom for i our$2 off specliall Offer expfres10l31I10' S E ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntainwater.com or by phone at: 1-800-472-9888. It's free! Delivery address: P CARMEL CLAY PARKS AND REC DEPT., 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 16.20 10124 780965 PAYMENT -THANK YOU -16.20 10119 0694519000 2 5 GAL ICE MOUNTAIN DIRK W /HANDLE 7.98 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 BOTTLE DEPOSIT: 2 CHARGED, 4 CREDITED -12.00 10131 0697620169 1 OIL/FUEL SURCHARGE 2.28 J9900504 RENT 9.98 TOTAL 1.23 Purchase T) Izl N1 W-1 P4 C VJATEt2 'A NO V 88 C� I Description C c ©t >P h l l rrr P.O.# PorF G.L. I LL- 4350 Lo a O i0if60CCii PiPPPPPPOF'PIi/ Budget Line Dascr Purchase Date E.oDroval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q Subject to terms on reverse side. 16.20 16.20 11.23 11.23 serviceAcemountainwater.com 215 6661 DIXIE HWY, SUITE 4 10/01/10 10/31/10 00JO121202766 ti t7 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED �I�II I�� WED- 17 0121202766 DEC MON- DEC 20 FRI- JAN 21 FRI- FEB 18 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 I�I�Illl�llllll��llll�llnl�lllllllll�ll�ll�l�l�ll�llllll�lnl��l �3l i� RIOU, AV� ,ILA8ainemade.goodness; bottle! °Organic Sweet Leaf aYeain,Orlglnai Svuee4 Tea and 'Lemonacle `16oz glass bottles, 92 �er.;case. Call. $00= 472 =98$8 or visitssenrlce lcemountain�n►atefcom for our $2 off speclllOfger expires 90!39190 a xkP m 's ^r t rt Pa you ACCOUNT ACTIVITY y r bill online at: service.icemountainwater.com or by phone at: 1 -8 00 -472-98 8 8. It's free! e. A=40MOINAUD c e every a ress: PREVIOUS BALANCE 49.87 10124 780964 PAYMENT -THANK YOU -49.87 10119 0694519067 9 5 GAL ICE MOUNTAIN DRK WIHANDLE 35.91 3 9 OZ PLASTIC UP 50C /SLEEVE 8.97 1 .5 L NATURAL SPRING WATER ICE MTN 5.99 BOTTLE DEPOSIT: 9 CHARGED, 8 CREDITED 6.00 10131 0697509339 1 OIL/FUEL SURCHARGE 2.00 J9970611 RENT 5.99 TOTAL o jai 0. JT 9 7 3 64.86 Purchase WaT0?F IND" 810 10 Description CAL —E V_' MCC, P.O.# PorF G.L. Budget Line Descr Purchaser lc gate ACCOUNT SL PyF6lRK PREVIOUS ®Ab NCE PAYMENT! ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 49.87 49.87 64.86 64.86 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 11!3110 J0120095351 Drinking water cooler Maint 11.23 1113110 J0121202766 Drinking water cooler MCC 64.86 Total 76.09 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 Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285 -6680 In Sum of 76.09 ON ACCOUNT OF APPROPRIATION FOR 101 General 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 J0120095351 4350900 11.23 1 hereby certify that the attached invoice(s), or 1091 J0121202766 4350900 64.86 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 18 -Nov 2010 Signature 76.09 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund