163790 09/17/2008 a CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $82.24
PO BOX 856680 CHECK NUMBER: 163790
LOUISVILLE KY 40285 -6680
CHECK DATE: 9/1712008
DEPARTMENT A CCOUNT PO NUM BER INVOICE NUM BER AMOUN DESC RIPTION
2201 4238900 08HO11782108 38.40 OTHER MAINT SUPPLIES
2200 4239099 08HO12004852 33.90 OTHER MISCELLANOUS
1701 4239099 08H722032704 9.94 OTHER MISCELLANOUS
A "M
IR 720106
M-C-am-POF o
8/01 /08 8/31 /08 08H7220327048
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service. icemountain.com
MON- SEP 15 7220327048
IIIIIII III IIIIIII III IIIIIIII IIIIIII IIIIIIIII TUE- 14
NOV
WED- NOV 12
#BVVNNVI/YR MON- DEC 15
#0400072203270488#
CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 472 -9888
ANN DAVIS
1 CIVIC SQ Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -2584 Remember, past due accounts are subject to a late
I fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com /service. If payment has been
made, we thank you.
Enjoy special savings! Order 2 cases of:our most popular on the go sizes for just $12! Choose from our half liter
bottles, Aquapod bottles or Nestle Pure `Life Splash flavors. Offer expires 10/15/08. Log onto
L service Icemountainwater.com or call 800- 472 -9888.
..��T
i
ACCOUNT ACTIVITY Pay your bill online at: service. icemoun tai n.com or by phone at: 1- 800 472 -9888. It's free!
Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SO, CARMEL IN 46032
PREVIOUS BALANCE 23.10
8/10 511184 PAYMENT -THANK YOU -12.74
8/14 0578678583 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
8/31 0582512380 1 OIL /FUEL SURCHARGE 2.96
H6241942 RENT 3.99
TOTAL 20.30
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU ENT ACT VITY PAY THIS AMOUiNT
1$�biect to terms on reverse side. 23.10 12.74 9.94 20.30
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 INF'ORMAI PLEASE 2. Remember, if you are renting equipment, your equipment rental is Charged one month in advance. That means
CALL 1- 800- 472 -9898 OR "'RITE US AT: y our 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.
If you think your bill is wrong. or if you need more information about
a transaction on your hill, write its on a separate sheet of paper. We
must hear from you in writing later than thirty after we SAMPLE INVOICE
sent you the first bill on which the he error or problem app d ays a 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.
r+tr I'S" -I
You are obligated to pay the pans of your bill That are not in question. 12 4567890 Your Account Number
You do not have to pay the disputed amount while it is being oolooloo- oolooloo
investigated. During the investigation, we cannot report your account
1 as delinquent or take any action to collect the amount in question. Nn oa o• Izl
moN OCR 29 Watch here for a
GENERAL INFORMATION or DEC DIC
tUE 10 p ersonalized account
I. Payments received after the billing (INVOICE) date will appear on Important messa ILII...IIL.III..IIIII�I.,, 1111 ,1,1111,.,.11111..II.•II.I.III cu.,umN S.,.d, «1- coo- a]z-9Aee
your next invoice. Past due invoices (not paid within 30 days of news and
'.A you I-, ug Ise M—W. pudun• b
billing date) may be assessed a late fee as allowed by law not to offers 1 123 M^ s aurvm...
exceed 520 per month. Additionally, third party collection /attorney cNys,
L. and., J., IIL•..• Il.. ll. ,,n.,LII,.1,,,1,I,LL,1,.11
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the ma.xinulm allowed by law. o [a 4 C r,��� °a Pay electronically
Each returned check Is subject to it service charge subject to the a.,Y,OOU,.adrn9+w nm«
maximum check return charge allowable in your Slate. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
amount has been
ACTIVITY your, ACCOUNTARIy1TY
y mM s, 'i s Gppp0 11 ?9 aid in full to
last
4. Equipment replacement costs will be charged for bottles lost. invoice •c,jKyAddres+. tunoo«. 99 P
,a
stolen. damaged or not returned. r,Nlou,aaw avoid late fees
so
5. In accordance with NWNA's Terms and Conditions T &C), y our ors wv i w„°,
swnoo N,�iu s 1 D �99
s keMw 96
Equipment Lease and/or Service Agreement account may he n] e s+a+a s ,,,,;,,swl n„um +,99 Monthly Oil
Irn�ue^iw.mm9°
subject to minimum monthly purchases and/or early cancellation o�9ni Surcharge, FUCI
57 tees. (A complete version of the current TRC may be viewed on the '""099' s,. Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the roTAE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. M A�,wN^ si,o
6. )on will be charged a monthly Oil Surcharge, Fuel Surcharge or vwu wA 9 Information
Deliver ee as described in our TRC. Only one of these fees Payment stub ACCOUNT SUMMARY •o•K:90
ry y our Y PAY BY PAY T.IS AMOUNT
will apply to each account. The fee that applies to your account e,w 0 -•^ww •1 ACCOUNT uuMeEa 00 sT,o
is stated on the front of the invoice. For further information please ricr ]89U BId11NG DATE MT, ENCLOSED
INVOICE NUMOnI
visit the wehsitc listed below or contact our customer service Izssa o01w1oo ]e90
center, P 1 Ou2nD963D] D42A2i12619 DD391oY9 211114 lA
7. As a food p bottled water is subject to the rules and Amount due
regulations promulgated by the federal Food and Drug 1 „1 oox
Administration (FDA)
1C rEACOM y.u�c r•y's' e1-m- Submit your
R Your first invoice indicates the products delivered on your first OOEp ,TOMEOSEMI+EEC]yLL099�]1 -9m,
delivery, alone with any a bottle and account dep sa. p ayment b y this
P L,. Ina.. d,. nl.,, ..nu,a,n „l,. a.l.nl.a..n m•. P^ ^y U• ^.,nvP..•..• date
fees. and any dispenser charges. All future Invoices s O Nw ow Eau 'v�uPa•9..��•^ °n"'"”"
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 limes per year, so approximately 5 of those invoices will reflect
two deliveries.
44 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 5/08
r,�
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))
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.
p ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
7aa 3Q� bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
720106
0®® A
0 N 8/01/08 8/31/08 08HO117821082
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0
service. icemountain.com
MON- SEP 22 0117821082
TUE- OCT 21
WED- NOV 19
MON- DEC 22
#BWNNWYR
#0400001178210823# Customer Service: 1- 800 472 -9888
CITY OF CARMEL STREET DEPATMEN
3400 W 131ST ST YOUR ACCOUNT IS PAST DUE and is subject to
WESTFIELD IN 46074 -8267 additional late fees. Water delivery service may be
I j rr l rrr l r l r ll rr l rrr jjl rr 'I interrupted. Please make your payment today. For
your convenience, pay online:
icemountainwater.com /service. If payment has been
made, we thank you.
Enjoy special savings! Order.2 cases-of our most popular on the go sizes for just $12! Choose from our half liter
bottles, Aquapod bottles or Nestle Pure Life Splash flavors. Offer expires 10/15108. Log onto
service. icemou or call 800 -472 -9888.
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800 472 -9888. It's free!
1 2d
Delivery address: CITY OF CARMEL STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074
PREVIOUS BALANCE 146.14
8/10 511182 PAYMENT -THANK YOU -61.66
8/21 0580237162 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98
3 5 GAL ICE MOUNTAIN DIRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00
3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00
8/25 0581621687 1 LATE FEE 15.00
8/31 0582614798 1 OIL /FUEL SURCHARGE 2.96
H6202364 RENT. 3.99
TOTAL 122.88
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT I
0 to terms on reverse side. 14614 61.66 38.40 122.88
BILLING RIGHTS 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 WAFER 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.
0216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE HWY., SUITE 4
LOUISVILLE. KY 40255 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
®I�/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 of your bill that are not In question. ,z3asb7a9 Your Account Number
You do not have to pay the disputed amount while it is being t 00/00100 00100100
investigated. During the investigation, we cannot report your account
,7,;1567
as delinquent or take any action to collect the amount In question. T an oa w
MOH DCT 79 Watch here for a
WEP NDV 3
GENERAL INFORMATION TEE -DEC ,O personalized account
I. Pa nicnts received after the billing (INVOICE) date will appear on p 7:.9888
g PP Important
n. Il,.. nf„ N ,ann,L „pp,l,lpl,,,,llal „p „paAtl a. °,,,.,xm<a:,- coo- message
your next invoice. Past due invoices (not paid within 311 days of news and Thank 7 nu m. 4dn9 •M°uman
date tat be assessed a late fee as allowed b y law not to rohnD«
billing
b Y offers tz3 Mum s,
exceed S20 per month. Additionally, third party collection /attorney o "Y'Sj1e 000ro
L,. IILI,,, IIII„ IL...IL.II „I,II,a,,,66ta,a.,11
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. —.9.
,n.mn.nro°u o Pay electronically
.9.
Each returned check is subject to a service charge subject to the DD ,.,a9w.nMV a
nrlxinium check return charge allowable in your State. Make Sure this
3. All home and equipment deposits are shown as CURRENT Activity I amount has been
ACTIVITY. since your ACCOUNTACTIVI71' 0000E paid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice a O.INery OOC•I73 Mans +,re! a, 99
stolen. damaged or not returned. o,M 4,oTM;<kvn° sa_0so avoid late fees
5. In accordance with NWNA's Terms and Conditions T &C our M11, WII"
y 5 S4albn Natul.l SD�b9
]17MSI4sM I<e MOU °fain Seal Dep 796
ui ment Lease and /or Service Agreement account may be i Monthly Oi
Equipment 9 P 6 Y m meesu+++ <.Mwmabscal aewm nm
091+, S, 7M51w IWa15ulcnarge
subject to minimum monthly purchases and /or curly cancellation �In sIvomll I I,— Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the 0913 Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the ToTU 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 w. 99 5 Information
Deliver our T &C. Only one of these fees Pa'ment stub AccouNTSUMM Aav
y Fee as described in y v --THIS AMOUNT
Dnr e
will apply to each account. The fee that applies to your account „,,;,,,;,�,,,,;,ww+° ACCOUNT MT. "C10110 CLOSlD
NUMeea
m s7 °o
is stated on the front of the invoice. For further information please ,7}456)090 BIWNO DATE
INVOICE NUMBE0. 00100100
visit the website listed below or contact our customer service ,734x67890
center. 115
7. As a food produc(, bottled water Is subject to the rules and 0420096307 042152112619 000391049 2004 Amount due
regulations promulgated by the Federal Food and Drug innn0”
Administration (FDA). ICE MOUNTAIN WATER COMPAN_ c, s�aie
W' Submit Your
S. Your first invoiinvoice s.
st invoice indicates the products delivered on )'our first Eo9 cuoMExuwl<E C•u,.Mw77.vem
delivery, along with any applicable bottle and account deposits,
p by this
ul. p r a..
redemption fees, and any dispenser charges. All future invoices ces date >EO4
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 I6 -17 deliveries per year. You will only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
0 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 5 /08
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$38.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 08HO117821082 42- 389.00 $38.40 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
Thursday, September 11, 2008
Street C r missioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Hoard 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))
09/04/08 08HO117821082 $38.40
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
720106
Ob O
8/01/08 8/31/08 08HO120048525
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 B e
service.icemountain.com
MON- SEP 15 0120048525
OCT
11111111111 IN 1111111111111111 IN 1//111111 TEE- NOV 1
WED- NOV 2
12
#BWNNWYR MON- DEC 15
#0400001200485252#
CITY OF CARMEL DEPT OF ENGINEE Customer Service: 1- 800 472 -9888
LISA SCOTT OR JUDY STOHLER
1 CIVIC SO Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -2584 Remember, past due accounts are subject to a late
I�I I 'I' fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com /service. If payment has been
made, we thank you.
Enjoy special savings! Order 2 cases of our most popular on the go sizes for just $12!. Choose from our half Iiter'
bottles, Aquapod bottles or Nestle Pure Life Splash flavors. Offer expires 10/15/08. Log onto
servic or call 800 -472 -9888
1
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SO, CARMEL IN 46032
PREVIOUS BALANCE 44.47
8/10 511181 PAYMENT -THANK YOU -17.95
8/14 0578678427 6 5 GAL ICE MOUNTAIN DIRK W /HANDLE 20.94
6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
6 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
3 9 OZ PLASTIC UP 50C /SLEEVE 8.97
8/31 H6214235 RENT 3.99
TOTAL 60.42
W l
CARMEL h)
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURR N•T —AC —TI Y PAY THIS 44. .90 60.42 AMOUNT
47 1795 33 I
hiect to terms on reverse side.
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR HILL, 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 ,NtOUN'I'AIN SPRING W>TER 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 UWY., 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 shiny (30) days after we SAM I NVOIC 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 arc obligated to pay the parts of your bill that are not to question. 12 +s67s Your Account Number
You do not have to pay the disputed amount while It is being 0010011/0 OOIOO100
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. TNR
a o4 123456789
MON. oa 79 Watch here for a
GENERAL INFORMATION 'L' NOY
UE- DEC ,p personalized account
I. Payments received after the billing (INVOICE) date will appear on Important
message
II,IL,. III.. III, �IIIIIa„�IIII .�.�IIIII�AI „11,1,111 aa,oma xrvkr. l.eo°- 472 -9RR
your next invoice. Past due Invoices (not paid within 30 days of news and IIII�I rn4 ^LY9„1ap °n9 "`M°" "v.9a °t l:
billing dale) may he assessed a late fee as allowed by law not to .A °.e.weea.
L offers Iii sl
ney a,rslme °�It
exceed S20 per month. Additionally, third party collection /attor
L ..III,L,L•IIL ....11 „I,II,I „a,Ll,l „1,.11
unpaid balance or the max Lecd l00% of the maximum allowed by law TPmam9erw�a�w ^,arol.me.aara ,S �n6
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 a ,p,a4.�^ '0Q4 .9n.
ACTIVITY. ACTIVITY amount has been
since our ,2, ACCOUNT E p E LCIY. S,a 000
Y Mal ^s aid in full to
4. Equipment replacement ast
ent costs will be charged for bottles lost, invoice Oe Y Aaae55 m^ p
sioten, damaged or not returned. p,rg o5pa�a ^4e 49 °s avoid late fees
paY,^9m.T6anAYpu x000
5. In accordance with NWNA's Terms and Conditions "T &C), your w
O p7„ 46,p9e s scanoP Nam.a, sP ^9 .96
9111 317p951M44 ke M94nu;n5 WlOposa`c, W
Equipment Lease and/or Service Agreement account may be Monthly' Oil
0911, 3,IBpSlaa S fuel Su�ctar9e
subject to minimum monthly purchases and/or early cancellation „p2636pn Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the .117 '�gpdp7 s „O Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TOTAL Fee (see #6 under
I -eased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. cvapLNTAoT si o
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or .A Information”)
pCCOUM SUMMARY 99
Delivery Fee as described in your T &C. Only one of these fees Payment stub nc. you rc n,Z: vAY T1EI5 AMOUNT
apply to each account. The fee that applies to our account ,e,,,'^N a PAY By
will a
z +O
pp pp y um ACCWMNUMBER "o
is stated on the froth of the Invoice. For further Information please 1234567890 POLING AT MT. ENCLOSE°
INVO,CE NUMRE0. w1w1w
visit the website listed below or contact our customer service 12x456789
center.
7. As a food product, bottled water Is subject t0 the rules and 0120096307 04262712619 000391019 2aOV 1 Amount due
regulations promulgated by the Federal Food and Drug 1 "h O^e
Administration (FDA). IC,,MOD Iy5LdcesLOOOOO Submit your
8. Your first invoice indicates the products delivered on your first
EOpCUSTOMEpTEpICE<ALLln0R.9pB6 ayment by this
delivery, along with any applicable bottle and accouaccount deposits, Itll. II
s. ^,eN.^9••°^4.. "sMe.
1... III. 1.... dl��al,.l,ll „I..,I.1.1.1.1.,11
redemption Pecs. and any dispenser charges. All future i nvo i ces date Skew Ma+w ^up4 ^I^1e°On °Rtle
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.
QQ 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 5 /09
r�
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.
Ice Mountain Payee
Purchase Order No.
OX
Terms
Louisville, KY 40285 -6680
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoices) or bill(s))
914108 08HO120048525 Rent and Service August, 2008 $33.90
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
We tam IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
$33.90,
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
n/a 0 HO120048525 E NG 4239099 33.90 materials or services itemized thereon for
Ac.,M0120048525 which charge is made were ordered and
received except
20OX
S' ature
Cost distribution ledger classification if Titff
claim paid motor vehicle highway fund