Loading...
HomeMy WebLinkAbout159922 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER 0 CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $124.71 PO BOX 856680 o CHECK NUMBER: 159922 LOUISVILLE KY 40285 -6680 CHECK DATE: 5/28/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 05DO12004852 21.44 OTHER MISCELLANOUS ?201 4238900 08DO11782108 57.92 OTHER MAINT SUPPLIES 2201 4238900 08EO11925208 45.35 OTHER MAINT SUPPLIES 720106 bk, ICE MOUNTAIN" 114.9 4101!08 4130108 08D0120048525 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 e e service. icemountai n.com THU- MAY 15 0120048525 III IIII 1II 1 IN 11111111111111111111111 HE II MOD- JUN 1 WED- JUL 16 6 #BWNNWYR THU- AUG 14 #0400001200485252# CITY OF CARMEL DEPT OF ENGINEE Customer Service. 1 -800- 472 -9888 LISA SCOTT OR JUDY STOHLER 1 CIVIC SQ Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery! We value your business. III II III II III11111 IIIIIIiIIIIIIII IIIIIIIIII II IIIi11I11I "Go P�aperless" Swt#ch ta bitlmg today and receive a FREE case of oilr new 41 Lifer Eco Shape bottleskon fr I uau, neXt dellveryt Also,�vlslt the web for a`speelal $5 savings;.when you order Perrier or,�Hatf Ointat f www servlce Icemountalnwatercom Soth offers ex pire 413 01 ©8 p .�ow�.�'."'s�"� r r a• .mss n a °��r '+r +c: t 1v w�i ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. It's free! i1 Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SO, CARMEL IN 46032 PREVIOUS BALANCE 36.99 4/25 906634 PAYMENT-THANK -36.99 4/16 0560385866 5 5 GAL ICE MOUNTAIN DRK W /HANDLE 17.45 5 5 GALLON ICE.- MOUNTAIN'BOTTLE DEPOSIT .00 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 4130 D5649000 RENT �nn�� 3.99 TOTAL cr, 21.44 ry MAY 2= o b �ZLZ 9z Z11 ACCOUNT SUMMARY LPIN t'F2tVEUUS BA�t PAYMENT /AL JUS` M T CURRENT AC T iVl T Y PAY TH16 AIViOUN i �bject to terms on reverse side. I 36.99 36.99 21.44 21.44 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, SEND 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means ALL CORRFSPONDENCETO: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash:" #216 If you prefer, you can pay your bill online at service.icemouutain.com. 6661 DIXIE HWY., SUITE 4 4. Never hesitate to call us with comments, questions, or concerns. LOUISVILLE, KY 4025$ 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 telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Date range of this invoice Your name, address, telephone and account numbers. The dollar amount of the suspectcd 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. 123 ,1567890 Your Account Number You do not have to pay the disputed amount while it is being JCL MOUNRIN mooloo -OW01 o investigated. During the investigation, we cannot report Your account 0=mz 23 rt+n OCT ors as delinquent or take any action to cof;cct the amount in question M oN -aT 2e Watch here for a wen -Nov zt GENERAL INFORMATION Important Tut beC'a personalized account rv1e t a°° 4,2.PSae 1. Payments are due upon receipt of invoice and should be mailed by news and 11,Ih„IVI „ikl „480..6 „Nlla,lllL,,,pQp,p,.ILIAa rnan3 rW r "g 1:, ^o.na�a, message the PAY BY date indicated on the invoices ro a ^a,•�+ offers 123 Mai^ 5r 2. Payments received aner bdGug {INVOICE) date will appear on a,ys.ate 60 your next invoice. 1 III I .1•all„ II 11 ILI,IL,I, till I dl u 3. Past due invoices (not paid within 30 days of billing date) may be Pay electronically assessed a late fee as allowed by law not to exceed S20 per month.e ^m l2h<m� Mn MN wtJU rMYatD ��t53n3Mu2F.,Rtlsfi Additionally, third party colleciionlattorncy expenses may be assessed at a rate not to exceed 100% of the unpaid balance or they;,.,, Make sure this maximum allowable by law. Activity amount has been since oar ...00rT ACTIVITY I c.,vsLZ1e ,wow 4. It is understood and agreed that each returned check is subject to it Y des ^N ^,10 Mm ^s ,1.99 paid in full to service charge. The amount of this service charge is equivalent to last invoice alas avoid late fees the maximum check return charge allowable in your State. owme�, menkYw w so oe pe131 661896 5 sWUon Na,µral sPrin9 -50 5. All bottle and equipment deposits are shown as CURRENT 1„ e,2eas°d ",a; eat o <o^ +'1 zm ACTIVITY. 61n areas s i,eMO„ "umscalanum n.Pe Monthly oil surcharge "mss' pp r' age P of u to $2.00 p er 6. Equipment replacement costs will be charged for bottles lost, uvni ns263as" 09112 1bF10a92 56 y stolen, damaged or not returned. month in any month 7. In accordance with NWNA's Terms and Conditions "T &Ca), your 'o- during which the Equipment Lease and/or Service Agreement, account may be "N monthly average price subject to minimum monthly purchases and/or early cancellation Y B umMAeY 99 r <56 a Y :^ate ^s' "s"�" M �Ta.Na,• N v,* 1 per barrel of oil is fees. (A complete version of the T&C may be viewed on the website listed below_) Upon service discontinuation, rent for Payment Stub Accourn s yAYTNnnMOUNr 1; renter than $50.00, PP Leased Equipment is charged through the end of the billing cycle K `w,�, m„,�,«��r+^ rcCWNrNUx+sER as determined by the in Which service is discontinued. ,21816)890 e;tpNGDATe MT.EN�, -u5to New York Mercantile wvoicr NUM era 8. As a food product, bottled water is subject to the rules and ,23856 s'. eor661aa Exchange regulations promulgated 9z00,1.aov cuzea713 ed by the Federal Food and Drug 61, 00039109, "a9 1a Administration (FDA). For further information, contact Ice Amount due Mountain Spring Water Company or Nc-stlb Waters North America t ^Nn ors Inc. at the address shown above. ,ceMOUNTnINwa A' c vs�r' 5 0°°°° Submit your 9. Your first invoice Includes the products delivered on your first rOe Ce5T0Mfe r rE a vr o .a2.9eae delivery, along with any applicable bottle Flititiccount deposits, i,Li a dt by this redem fees, and an dis char Y P b e9. A[! "future i 1. r Ill�l. �d nl IL .,r Q on ^l ern ^Pn o "x.u<r=<aa•. p ayment r,rtc date will reflect charges for water dclivered and dispenser rental, �a�^ bottle deposits and credits plus charges for any additional products ordered by you. Deliveries arc 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. cQ 2007 Ice Mountain Spring Water Company, a Division of Nesti6 Waters North America Inc. Form No. N* 509 09/07 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 invoice(s) or bill(s)) 513108 OBDO120048525 Rent and Service -April, 2008 $21.44 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 Ire M ountain IN SUM OF P.O. Box 856680. Louisville, KY 40285 -6680 $21.44'.' 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 Doi 20048525 f�ca 239099 materials or services itemized thereon for Ac c nt 012OM525 'which charge is made were ordered and received except S' 2 nature Cost distribution ledger classification if /Title claim paid motor vehicle highway fund MOUNTANG 720106 6_ O 4101/08 4/30/08 08DO117821082 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service. icemo untai n. com THU- MAY 22 0117821082 III IM 11111aH181IIIIf81IMIIINIII111IIDMI MON- JUN 23 WED- JUL 23 THU- AUG 21 #BWNNWYR #0400001178210823# Customer Service: 1 -800- 472 -9888 CARMEL ST. DEP. 3400 W 131 ST ST Did you forget about us? Kindly pay upon receipt. WESTFIELD IN 46074 -8267 Remember, past due accounts are subject to a late 1I111I111 AIIEI1 „I.I.II.J.III.11 II'.I fee. Your prompt payment is appreciated. For your convenience, pay online: icemountainwater.comiservice. If payment has been made, we thank you. Btyglrining within atetl J ne 18, k2 8 the $'QU inonthiy011 Surcharge WIIIkier placetl wtt a Fuel£ urcliargrased on the aijerage�mcnthl�r�F ;ce c1:�5a�lcn o tlesel`,fuel as publlsheiby tfie USA ©ept a9sl ergy. t. Fnr detalfs,zplease go www sefylce rcernountalnwater com ater 1 ���..P s- §z r 3�''t'y s:� +e 'g .-a �--'ti t '�-3 +:$`yq�re �•a M c., ,w�:.� -'"fir- r xya, s ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800- 472 -9888. It's freei OEM! MME Delivery address: CARMEL ST. DEP., 3400 W 131TH ST, WESTFIELD IN 46074 PREVIOUS BALANCE 70.94 4125 906639 PAYMENT THANK YOU -55.94 4/23 0561633926 3 9 OZ PLASTIC UP 50C /SLEEVE 8.97 4 5 GAL ICE NOUNTAIN DRK W' /HANDLE 31.96 4 5 GALLON I'CE MOUNTAIW BOTTLE DEPOSIT 24.00 3 5 GALLON.ICE MOUNTAIN.DEPOSIT RETURN -18.00 4130 0563637917 1 OIL SURCHARGE 2.00 D5638554 RENT 8.99 TOTAL 72.92 i ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 70.94 55.94 57.92 72.92 bject to terms on reverse side. BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. IN CASE OF ERRORS OR UulsT1ONS ABOU r YOUR BILL. SEND 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means ALL CORRESPONDENCE To: 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 4. Never hesitate to call us with comments, questions, or concerns. LOUISVILLE, KY 40258 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 telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Date range of this invoice Your name, address, telephone and account numbers. 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 arc not in question. oalaolao aolDOloo a 1236ea9evo Your Account Number �p You do not have to pay the disputed amount while it is being ICE MOU �N investigated- During the investigation, Nye cannot report your account f c NR -C 145678 as delinquent or take any action to collect the amount in question. mo -ocr r9 Watch here for a wro -Nov GENERAL INFORMATION raE aEC,O personalized account Important I Payments arc due upon receipt of invoice and should be mailed by news and a, 11 ah.1 11r. 11 Irlarr .uaa,ua,,,,unl „II „n,l,ltl nomer e, w ^a�e message Thank You la• ^dng the PAY 13Y date indicated on the invoice. hour e a.rvk� offers ,z3M ­o S 2. Payrnct ntved after billing (INVOICL) date will appear on on.S 000 invoi 3. Past due invoices (not paid within 30 days of billing date) may be Pay electronicall assessed a late fee as allowed by law not to exceed S20 per month. y *wr Additionally, third party collectionlatiorney expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the Make sure this maximum allowable by law. Activity 3 amount has been y our PCCOUNCACTWIT' paid in full to d. It is understood and agreed that each returned check is subject to a since D la3Mdins +.e rsa'� °p° service charge. The amount of this service charge is equivalent to fast invoice xo- «rraderes wn 1 q9 a= s avoid late fees the maximum check return charge allowable in your State. vavme ^,.Tha ^pr Ono 5 Gallon Nawral Spring Water -50,00 00111 A61848 ypp 5. All bottle and equipment deposits are shown as CURRENT g11 3 1805, G,l ACTIVITY. mess,.<.< s ,ceMou ^,alnsGalRe, 11.9 Monthly oil surcharge „I Ta�� �ils�,�aa�• 6. Equipment replacement costs will be charged for bottles lost. of up to $2.00 per ten: 3 se,w stolen, damaged or not returned. 1°° month in any month 7. In accordance with NWNA'sTCnns and Conditions "T&C" your jp during which the Equipment Lease and/or Service Agreement, account may be monthly average price subject to minimum monthly purchases and/or early cancellation 1., per barrel of oil is fees. (A complete version of the T &C may be viewed on the ��nOOS,'g _sw websiie listed below. U on service discontinuation, rent for Pa stub nccour3r sumMAa' a c greater than $50.00, 1 P WBY J PAY IM, AMOUNT Leased Equipment is charged through the end or the billing cycle �n Accouw, umSm 08100100 5,A4 as determined by the In which Service is discontinued- ,23656)890 BILLING OATE MiENCLOSED New York Mercantile INVOICE NDMBE0. RR 80 S. As a food product, bottled water is subject to the rules and lz3<seM Exchange regulations promulgated by the Federal Food and Drug 00039aan9 zoDR ss Administration (FDA). For further information, contact Ice ou200963a7 aaeaa73ab Amount due Mountain Spring Water Company or Nestle Waters North America I^h^oce Inc. at the address shown above. IcE MOUNrAINwniE RCoMPnrvr 9 Your first invoice includes the. products delivered on your first a""""'" Submit your delivery, along with any applicable bottle and account deposits, Indaa..a., tit.. ..•n...•n. ••ILaat.u.,a,hLl .a••n FOR CUSrOMER tE Rw<E�AEE,a^o 9a� a ment by this redemption fees, and any dispenser charges. All future invoices date E wror., s19n,,, „ro,„..a °n x... will reflect charges for water delivered and dispenser rental, °p bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a wwl 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. 2007 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 509 09/07 Sr 720106 hE MOUNTAIN® 04/13/08 5/12/08 08EO119252823 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com 1 0 1 0 11 'up MON- JUN 16 0119252823 II II III III II 1 HE 1111111111111111 WED- JUL 16 THU- AUG 14 #BWNNWYR MON- SEP 15 #0400001192528234# CARMEL STREET DEPT Customer Service: 1- 800 472 -9888 BONNIE CALLAHAN 3400 W 131 ST ST Thank you for choosing Ice Mountain Home Office WESTFIELD IN 46074 -8267 Delivery! We value your business. F7ord e9ils,please with invoices ,dated June 18, 2008, the_ $2.00 monthly Oil Surcharge will be replaced with a Fuet based on the average monthly price of a gallon of diesel fuel as published by-the US Dept of Energy. goao ;wwwservice.icemountainwater.com ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. Its free! Delivery a ress: PREVIOUS BALANCE 79.50 4/20 874709 PAYMENT -THANK YOU -29.16 4/25 906638 PAYMENT -THANK YOU -29.16 5/11 997911 PAYMENT -THANK YOU -50.34 4/16 0560385635 6 5 GAL ICE MOUNTAIN DRK W /HANDLE 45.54 6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 36.00 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 5/12 0565514973 1 OIL SURCHARGE 2.00 E5811669 RENT 8,99 TOTAL 45.35 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 79.50 108.66 74.51 45.35 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. t IN CASE OF ERRORS OR QUES'T'IONS ABOUT YOUR BILL. SEND 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means ALL CORRESPONDENCE TO: 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 4. Never hesitate to call us with comments, questions, or concerns. LOUISVILLE, KY 40258 If you think your bill is wrong. or if you need more information about a transaction on your bill, write us on it separate sheet of paper. We must hear from you in writing no later than thirty (30) clays after we sent you the first bill on which the error or problem appeared. )on can telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Date range of this invoice Your name, address. telephone and account numbers. 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 pans of your bill that are not in question. 00100100 123456 Your Account Number �p You do not have to pay the disputed amount while it is being 'CE IV1�N 001o01�j_ investigated. During the Investigation, we cannot report ,your account I;=MMZW 1234 TNe -OC as delinquent or take any action to collect the amount in question. MON OCT =9 Watch here for a w O -NO 71 GENERAL INFORMATION Importa UE. DC 10. personalized account -eo0.n gag a ILIL�, 111,. IIL�11111 1 „„IIIII.11 „II,LIII CurtamnSeM�ntalnP'°4""s message I. Payments are due upon receipt of invoice and should be marled by news and ­4 the PAY BY [late indicated on the invoice. 1 DO• ^e ,..,M•• otters 1 23 Slam 5t 2. Payments received after billing (INVOICE) date will appear on c 00000 I... IIIA I„ IIL., IL II .II,.LO,d,,,1,1,1,1 „1.. your nest invoice. 3. Past due invoices (not paid within 30 days of billing date) may be T91^ aMxY�” a^,4 DY, 1,,, Gk' �y2E• n ^N71v`�".<,Mn;.tYr'9,, ;�ar�m ^9 Pay electronically assessed a late fee as allowed by law not to exceed $20 per month. You1A^, Y a9,9m.m9a ^'pd ,c,N,c�9ECm,9unlaincom.wWe vanelY dD,9J9c,a.9n Additionally, third party collcetion/atiorney expenses may be I x„ dnvE^�.°'°°10in°”' Make sure this assessed at a rate not to exceed 100% of the unpaid balance or the .1010 maximum allowable by law. Activity .�.9 r amount has been since your ACCOUNT ACTIVITY a 417.5 00000 aid in full to 4. It is understood and agreed that each returned check is subject to a •peliaennaaea b2n ,,nMa�^ °KV p service charge. The amount of this service charge is equivalent to last invoice .,I ?9 va9�9,�u9u 4 avoid late fees the maximum check return charge allowable in your State. armem wale wro oW3 ab,fi98 aWll9n Nawral SPAn9 5. All bottle and equipment deposits are shown as CURRENT g 3,7eas,aau s i e M99mamsealDwa l 200 ACTIVITY. "IM51 aaa s m9 -1 11.99 Monthlv oil surcharge 09111 3170.0.a 5 O S`�c2+ 6. Equipment replacement costs will be charged for bottles lost, w 31kil See„ of up to $2.00 per '�^Oi9' ab.+ month in any month stolen, damaged or not returned. 09,1= 7. In accordance with NWNA's Terms and Conditions "T &C" your TOTAL during which the Equipment Lease and/or Service Agreement, account may be monthly average price subject to minimum monthly purchases and /or early cancellation 0 a. a per barrel of oil is fees. (A complete version of the T &C may be viewed on the g ...1.N website listed below.) Upon service discontinuation, rent for Payment stub ACC o ,cwW YAY TN1 AMOUNT g reater than $50.00, p PAY Leased Equipment is charged through the end of the billing cycle ,A„„,�,- ,�M,.�M1�Yw�^'""° ACCOUNT NUMSM eV se as determined by the in which service is discontinued II NVO N uM aE0. aCENI,NDDAn MTfeaoaED New York Mercantile IUM 00100100 S. As a food product, bottled water is subject to the rules and I2N5 Exchange regulations promulgated by the Federal Food and Drug t 7126 0920096307 0426219 0003910'19 2009 1 Administration For further information, contact Ice Amount due Mountain Spring Water Company or Nestle Waters North America Id,90oe Inc. at the address shown above. aN wema o PAm c yxa�9 9. four first invoice includes the products delivered on your first Submit hour delivery, along with any applicable bottle and account deposits, aOa NSTOME0. afT9CE CALL b0.00.aR -90.0.0. a ment by this L.,III,I „�2�1u..,,11 ....11,.11 „1.11,.1,,,6661,.1.41 M,V Se.. redemp fees, and any dispenser charges. All future mvmces D9 a•9,a .ao ^a will re(lcet charges for water delivered and dispenser rental, date srn vv ,aEf A U,o9an 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. 2007 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 509 09 /07 Sr 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. Payee 1 h Purchase Order No. Terms f Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1 57. �lz I3 t 5.35 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. r ALLOWED 20 IC.0 Q� IN SUM OF 70 i L o ItLAI D�Lu L 40 L& 5- "60 r )03. ,aq ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. 1 hereby certify that the attached invoice(s), or l n8',1 bill(s) is (are) true and correct and that the �3 materials or services itemized thereon for which charge is made were ordered and received except �j O-Q 3 2 0 08 _�1"�� C On� lg &01y l LIZ bl"� Cost distribution ledger classification if Title claim paid motor vehicle highway fund