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157972 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $29.16 PO BOX 856680 CHECK NUMBER: 157972 LOUISVILLE KY 40285 -6680 CHECK DATE: 4/1/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 080019925282 29.16 OTHER MAINT SUPPLIES cr 720106 ICE�a NIOUNTAIN® azmftmo RIM 02/13/08 3/12/08 0800119252823 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 a service.icemountain.com TUE- MAR 18 0119252823 IIIIIIIII II IIIIIII III IIIIIIIIIIIIII II WED- APR 16 THU- MAY 15 C,F,TVF+ D MON- JUN 16 #BVVNNVVYR #0400001192528234# MAR 2 0 2008 Customer Service: 1 -800- 472 -9888 CARMEL STREET DEPT Sk 4co 3 i Did you forget about us? Kindly pay upon receipt. (3ARMEL--IN- 469.-32 -3435— N Remember, past due accounts are subject to a late fee. Your prompt payment is appreciated. For your convenience, pay online: icemountainwater.corn/service. If payment has been made, we thank you. "Go Paperless "...Switch to e- billing'today and receive a FREE case of our new 1/2 Liter Eco- Shape, bottles on your next deiiveryl Also, visit the web °'fora special $5 savings when you order Perrier or Haff Pint at L w— w.ser-vice ieemountainwater,com.- Both, offers expire 4/30/©8.: ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. It's free! Deliver address: CARMEL ST: DEP- 2_CIVIC SQ, CARM I-N 4603 Delivery z7 PREVIOUS BALANCE 61.31 2/22 534427 PAYMENT -THANK YOU -32.15 2/15 0551074487 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 15.18 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 2 5 GALLON ICE MOUNTAIN'DEPOSIT RETURN -12.00 3/12 0556215242 1 OIL SURCHARGE 2.00 C5527121 RENT 8.99 TOTAL 58.32 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CUURa TIVITY 4 PAY THIS AMOUNT I �ublect to terms on reverse side. 61.3161.31 32.15�29.16�58.32 BILLING RIGHTS SUMMARY FOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER I. 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 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 its 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. Y'ou can telephone us, but doing so will not preserve your rights. In your letter, give its 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 are not in question. 0 0 1234567890 Your Account Number You do not have to pay th ICE MOUN �IDDID� e disputed amount while it is being investigated. During the investigation, we cannot report your account 12345 as delinquent or take any action to collect the amount in question. MDNoa z9 Watch here for a wED. ROV 31 GENERAL INFORMATION DEC [0 personalized account I. payments are due upon receipt of invoice and should be n Important mailed by p, n., dttdn„ ptll,l,,,pa,l,lla „tpa „I( „ud,ta co,lanns °n"":'.800`n.9e mess news and Thank Yn9 for 9pr5l<e Mounlaln pradum g the PAY BY date indicated on the invoice. loon E3oc and uM.•* offers 123 Ma 5[ 2. payments received after billing (INVOICE) date will appear on alysl „e wood your next invoice. 1.•.111,1..1. 111,.„ IL...II,,,IL,ba „I,,,I,LLI,.L.II 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 $20 per month. Additionally, third party collection /attorney expenses may be O. n,l MK. assessed at a rate not to exceed 100% of the unpaid balance or the Activity Make sure this maximum allowable by law. Smee amount has been mw. 4. It Is understood and agreed that each returned check Is subject to a y ou ACCOUNT ACTIVITY 23 Ma ns[r� cry Sa[ 0-WI n.q9 paid in full to Deliv"rYA�1ess. J9nn DUe .11.99 service charge. The amount of this service charge is equivalent to last invoice 1245 avoid late fees sBalan<k YOY 0000 the maximum check return charge allowable in your State. ✓w I w,[e� sow 110131 ,61090 Na[ulal5p n9 5. NI bottle and equipment deposits are shown as CURRENT SG,Ibn n7ees44+4 s M9 �nu;nse l Dero+B 1uo ACTIVITY. ,11 3,7003,4 s eM„na;nswlRel °a 99 Monthly oil surcharge 09111 31 pct `urcna,9e 6. Equipment replacement costs will be charged for bottles lost, o9 „z 630011 of up to $2.00 per py111 1664W91 3604 stolen. damage) or not returned. month in any month 7. In accordance with N WNA's Terms and Conditions TRC 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 <°°a.' sa per barrel of oil is Ices. (A complete version of the TfiC may be viewed on the RY 99 99 website listed below.) upon service disconninuallon, rent for Payment stub ACCOUNT SUMMA .oa raw pAYBY qY TNIS AMOUNT g reater than $50.00 p Leased Equipment is charged through the end of the billing cycle «a�+�•n•r'^•^` X A ccouNrNUTABRR as determined by the 113/567090 W. ENCLOSED New York Mercantile m wh ich service IS discontinued. INVOICE NUMBER eIWNO DATE S. As a food product, bottled water is subject to the rules and 00140100 Exchange p J 123456 regulations prom nt ulgated by the Federal Food and Drug pV20 a963D7 Oy2B2712619 000391 2 p°” 1° Administration FDA). For further information, coact Ice Amount due plountain Spring Water Company or Nestle Waters North America Innn Da 111e. at the address shown above. ICE MOUM NWATE 1 13000° COMPANY C YSIatr w ATI Submit your 9. Your first invoice Includes the products delivered on your first •0n"�� oRCU3,DMER3LIMCE<AL L1.,Bn+lz °BBB delivery. along with any applicable bottle and account deposits, amen b this ...1.. 111... IL ..,IL..al,I,1,1,A ^tt r.n. „a v n,nm<6+�9� °n"•”' s,• redemption fees. and any dispenser charges. All future invoices L,. 111,1 y n d ate will reflect charges for water delivered and dispenser rental ❑s"'" bottle deposits and credits plus charges for any additional products ordercd by you. Deliveries are made every three or tour 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 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 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. CL 7/� ALLOWED 20 1 101 1 11 A-:- IN SUM OF 40 b b 8o 02 4 lQ ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or b8C0(l�( l_5 �2 2�t, 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 MAR 3 1 ?_008 20 Sig ure Cost distribution ledger classification if Title claim paid motor vehicle highway fund