HomeMy WebLinkAbout205493 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $138.87
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 205493
LOUISVILLE KY 40285 -6680
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 01LO11782108 3.99 01LO117821082
2200 4239099 01LO12004852 7.48 01LO120048525
1125 4350900 01LO12009535 37.51 01LO120095351
1091 4350900 01LO12120276 64.85 01LO121202766
1205 4353099 01LO12177619 17.06 01LO121776199
920 4239099 01LO12220610 3.99 02LO122206105
1701 4239099 11L722032704 3.99 11L7220327048
service. icemountainwater.corn
#215 6661 DIXIE HWY, SUITE 4 12/01/11 12/31/11 01LO117821082
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED 6 e
II���'lllll�ll III��I�II'll� III'll TUE JAN 17 0117821082
WED- FEB 15
FRI- MAR 16
TUE- APR 17
Customer Service: 1 800 472 9888
CITY OF CARMEL STREET DEPATMENT Thank you for choosing Ice Mountain Home Office
3400 W 131ST ST Delivery! We value your business.
CARMEL IN 46074 -8267
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Fn,U ear-off right with'a variety of zero calorie beveragest For a limbo dime, enjoy. p $2 off per case
ImL Sport _Bottles, Tradewtnds Unsweet Tea, Ice Mountain Sparkling Waters; and Perrier -prod ucts
472-9888 Suffer expiies.2129112 "ae Q WE
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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: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074
PREVIOUS BALANCE 8.12
12/11 942766 PAYMENT -THANK YOU -35.04
12/28 032219 PAYMENT -THANK YOU -8.12
12/15 0754127439 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
5 5 GAL ICE MOUNTAIN DIRK W /HANDLE 17.45
5 5 GALLON ICE,MOUNTAIN BOTTLE DEPOSIT 30.00
3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00
12/31 0757384250 1 OIUFUEL SURCHARGE 2.60
L1893600 RENT 3.99
TOTAL 3.99
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
8.12
Q Subject to terms on reverse side. 43.16 'f' 39.03 3.99
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 1-800472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month, plus the next month 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 p g C MPLE �1`,
sheet of paper. We must hear from you in SA INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. 1214567890
The dollar amount of the suspected error.
ooiDDiDD- 0 °I 0 0°
Describe the error and explain if you can, why you believe there is
12345678
an error.
MOHDC 79 Your Account Number
You are obligated to pay the parts of your bill that are not in question. wEo-NOV
You do not have to a the disputed amount while it is being ruEDEC ,e
to p ay P g 1414 „.o�g.6,llLm C. „o,,,e,y,vke:,- BOD472 -98ee
investigated. During the investigation, we cannot report your account lbu..dlLAt••a ma ^YY^",dudMBeMounMl „R•�•
as delinquent or take any action to collect the amount in question. „h ^o°e 5 Watch here for a
123 w'" personalized account omm
GENERAL INFORMATION Important pay „n a4,4nA
message
L Payments received after the billing (INVOICE) date will appear on news and y^r
your next invoice. Past due invoices (not paid within 30 days of offers
billing date) may be assessed a late fee as allowed by law not to aaro. �'Y 4 y
Pay electronically
exceed $20 per month. Additionally, third party colleetion/attomey x "aob" „°°'n.�..
expenses may be assessed at a rate not to exceed 100% of the .«••a0"
ACCOUNT ACTIVITI'
unpaid balance or the maximum allowed by law. r,a6,ess ^s «EO °0°°° Make sure this
ceR.e�r i;.w
2. Each returned check is subject to a service charge subject to the amount has been
az es
maximum check return charge allowable in your State.
Activity ea�„uvw s °ao
paid in full to
since your m,n 318B5 Bella 5G 10 p°
3. All bottle and equipment deposits are shown as CURRENT avoid late fees
ACTIVITY. last invoice
89n7 ne:n188 „�d'
4. Equipment replacement costs will be charged for bottles lost, 17.
stolen, damaged or not returned. 10- Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C•'). your
Equipment Lease and /or Service Agreement account may be NK,M„ Surcharge, Fuel
subject to minimum monthly purchases and /or early cancellation Your new Surcharge or Delivery
Accouw SUMMARY .800 ae6
fees. (A complete version of the current T &C may be viewed on the delivery _,•e c "„„.•..B�� Fee (see #6 under 11.
website listed below) Upon service discontinuation, rent for the calendar. M Deliveries I "General
6crwm "°HBR 090
Leased Equipment is charged through the end of the billing cycle 'D' indicates a "SID' Information')
in which service is discontinued. °o�+
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a Scheduled
Delivery Fee as described in your T &C. Only one of these fees deliver}'
will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information please •,;o;, t,oG
visit the website listed below or contact our customer service v v a
center. Payment stub n
MYBY AY THIS WOUW
7. As a food product, bottled water is subject to the rules and ACCOUHrNUMeEn iWim I Amount due
0 p 5 NCEOSED t
regulations promulgated by the Federal Food and Drug I 135456 NVOICE NUMBER BIWNG DA,E
Administration (FDA). ,234567890 Wiwi.
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, 042OU96307 00262112619 000391009 200007D16 Submit your
redemption fees, and any dispenser charges. All future invoices will im "D« payment by
reflect charges for water delivered and dispenser rental, bottle this date
deposits and credits plus charges for any additional products wRCV51 DMER5ERwcECAH ,eoo4 2.988a
ordered by you. Deliveries are made every three or four weeks, for i ip6, a „1n:,.•n^s1••n�•u'a °6M.u'4't! o••"
a total of 16 -17 deliveries per year. You will only receive invoices Qswl+w anVpO °ceOM
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 708 5 /08 Se
service. icemountainwater.com
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))
01/04/12 01 LO117821082 $3.99
1 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
VOUCHE NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$3.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member;
2201 01 LO117821082 42- 389.00 $3.99 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
j Wednesday, January 11, 2012
I A
Street Commission(V
Street Cf- ,grnlssioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service. icemountainwater.com O b O
"N A M., 215 6661 DIXIE HWY, SUITE 4 12/01/11 /11 12/31/11 11L7220327048
LOUISVILLE KY 40258
B e
ADDRESS SERVICE REQUESTED
II I I II I �I III I IIII II I I I I I I I I I II�
MON FEB 06 7220327048
WED- MAR 07
THU- APR 05
MON- MAY 07
CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1- 800 472 -9888
ANN DAVIS Thank you for choosing Ice Mountain Home Office
1 CIVIC SQ Delivery! We value your business.
CARMEL IN 46032 -2584
'�'�'I'�III�'I'I��I II "I'�IIII�I�IIIII� "�'I II'�IIIII "I "'�I'lll
ca
Stmt thexyear offr�gtit�with avarlety ofzero lorie beverage's Fora I[mited en,ioy up�to $2 off >percase
on our 700 mL Sp rt .Bo es Tradewinds Unsweet T� Ice_ M untain ing �W
Sparklaters; andRerrier products.
Call 1 -800 472 =9888 Offer expires 2/29/12
ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1 -800- 472 -9888. It's free!
e e
MMUM
Delivery address: CITY OF CARMEL, 1 CIVIC SQ, CLERK TREASURER OFFICE, CARMEL IN 46032
PREVIOUS BALANCE 10.12
12/26 022602 PAYMENT -THANK YOU -10.12
12/31 L1930841 RENT 3.99
TOTAL 3.99
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 10.12 10.12 3.99 3.99
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE 01 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- 800472 -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. If you
#2 16 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. ,a3s6=eso
The dollar amount of the suspected error. 0 100 .00100100
Describe the error and explain if you can, why you believe there is ,13 5679
an error.
You are obligated to pay the parts of your bill that are not in question. W 6NOV Your Account Number
NE- OEC ,e
You do not have to pay the disputed amount while it is being dt,oit..,mn•db,da•N c „ao^,nserMe:,aoon "9888
investigated. During the investigation, we cannot report your account ni�tl ►,n�.iva,�.0 rb.,, r°"'°` Watch here for a
as delinquent or take any action to collect the amount in question. ^n°oe a^a
113 M n s` ersonalized account
y s
GENERAL INFORMATION Important i;a -i m^a c "ua "'��n', message
1. Payments received after the billing INVOICE date will a 've6V"" z
y g appear on news and ywoen =a'
our next invoice. Past due invoices not aid within 30 days of r ".+A•9+wa X98 "`0'r'""''"”„ vxam+n
Y P Y offers oruv `a T a
billing date) may be assessed a late fee as allowed by law not to w
t, Pay electronically
exceed S20 per month. Additionally, third party collection /attorney ..00
expenses may be assessed at a rate not to exceed 100% of the
p aid balance or the maximum allowed b' law. "ccpONT Aarvrry °ry'sjjje 000m
unpaid amerv^aa jpOnD"`'�3� s «c Make sure this
2. Each returned check is subject to a service charge subject to the "aro amount has been
maximum check return charge allowable in your State. Activity na,�e^•-TMan w„e s000
oe, .6 s can^„ ^•a� paid in full to
since our
3. All bottle and equipment deposits are shown as CURRENT Y 9 ^scan•^"^ avoid late fees
ACTIVITY. last invoice o9n, nms ws" m,q
4. Equipment replacement costs will be charged for bottles lost, 8 s
stolen, damaged or not returned. .mnE Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C" your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be ..E•n.�+^ siw
subject to minimum monthly purchases and/or early cancellation Your new Surcharge or Delivery
AccouWSUM
8e
fees. (A complete version ofthe current T&C may be viewed on the delivery „�.•o. "••W Fee (see #6 under
website listed below) Upon service discontinuation, rent for the calendar. eEe. ""56° "General
j�y Deliveries Ac ou m
Leased Equipment is charged through the end of the billing cycle `D' indicates Information
in which service is discontinued. "ova "5;
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled
delivery
Delivery Fee as described in your T &C. Only one of these fees
will apply to each account. The fee that applies to your account m' Y
is stated on the front of the invoice. For further information pleased,', M „�P
visit the website listed below or contact our customer service v
center. Payment stub
nRY BY AY rN 3 AMOUNT
7. As a food product, bottled water is subject to the rules and w�,„,,,.,..,n.,�"•.^°' AaoUNrNUMal rot Amount due
wroo
regulations promulgated by the Federal Food and Drug ,=}sb B11 OA.E Naosro
,NYOICE NUMBER 1p,00t00
Administration (FDA). ,a }ss,e90
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, 942oo96301 34212py2619 000391ov9 aoavaaol Submit your
redemption fees, and any dispenser charges. All future invoices will �on^oa payment by
Ma n St
reflect charges for water delivered and dispenser rental, bottle c
00000 this date
deposits and credits plus charges for any additional products nU•W "m° w "eOnoMen sEm^OErµE'
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 0 s c N^P •^^fPfE"" gi1p
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 708 5/08
service. icem ountainwater.com
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 l�� 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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
N�
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. a I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
I (L1D-D0'!V 04 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service.!cemountainwater.com O 151 10080411101
r, J1111099
XIM 215 6661 DIXIE HWY, SUITE 4
LOUISVILLE KY40258 12/01/11 12/31/11 01LO122206105
ADDRESS SERVICE REQUESTED e B e
Il 1 1 11 l it 1 1 11 l II I I I II I I I I I I I II
MON FEB 07 0122206105
WED- MAR 07
THU- APR 05
MON- MAY 07
CITY OF CARMEL ENGINEERING /1ST AVE Customer Service: 1- 800 472 -9888
KATIE NEVILLE Thank you for choosing Ice Mountain Home Office
1 CIVIC SQ Delivery! We value your business.
CARMEL IN 46032 -2584
VIII' �II��II�III�������III�II���II�II��IIII����Il�����l�ll IIII�'I
St the year off right wdha varlefy ofzeo calorie beverages For almltedalme, enjoy up.to $2 off per case
on;our700 °mL Sport Bottle T
s, radewlnds_Unsweet Tea; Ice Mountain Sparkling, Waters, and.Perrierproducts
Cai, .1 1 80072 0 0 rlexplres 2f291 i 2
v u
ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at:1 -800- 472 -9888. It's free!
r s
9
Delivery address: CITY OF CARMEL ENGINEERING, 130 1ST AVE SW, CARMEL IN 46032
PREVIOUS BALANCE 7.98
12/11 942762 PAYMENT -THANK YOU -3.99
12/28 032223 PAYMENT -THANK YOU -3.99
12/31 L1895561 RENT 3.99
TOTAL 3.99
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 7.98 7.98 3.99 3.99
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 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. Z3.z6ra90
The dollar amount of the suspected error. I OU10�I00 00100100
Describe the error and explain if you can, why you believe there is 1234562890
an error. Your Account Number
You are obligated to pay the parts of your bill that are not in question. wEo- r�mv n
You do not have to pay the disputed amount while it is being 1uEoec ,e
investigated. During the investigation, we cannot report your account a.
Watch here for a
as delinquent or take any action to collect the amount in question. n ^a um,.
123 Main St p ersonalized account
GENERAL INFORMATION Im p �1,..5N,.
t UC.1.m P«w 6'tiaa r.a,ran message
X66
I. Payments received after the billing (INVOICE) date will appear on news and ro�- e ,„>�wSMoN.'
your next invoice. Past due invoices (not paid within 30 days of offers T°t"”- 9
billing date) may be assessed a late fee as allowed by law not to
exceed $20 per month. Additionally, third party collection/attorney _•,.a --r a ,,,,,;;e,,,,.w...,«•� Pay electronically
expenses may be assessed at a rate not to exceed 100% of the
ACCOUNr ArnVITY sntt` ary.SUne a0006
unpaid balance or the maximum allowed by law. 0 6.,e,y6aa,.., 3n6 12361 Make sure this
2. Each returned check is subject to a service charge subject to the +2.s amount has been
maximum check return charge allowable in our State. Activity
g Y paid in full to
our osm 3veen.w ;,MOB ^umswlarou+ :96
3. All bottle and equipment deposits are shown as CURRENT Since Y „acs, w 3 M ^sw16. avoid late fees
ACTIVITY. last invoice F
4. Equipment replacement costs will be charged for bottles lost, __v
stolen, damaged or not returned. 0 eE Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be ..urtM*m^
subject to minimum monthly purchases and/or early cancellation Your new Mw Se 5140 Surcharge or Delivery
fees. (A complete version of the current T &C may be viewed on the 6ccouNr sUMnunv Fee (see #6 under
delivery calendar M.x d
website listed below) Upon service discontinuation, rent for the ro „ON.Ea +rrs^'° "General
p win
Leased Equipment is charged through the end of the billing cycle in M y elvenes
Information
D i ndicates
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled
eo
delivery
Delivery Fee as described in your T &C. Only one of these fees will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information pleasem;
visit the website listed below or contact our customer service a T9
center. Payment stub P6T..
p6T AMOUM
7. As a food product, bottled water is subject to the rules and wow+^•^'
s1 Amount due
oorooloo
123456) 6 NCEOSED
regulations promulgated by the Federal Food and Drug a1WNG D6rE
Administration (FDA). `MZ3 UM a 4s62avo 00 r°Oj 00
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, OV2009630i OV262i12639 00039YOV9 z00�o20� Submit your
redemption fees, and any dispenser charges. All future invoices will i „6^ ox payment by
reflect charges for water delivered and dispenser rental, bottle ICE MO N *aNw"TE" uwsvie this date
deposits and credits plus charges for any additional products w c ME sEahcE UUleao.rl.vaea
ordered by you. Deliveries are made every three or four weeks, for 6 a, y, a „m „.,aiaar ar•a'u' 61u r °r ^a
a total of 16 -17 deliveries per year. You will only receive invoices
pn6e
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 708 5/08
service. icemountainwater.com
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
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))
01/04/12 01 LO122206105 Keystone Reconstruction Project $3.99
Miscellaneous
Project 07 -08
Total $3.99
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
VOUCHER NO. WARRANT NO.
Ice Mountain Direct ALLOWED 20
PO Box 856680 IN THE SUM OF
Louisville, KY 40258 -6680
3.99
Fb k Fb �x* Kb- Y -F-- 0 lbF- *'�%Fbx
1'11 R 6'E1*0* XE 1XC3ff U*
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
DEPT.#
NA 01 LO122206105 4239 $3.99
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
16 -Jan 20 12
Total $3.99 Signatur
Cost distribution ledger classification if Cit En
claim paid motor vehicle highway fund Title
service. icemountainwater.com 9 9 3 101 B
N '4191
215 6661 DIXIE HWY, SUITE 4 12/01/11 12/31/11 01 L0120048525
G
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
MON FEB 06 0120048525
11111111111111 111 oil II' WED
WED- MAR 07
THU- APR 05
MON- MAY 07
CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1- 800 472 -9888
LISA SCOTT OR JUDY STOHLER Thank you for choosing Ice Mountain Home Office
1 CIVIC SQ Delivery! We value your business.
CARMEL IN 46032 -2584
III' II' ll��l�l�llllllll�lllll�����ll���l 'I�'I�II����I��I�I�I�I'I�
Start tlie�year off right with: a'variety of zero calorie beverage For a limited t me, enjoy up to $2 off per cue
on�our:700mL Sport Bottles.TradewmdsUnsweet Tea;Ice Mountan 1N aters anciWPerrier products.
CAll 1 -800-4 Offer ezpires,2 /29/12
ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntai nwater.com or by phone at:1- 800 -472 -9888. It's free!
M
Delivery address: CITY OF CARMEL, 1 CIVIC SO, CITY ENGINEERING DEPT, CARMEL IN 46032
PREVIOUS BALANCE 11.47
12/11 942765 PAYMENT -THANK YOU -10.97
12/26 022603 PAYMENT -THANK YOU -3.99
12/06 6678285203 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 .00
12/31 L1904944 RENT 3.99
TOTAL 7.48
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 11.47 14.96 10.97 7.48
Customer Service: 1- 800- 88 My ®elGVeG''BeS ACCOUNT NUMBER: 0120048525 service. icemountainwater.comer.com
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BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR l 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. Z3as61690
The dollar amount of the suspected error. OOIDNI00- D0100MD
Describe the error and explain if you can, why you believe there is
TM0. a 123456789
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investigated. During the investigation, we cannot report our account YW Watch here for a
as delinquent or take any action to collect the amount in question. ro •bu^^
123 Main St personalized account
GENERAL INFORMATION Important i..mua. f
message
I. Payments
our next invo
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AA
P aid within 30 days of offers 1°'nid "1D�"Ywat'�'n°"`"1�''"""h
billing date) may be assessed a late fee as allowed by law not to d•'""';` Pay electronically
exceed $20 per month. Additionally, third parry collection/attorney
expenses may be assessed at a rate not to exceed 100% of the AccO UMACrrvrn'
unpaid balance or the maximum allowed by law. 11 M+ s cry's MW Make sure this
Delivery Add ess:
2. Each returned check is subject to a service charge subject to the 9 ,hM• amount has been
maximum check return charge allowable in your State. Activity „,.,,,e ^,.D.• "IYOU
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3. All bottle and equipment deposits are shown as CURRENT since your o9m 1 keM0u0u'nSGII�M
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4. Equipment replacement costs will be charged for bottles lost, o9n1 ,6aw91
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5. In accordance with NWNA's Terms and Conditions "T &C your si Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be .ry, <,,..w."<�^
subject to minimum monthly purchases and/or early cancellation Your new ,„w w Surcharge or Delivery
fees. (A complete version o t e current T&C may be viewed on the
ACCOUNT SUMMARY Fee (see #6 under
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delivery •o ,,rte x•m•
websi(e listed below) Upon service discontinuation, rent for the calendar. a y- "General
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`D' Information")
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a Scheduled
livery
Delivery Fee as described in your T &C. Only one of these fees de
will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information pleaseo;,,',7. �`'o" n »n
visit the website listed below or contact our customer service
P stub
center. Y N r AY 9v rAV THIS AMD
7. As a food product, bottled water is subject to the rules and ,"•mM. A<couNrNUneEx Amount due
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regulations promulgated by the Federal Food and Drug 121+s61990 suwc DATE A Nc1oSED
IM'OICE NUM9E0.
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8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, 0420096309 04262712619 000393049 200407 Submit your
redemption fees, and any dispenser charges. All future invoices will lo^�— S payment by
reflect charges for water delivered and dispenser rental, bottle icEMOU w °M .,,,'e.
123 .sse 000 this date
deposits and credits plus charges for any additional productsa w asrDMEASEnvI <AEE1•90-029°°°
ordered by you. Deliveries are made every three or four weeks, for 6. msJ ,.n,;.,n�ai.au.6n,a.,la.ue +.n 9d• D. N.•, ,Rs— "•nes9..
a total of 16 -17 deliveries per year. You will only receive invoices ❑:w�„o
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 708 5/06
service. icemountainwater.com
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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
P.U. 1:30X 8b6680 Purchase Order No.
Terms
Louisville, KY 40285 -6680
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/4/12 01L Rent and Servie Dec $7.48
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 Moilntain IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
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
01L Ef K3 4239U99 .48 bill(s) is (are) true and correct and that the
na
materials or services itemized thereon for
Acc it 0120048525
which charge is made were ordered and
received except
\il �I12 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service.icemountainwater.com 0 D 0
215 6661 DIXIE HWY, SUITE 4
12/01/11 12/31/11 01L0121776199
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED e B e
MOD- FEB 06 0121776199
WED- MAR 07
THU- APR 05
MON- MAY 07
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
Il�lllllll�lll llll�lllll�llllllln�ll��llnlll l�lllllllnn�l llll
Start the�year off right "wlth,awanety of zero calo�le`6eTferages For a limlted�tlme, enjoy up to`$2 offyper case WkIl on -our 700 mL Sport Bottles,, Tradewlnds Unsweet Tea, Ice Mountain Sparkl g`Waters`, and. Perrier, products...
Ca111,800472 2 /29/12
yy
h'..a... d
ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1 -800- 472 -9888. It's free!
Delivery address: CITY OF CARMEL, 1 CIVIC SQ, HUMAN RESOURCE DEPT, CARMEL IN 46032
PREVIOUS BALANCE 17.60
12/11 942761 PAYMENT -THANK YOU -13.61
12/28 032222 PAYMENT -THANK YOU -3.99
12/08 0754172526 3 5 GAL ICE MOUNTAIN DIRK W /HANDLE 10.47
BOTTLE DEPOSIT: 3 CHARGED, 3 CREDITED .00
12/31 0757340898 1 OIL /FUEL SURCHARGE 2.60
L1897835 RENT 3.99
TOTAL E DO,
17.06
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 17.60 17.60 17.06 17.06
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 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. 1 1234567890
The dollar amount of the suspected error. oot00loo oaooloo
Describe the error and explain if you can, why you believe there is
4Y4 1234567B
an error. 7"
You are obligated to pay the parts of your bill that are not in question. ^w°o- Your Account Number
UE. p C 18
You do not have to pay the disputed amount while it is being �,,,.eoo- •74.9
investigated. During the investigation, we cannot report your account`„pwm,nmG•Ima.ot ttJte
Watch here for a
as delinquent or take any action to collect the amount in question.
123 MS" S' personalized account
p ryState 00000
GENERAL INFORMATION
Im r m 51- o ,.au a, u.�ua.,t.taa.a.n
message
I P our t next r invoice. Past due no dwith wi 30 news and
Ywo
s of K
Y P Y offers
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billing date) may be assessed a late fee as allowed by law not to mNk6« r r
exceed S20 per month. Additionally, third party collection/attorney _Y— �„••e,,,.,a,..• Pay electronically
expenses may be assessed at a rate not to exceed 100% of the
P Y Accour+r Acrn9TV
unpaid balance or the maximum allowed by law. s'a'e 00000 11,E Make sure this
2. Each returned check is subject to a service charge subject to the W,Bala sow amount has been
maximum check return charge allowable in your State. Activity a>"mm L"' so.. paid in full to
since
swno" "m I «Ma "1
3. All bottle and equipment deposits are shown as CURRENT y our .11 31ees,.w 3,7066,4 M mlcq" ",aism•9w „r 1 avoid late fees
ACTIVITY. last invoice o6n, 3,76
4. Equipment replacement costs will be charged for bottles lost, 0 7 'x°
stolen, damaged or not returned. mw Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be �,.c7P07+ a 4
subject to minimum monthly purchases and/or early cancellation Your new �a Surcharge or Delivery
fees. A complete version of the current T &C may be viewed on the pCCOU SUMMARY
delivery E Fee (see #6 under
P y M NI S M
website listed below) Upon service discontinuation, rent for the calendar. D Kc "General
Leased Equipment is charged through the end of the billing cycle `D' indicates H Information')
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a Scheduled
Delivery Fee as described in yourT &C. Only one of these fees delivery o
will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information please
visit the website listed below or contact our customer service
center. Payment stub
PAY By PAY TNISMOUNr
7. As a food product, bottled water is subject to the rules and ,wp.,�' Accou 5678AeEB Wooer Amount due
regulations promulgated by the Federal Food and Drug oI C NUM &WNG OATE A NCLOSEO
IM'OICE NUMBER oo /w 00
Administration (FDA). 1:34567690
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, 0 "20096301 09zez13z639 000391099 zo0901m6 Submit your
redemption fees, and any dispenser charges. All future invoices will payment by
reflect charges for water delivered and dispenser rental, bottle ICEMWN3 ^TE„;° P ovs'aa this date
deposits and credits plus charges for any additional products ova „.,ww•,•� c05TOMEAIE6YICErA3.'800'739°6B
ordered by you. Deliveries are made every three or four weeks, for u..wAa iw»aa,.at.a6.tip.a.,4ua,a n Iue +08��
a total of 16 -17 deliveries per year. You will only receive invoices 0000 >IO•E^�""°
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 708 5i08
service. icemountainwater.com
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))
01/04/12 01 LO121776199 $17.06
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
PO Box 856680
Louisville, KY 40258
$17.06
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1205 101 LO121776199 I 43- 530.99 I $17.06 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
Friday, January 1 2012
Director, Admin
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
1 -4 -1�
service. icemountainwater.com
®4 215 6661 DIXIE HWY, SUITE 4
12/01/11 12/31 /11 01LO121202766
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED Jam MM=
MOD- JAN 23 0121202766
WED- FEB 22
THU- MAR 22
MON- APR 23
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
iiriinlllll�l�nlli�llllrll�illlnlll��rl�n�lll�l�lll��l�ill
Start theyear off ri ht,wifh auarietyofzero calorie beverages. For a limited time; enjoyup to $2, off percale
son our 700 mLSport Bottles, Tradewinds Unsweet,'f�ea, Ice�Mountain Sparkling Waters�:and Perrie p ducts
e
ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at: 1 -800-472-9888. It's free!
Delivery address: CITY OF CARMEL PARKS DEPT /MONON CENTER, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032
PREVIOUS BALANCE 109.72
12/11 942764 PAYMENT -THANK YOU -49.86
12/28 032220 PAYMENT -THANK YOU -59.86
12/22 0755213428 2 .5 L NATURAL SPRING WATER ICE MTN 11.98
3 9 OZ PLASTIC UP 50C /SLEEVE 8.97
9 5 GAL ICE MOUNTAIN DIRK W /HANDLE 35.91
BOTTLE DEPOSIT: 9 CHARGED, 9 CREDITED .00
12/31 0757517941 1 OIL/FUEL SURCHARGE D 2.00
L1995551 RENT 5.99
F'iirchase A-, T AL JAN 0 9 2012 64.85
C: <scription DRINKING UJ TE
.0.# PorF
,.L. io BY
L ine Descr C a aC" y 01 5
Purchaser Date
Approval Date
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
o'er Subject to terms on reverse side. 109.72 109.72 64.85 64.85
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR l 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. 1234S67990
The dollar amount of the suspected error. I o0tN/00. 0010011
Describe the error and explain if you can, why you believe there is
taY 123456]
an error. TH9 -o<T oa
You are obligated to pay the parts of your bill that are not in question. w °o- o Your Account Number
You do not have to pay the disputed amount while it is being TOE -DEC
I9
g g g P Y snmad.at ®iu,u m.0 ®it M am,•
investigated. During the investigation, we cannot report our account m nE y nulue9e^9 KeMOU ^o<
Watch here for a
as delinquent or take any action to collect the amount in question.
123 Ma Sl personalized account
ry.5.
Im C4 5 i.re
GENERAL INFORMATION iw.aw6ua..l:wa; +'1
message
1. Payments received after the billing (INVOICE) date will appear on news and fry"
y ou< x9T1��9
your next invoice. Past due invoices (not paid within 30 days of offers
billing date) may be assessed a late fee as allowed by law not to
exceed $20 per month. Additionally, third a collection/attorney
Pay electronically
P Y P Y
expenses may be assessed at a rate not to exceed 100% of the
P Y ACCOUNT ARIVITS' C kam oaDW
unpaid balance or the maximum allowed by law. Mi nsveec n Make sure this
O �W ry ACe,ess. loon Doe
2. Each returned check is subject to a service charge subject to the Yn :0:90 amount has been
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maximum check return char PaWnem w
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since our o9,,, 3»E95,wx 5 ice Nnun,zinSW D P°
3. All bottle and equipment deposits are shown as CURRENT Y c i?.wm 199 avoid late fees
ACTIVITY. last invoice
4. Equipment replacement costs will be charged for bottles lost, 9�9i11i ,Ie�,z6D319e n.a
stolen, damaged or not returned. ToTAE v Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be s,�
subject to minimum monthly purchases and/or early cancellation Your new N.r,< Surcharge or Delivery
SUMMARY Fee (see #6 under
fees. (A complete version of the current T &C may be viewed on the delivery ACCOUNT
website listed below Upon on service discontinuation, rent for the calendar. =use e9° JE "General
y p M
Leased Equipment is charged through the end of the billing cycle 'D' mdtcates M Information
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge of a Scheduled p ;9a
Delivery Fee as described in your T &C. Only one of these fees delivery n a E
m 13
will apply to each account. The fee that applies to your account
is stated on the front of the invoice. For further information please
visit the website listed below or contact our customer service
center. Payment stub
PAY BY PAY THIS AMOUNT
7. As a food product, bottled water is subject to the rules and w,,..,,n, P.r�^ Ac..UNTNUM9ER n.o Amount due
a01oo10
A NCLOSED
regulations promulgated by the Federal Food and Drug Irrv DICE acE N990 UM9E9 9auNC Dnre
Administration (FDA). 1234561890 ppj000
8. Your first invoice indicates the products delivered on your first
delivery, along with any applicable bottle and account deposits, 092009630/ 09262712619 000391099 20090v0r Submit your
redemption fees, and any dispenser charges. All future invoices will
�o „nDce payment y
2) Main St
reflect charges for water delivered and dispenser rental, bottl I cMOUNTAiNwAT? P c¢as,a,e 00000 this date
deposits and credits plus charges for any additional products Bs E9,^C =CAEE
ordered by you. Deliveries are made every three or four weeks, for 1,,, m. 6. a «lun.,t! „,al „:n,a,ua..6u.u,u,u ems.^ ❑`°a Am re,,.5,
a total of 16 -17 deliveries per year. You will only receive invoices 1GNOPEOe1 ^sgo °n•
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 708 5108
service. icemountainwater.com
service.icemountainwater.com C p
215 6661 DIXIE HWY, SUITE 4 12/01/11 12/31 /11 01 L0120095351
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
111 I I I I �����I I I I II �I� MON JAN 23 0120095351
WED- FEB 22
THU- MAR 22
MON- APR 23
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 Delivery! We value your business.
CARMEL IN 46032 -3455
I�III'III'I��I'�II' 1 I�Illlllllil 'll'I'll�ll'�IIIII'I'lll�lll
Start the year off right with a variety ofzerocalor =te��eerages. Fora limiter! time, enjoy up o $toff per- case
'on our700 mLSport Bottles, Tradewinds Unsweet Tea, I.ceMounfan Sparkling Wateand Pe tier °products
Call 4- 80f)�72 =9888. Offer�expires 2%29112.
y�
ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.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 73.09
12/11 942763 PAYMENT -THANK YOU -41.54
12/28 032221 PAYMENT -THANK YOU -31.55
12/21 0755213394 4 5 GAL ICE MOUNTAIN DIRK W /HANDLE 15.96
3 9 OZ PLASTIC UP 50C /SLEEVE 8.97
BOTTLE DEPOSIT: 4 CHARGED, 4 CREDITED .00
12/31 0757390141 1 0!L /FUEL SURCHARGE 2.60
L1918531 RENT D 9.98
TOTAL JAN 01Z 37.51
Purchase
P.O. PorF BY....
—I a5�._D�
G. L.
Budget
Line Deser� COy.
i'u; —V IasQr Date
Approval Date
A C CUFIT SU 1Vf IOfARY PREVIOUS BALANCE PAYMENT ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subje to terms on revert d 73.09 3751- 37.51
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 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. If you
#216 prefer, you can pay your bill online at service.icemountainwater.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 SAMPLE INVOICE
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 Date range of this invoice
so will not preserve your rights. In your letter, give us the following
information:
Your name, address, telephone and account numbers. 23esgrgeo
The dollar amount of the suspected error. I 00100100 00,00
Describe the error and explain if you can, why you believe there is I115e7890
an error.
You are obligated to pay the parts of your bill that are not in question. moo_, YOnr Account Number
You do not have to pay the disputed amount while it is being wE Mc B
investigated. During the investigation, we cannot report your account ILIEmta k16.01aaddl9d@14ma1a.16dld'al c n°n,<. sax u gg
Watch here for a
as delinquent or take any action to collect the amount in question. ,w
123 Ma 1, personalized account
ccy.l,a °0°� a.a6 �IGd +1.W�hA
GENERAL INFORMATION Important nti i m message
I. Payments received after the billing (INVOICE) date will appear on news and
your next invoice. Past due Invoices (not paid within 30 days of offers
billing date) may be assessed a late fee as allowed by law not to
exceed $20 per month. Additionally, third party collection/attorney Pay electronically
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. ncc °uNr Arnvrrr sv<ec ca s,am 000BB
Make sure this
2. Each returned check is subject to a service charge subject to the ,cal, •z amount has been
maximum check return charge allowable in your State. Activity ^EY«' wain w
Paid in full t0
3. All bottle and equipment deposits are shown as CURRENT since your o-m ivael,Aw. rnW
avoid late fees
ACTIVITY. last invoice mm
Benz 3 zs3ee
4. Equipment replacement costs will be charged for bottles lost, RN"
stolen, damaged or not returned. Monthly Oil
5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel
Equipment Lease and/or Service Agreement account may be
subject to minimum monthly purchases and/or early cancellation Y our new Surcharge Or Delivery
P Y de►ivery MAR
fees. A coin lete version of the current T &C maybe viewed on the A ccouNT SUMMARY c Fee (see #6 under
�k
"General
website listed below) Upon service discontinuation, rent for the calendar.
«o°
Leased Equipment is charged through the end of the billing cycle 'D' indicates my De wen Information
in which service is discontinued.
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled
Delivery Fee as described in your T &C. Only one of these fees delivery
will apply to each account The fee that applies to your account"
is stated on the front of the invoice. For further information please
visit the website listed below or contact our customer service
center. Payment stub 4
PAY BY PAY TNIS�MOU
7. As a food product, bottled water is subject to the rules and m,.�, Pte^^^ AccouwNUMBER Amount due
regulations promulgated by the Federal Food and Drug 1 161 NU,NeW A NcEosED
IN 1c, NUM BER WIW�W
Administration (FDA). I23456789
8. Your first invoice indicates the products delivered on your firs[
delivery, along with any applicable bottle and account deposits, 142BD%3°1 D�zez�1z6i9 UDD393DV9 zoD "DVOie Submit your
redemption fees, and any dispenser charges. All future invoices will paym y
a
reflect charges for water delivered and dispenser rental, bottle H. cws�xi 0000° this date
ment b
deposits and credits plus charges for any additional products
ordered by you- Deliveries are made every three or four weeks, for t mu :a »�n�w�t�- ai^•f 1,,• O «"^Y ^•sue
a total of 16 -17 deliveries per year. You will only receive invoices sw "OPEOBEA
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 708 5108
rvlra IcemnuntatrnAi
t
t«^� �:rs`� .�C_ .,jam .�s...� �..t�r ""�5,,. 3 ,a�<r_ I� II z t`+xi •ti ��zm, `'I I �I
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
1/4/12 01 LO120095351 Drinking water cooler- Maint 37.51
114112 01 L0121202766 Drinking water cooler- MCC 64.85
Total 102.36
1 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
102.36
ON ACCOUNT OF APPROPRIATION FOR
101 General 109 Monon Center
PO# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
Dept
1125 01LO120095351 4350900 37.51 1 hereby certify that the attached invoice(s), or
1091 01LO121202766 4350900 64.85 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
11 -Jan 2012
Signature
102.36 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund