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168038 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 0 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $197.19 PO BOX 856680 CHECK NUMBER: 168038 LOUISVILLE KY 40285 -6680 CHECK DATE: 1/21/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 120048525 21.44 OTHER MISCELLANOUS 1125 4353099 120095351 X 31.45 OTHER RENTAL LEASES 1047 4353099 121202766 42.91 OTHER RENTAL LEASES ,1205 4239099 121776199 —53.43 OTHER MISCELLANOUS 1701 4239099, 7220327048 12.99 OTHER MISCELLANOUS ;°,2201 4236900 78'21082 r 34. 97 OTHER MAINT SUPPLIES 4. a e �s 720106 w _,_r<_.- 10 AM 12/01/08 -12/31/08 08LO120048525 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com TUE- JAN 20 0120048525 III IM IN I I M 1 II 1II N I0l1 IN IN BI III IN THU- MA 19 THU- MAR 19 #BWNNWYR FRI- APR 17 #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. Enjoy special, savings! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery, save $2 /box on Nestea Flavored Tea Sticks. Limit offer to 6 of each .per del;very, expires 2 /27/09. More info. go to servlce.icemountalnWa or call 800 888 ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free! Mum. IM Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 49.36 12/07 176148 PAYMENT -THANK YOU -24.93 1/04 312723 PAYMENT -THANK YOU -24.43 12/15 0597615459 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 ,14111? y3��,s .00 12/31 L6792442 RENT 3.99 TOTAL f EQ 21 .44 I JAN 2009 N L Z e m A CCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT ubject.to.terms onseverse side..... 49.36 m 49.36 21.44 21.44 My Deli ve ries ACCOUNT NUMBER: 0120048525 Customer Service: 1- 800 472 -9888 service. icemou ntain.com 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 I 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.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in 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: MT Your name, address, telephone and account numbers. -m ,zs+s6iaso The dollar amount of the suspected error. Y OOr00rOO.O0r0Oroo Describe the error and explain if you can, why you believe there is 12,,567890 an error. Wo„ p Your Account Number You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being i0E DEC Ifl g g investigation, Y it'll n611h.11111 dn6l,uti „nnt „n.,na,ni eU G^K• ery ea- 80003 -9680 investigated. Dunn the mvesti anon, we cannot report our account 1n. YO°�or uA^9 Ne MamLM ^w°a"”' as delinquent or take any action to collect the amount in question. 10. Watch here for a 123 Mill St personalized account GENERAL INFORMATION Im p e11 D�Do i.,anl i m ,ab,,,n n rn t i6la,a,ni message 1. Payments received after the billing (INVOICE) date will appear on news and our next invoice. Past due invoices (not aid within 30 days of i<m+;�D "`y �*e:< Y paid Y� offers billing date) may be assessed a late fee as allowed by law not to aa•�na.,a..nE,w+�n 3'--"` exceed $20 per month. Additionally, third party collection/attomey q Pay electronically expenses may be assessed at a rate not to exceed 100% of the nccouNT r 0 unpaid balance or the maximum allowed by law. D.nr<nAea,ESr; ,w, ^D�. ,31r.>ammm�. cM.s °u Make sure this 2. Each returned check is subject to a service charge subject to the amount has been maximum check return charge allowable in your State. Activity p ^LYa wnH m since our swlmDnw.I paid in full to IceMw^,a1nS W1DFwlt 3. All bottle and equipment deposits are shown as CURRENT y avoid late fees ACTIVITY. last invoice 4. Equipment replacement costs will be charged for bottles lost, 6•w9' r 9JW stolen, damaged or not returned. r Al Oil l 5. In accordance with NWNA's Terms and Conditions (•`T &C your Monthly O l Equipment Lease and/or Service Agreement account may be s wD+.. vw Fuel subject to minimum monthly purchases and/or early cancellation Your new Y ,MY,N M L Surcharge or Delivery fees. A complete version of the current T &C may be viewed on the A CCOUNT zuMMAn w. Fee (see #6 under P Y delivery website listed below) Upon service discontinuation, rent for the calendar. �,,n, pelN Mra,^"fl"'�` "General Leased Equipment is charged through the end of the billing cycle `D' indicates 1 Information') in which service is discontinued. 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a Scheduled S ,'m ;;o; n nn•^' Delivery Fee as described in your T &C. Only one of these fees delivery n will apply to each account. The fee that applies to your account is stated on the front of the invoice. For further information please Y;o;,;,,. Y;,;,;9;; '•;n nn r nn visit the website listed below or contact our customer service '•o�`' a Uen center. Payment stub v rvvv• v T By AY THIS AMOUNr A 7. As a food product, bottled water is subject to the rules and wnww AccouarouM^E" P AY sza Amount due 31�56J890 ,cLoSED regulations promulgated by the Federal Food and Drug Ir,volcE r+uMflu CDATE Administration (FDA). ul416J890 oorooIoo 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, 092D096307 09282712619 0003910 200901016 Submit your redemption fees, and any dispenser charges. All future invoices will payment by reflect charges for water delivered and dispenser rental, bottle IcE MO amN�wATEa g P 9� ,,,,,e,,,, cnr.sMm o000o this date deposits and credits plus charges for any additional products fOa NSTOMFA SLB9KE CALL, ordered by you. Deliveries are made every three or four weeks, for ill I i„ In. ,:,,n.,.at. „a ^Ii 0 a total of 16 -17 deliveries per year. You will only receive invoices Cl s wfl�a^•�LN 10 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 S 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 l IVlountain y r.. 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)) 1/6/09 08LO12004852E Rent and Service, December 2008 $21.44 ccnt 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 Ir_P Mn`anfain 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 81-0120048525 N 4239099 materials or services itemized thereon for A cnt 0120048525 which charge is made were ordered and received except 20 Si nature Title Cost distribution ledger classification if claim paid motor vehicle highway fund 720106 E 0 12/01/08 12/31/08 08LO120095351 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 to service. icemountai n.com THLI JAN 22 0120095351 III 1991191 1 911 DD ID 1 9110 1911 01118 119 91 1 199191 MON— FEB 23 MON— MAR 23 #BWNNWYR TUE- APR 21 #0400001200953515# CARMEL CLAY PARKS AND REC DEPT Customer Service: 1- 800 472 -9888 AUDREY KOSTRZEWA 1411 E 116TH ST Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -3455 Delivery! We value your business. Enjoy special savings! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery, save $2 /box on Nestea Flavored Tea Sticks. Limit offer to 6 of,each per delivery, expires 2/27/09. More info. go to service.icemountainwater com,or ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. It's free! e Delivery address: P CARMEL CLAY PARKS AND REC DE, 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 61.40 12107 176147 PAYMENT -THANK YOU -55.73 1/04 312720 PAYMENT -THANK YOU -5.67 12117 0598066736 4 5 GAL ICE MOUNTAIN DIRK W /HANDLE 15.96 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 BOTTLE DEPOSIT: 4 DELIVERED, 4 RETURN .00 12/31 0601029382 1 OIL /FUEL SURCHARGE 2.52 L6805853 RENT �jo 9.98 TOTAL 6 �QO� 31 45 0 C�u A CCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY o PAY THIS-AMOUNT rf 61.40 61.40 31.45 31.45 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR I. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 -800 -472 -9888 OR WRITE US AT: your first Invoice will Include a pro -rated fee for the current month plus the next month's rental. ICE MOUNTAIN SPRING RATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. If you M216 prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate 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. Ia3+se7s The dollar amount of the suspected error. I ootooloo. Describe the error and explain if you can, you believe there is 1231567990 an error. D -aT M« 9 Your Account Number You arc obligated to pay the parts of your bill that are not in question. wroNw You do not have to pay the disputed amount while it is being m E oec ,B Cuaromee 5enice 18W-37 9886 investigated. During the investigation, we cannot report your account p, a,,, ul,, nt ,dnn. j1111 II tttt a k•M°"nwn w�^Y6i Watch here for a as delinquent or take any action to collect the amount in question. wMiDO` :3M "s3 personalized account p city's Im Important I,,, tn, t., a.. nt .,.,n „at „at.a.n,.6•a�t•t��•'t GENERAL INFORMATION 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 reMeekemm� +min daodu,ae�.m,d4�'^rtn billing date) may be assessed a late fee as allowed by law not to a °w pay electronically exceed $20 per month. Additionally, third party collection/attorney ,..,"__.z "q ;�.,,°,.,n,m� expenses may be assessed at a rate not to exceed 100% of the ACCOUM ACiNrtY •tl�O'• 23 Main 5 eu CrtY.SUre 000w unpaid balance or the maximum allowed by law. oen"enAac nnooe Make sure this 2. Each returned check is subject to a service charge subject to the no„aB,laMa soro amount has been maximum check return charge allowable in your State. Activity wB B� 2a,mw w sow »BBS ^3G ,D G°' paid in full to 3. All bottle and equipment deposits are shown as CURRENT Since your wn, mss,, s ��,M�,�, ^sw,Ba 'T avoid late fees ACTIVITY. last invoice wn� nB7n3BB” BaM s71B 4. Equipment replacement costs will be charged for bottles lost, stolen, damaged or not returned. ro 7AE Monthly Oil 5. In accordance with NWNA's Terms and Conditions &C your Surcharge, Fuel Equipment Lease and/or Service Agreement account may be "wM�•!"c'""" 5— subject to minimum monthly purchases and/or early cancellation Your new P Y be viewed on the delivery A complete version of the current T &C may r ..Ea+99 Surcharge or Delivery fees. corn ACCOUM SUMMAa Cu,uM. w.k 9°°° Fee (see #6 under .,<..,.<a.W website listed below) Upon service discontinuation, rent for the Calendar. `D' indicates ype& ries.aw,mNO""OL2"S7t90 "General Leased Equipment is charged through the end of the billing cycle M Information in which service is discontinued. e 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge of a Scheduled „„o o,a;;" n nom ;;L delivery Delivery Fee as described in your T &C. Only one of these fees n will apply to each account. The fee that applies to your account M� m- ��',;,t, is stated on the front of the invoice. For further information please visit the website listed below or contact our customer service rep center. Payment stub F s 9Ar of s w--w 7. As a food product, bottled water *is subject to the rules and ACCDUNr PAY %y NUMBflI AY s a Amount due d1i'U ,531567890 NCLOSED regulations promulgated by the Federal Food and Drug Biuwa DArE INVOICE NUMBE1t 00twlw Administration (FDA). ,53+s6 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, 0920096307 09262712619 000391099 zoa9o7a16 Submit your redemption fees, and any dispenser charges. All future invoices will pl,no« payment by C's. reflect charges for water delivered and dispenser rental, bottle is MO aN3u�N wA3Ex coMrANa' u „„„,,,,,,a,...K cAr.s�a w� this date deposits and credits plus charges for any additional products rtv�cEC.au 72 -9 ordered b y ou. Deliveries are made eve three or four weeks, for ,a,anoMLaE YY every 6 nt, i„ a.. n6 ..,,n.. „6 „I,ta,t „t.dt K a<_ �A,^,"m�onB<.•^•s,a•. a total of 16 -17 deliveries per year. You will only receive invoices p sK.,,° °wB�� °I ^B• 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 708 5 /08 0 I 720106 9 12/01/08 12/31/08 08LO121202766 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 e service. icemou ntain.com THU- JAN 22 0121202766 III IM I NO IN I Mil H 8 III IM IN M IN IN MON- FEB 23 MON- MAR 23 #BWNNVVYR TUE- APR 21 #0400001212027662# CITY OF CARMEL PARKS DEPARTMEN Customer Service: 1- 800 472 -9888 MANDY SPADY 1411 E 116TH ST Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -3455 Delivery! We value your business. Enjoy special savings! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery, save $2 /box on Nestea Flavored Tea Sticks. Limit offer to 6 of each per delivery, expires 2/27/09. More info. go to servlce.icemountainwater.com or call 800 d ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800- 472 -9888. Its free! Delivery address: CITY OF CARMEL PARKS DEPT/MONO, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032 PREVIOUS BALANCE 35.89 12/07 176146 PAYMENT -THANK YOU -31.94 1/04 312719 PAYMENT -THANK YOU -3.95 12/17 0598066785 6 5 GAL ICE MOUNTAIN DRK W /HANDLE 23.94 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 BOTTLE DEPOSIT: 6 DELIVERED, 5 RE; X'11� ED 6.00 12/31 0601047491 1 OIL /FUEL SURCHARGE 2.00 L6879618 RENT 4.99 TOTAL ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT+ CURRENT ACTIVITY m PAY THIS AMOUNT c r Y� ihicet M forms nn rovcrcn ci(in 35.89 35.89 42.91 42.91 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.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in SAMPLE INV =E 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. ,Z34s67e90 The dollar amount of the suspected error. oolooloD -00/ w/W Describe the error and explain if you can, why you believe there is 1234567a90 an error. TMa D You are obligated to pay the parts of your bill that are not in question. o-, Your Account Number You do not have to pay the disputed amount while it is being me. ccc ,B investigated. During the investigation, we cannot report your account 11n 111 al „tl „dl0a,nu,,,,unlalaada Cus,ome'SeMC<: -000 -V2 "9008 ,EUnEYw ior,nl^9 Watch here for a as delinquent or take any action to collect the amount in question. 123 W- S' personalized account GENERAL INFORMATION Important i; is,.,ial .,•,n•••n,aet.a,,,t.Ia,l „l.,n message 1. Payments received after the billing (INVOICE) date will appear on news and .nw yYd 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/atiorney Pay electronically expenses may be assessed at a rate not to exceed 100% of the ACC ONnACTIVETr unpaid balance or the maximum allowed by law. .ea2s� =3M 00W Make sure this DelNery 2. Each returned check is subject to a service charge subject to the .p�,0+la,w• amount has been maximum check return charge allowable in your State. Activity TMn wrt« 900° paid in full to 885 our meMwmaln 0Gs10 3. All bottle and equipment deposits are shown as CURRENT since Y ,,,BBS,a4+4 M msw�B• avoid late f¢¢S ACTIVITY. last invoice 4. Equipment replacement costs will be charged for bottles lost, urn= 16' 9 stolen, damaged or not returned. mTAE 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 Oww�KTM^Y s�+^ subject to minimum monthly purchases and/or early cancellation Your new Y ..E«w M E,4•Q „.E Surcharge or Delivery ACCOUMSUM C„n« a X89. 9°BB Fee see #6 under delivery fees. (A complete version of the currentT &C may be viewed on the .,,.a.r.••«••*•«"' website listed below) Upon service discontinuation, rent for the calendar. "Gcalendar. M Deliveries mm Leased Equipment is charged through the end of the billing cycle `D' indicates Information in which service is discontinued. 14 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 is stated on the front of the invoice. For further information please o,', ;,L visit the website listed below or contact our customer service center. Payment stub as n aaaan J PAY BY YAY 1HSµ,ouw 7. As a food product, bottled water is subject to the rules and ,a B^ AccamrNUweaB w =oB s Amount due regulations promulgated by the Federal Food and Drug CLOSED 90 BIWNO DATE INVOICE NUMBER 09 =WI00 Administration (FDA). u3+ss7a 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, 0420096307 0"202732619 000391049 zoD4o7m Submit your redemption fees, and any dispenser charges. All future invoices will M=' payment by reflect charges for water delivered and dispenser rental, bottle IcEmopN ATE B y C p O crvsB this date deposits and credits plus charges for any additional products ra" wB UO M EBBEA• KEwzE ,oB+ ordered by you. Deliveries are made every three or four weeks, for i m E i m .n.,.•n••al.a.n,a „ade,I,a.ai y„ a total of 16 -17 deliveries per year. You will only receive invoices sw a0 „OB °�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 ST 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)) Amount 12/31/08 08LO120095351 Water cooler lease 31.45 12/31/08 08LO121202766 Water cooler lease 42.91 Total 74.36 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 1 20 Clerk- Treasurer Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. box 856680 Louisville, KY 40285 -6680 In Sum of 74.36 ON ACCOUNT OF APPROPRIATION FOR 101 General 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 08LO120095351 4353099 31.45 1 hereby certify that the attached invoice(s), or 1047 08LO121202766 4353099 42.91 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 14 -Jan 2009 Signature 74.36 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 720106 co 12/01/08 -12/31/08 08LO121776199 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com TUE- JAN 20 0121776199 III If01IHNIN�IX I W N IN IN IM NIII�IN THU- FEB 19 THU- MAR 19 #BWNNWYR FRI- APR 17 #0400001217761992# CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888 SHELLY LINGELBAUGH 1 CIVIC SO Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery! We value your business. LI��I�I111113111111, 11 11111 11 I I Enjoy special savings! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery, save 1 $2/box on Nestea Flavored Tea Sticks. Limit offee to 6 of each per delivery, expires 2/27/09. More info. go to Gervice.icemountainwater.com_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! Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032 PREVIOUS BALANCE .00 12/15 0597995091 4 5 GAL ICE MOUNTAIN DRK W /HANDLE 13.96 1 PLEATED CUP DISPENSER .00 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 BOTTLE DEPOSIT: 4 DELIVERED, 0 RETURNED 24.00 12/31 0600899116 1 OIL /FUEL SURCHARGE 2.52 6902304 1 RENT(12/15/08 12/31108) 2.13 RENT(O1 /01/09 01/31/09) 3.99 SALES TAX .85 TOTAL 53.43 THIS RENT IS FOR A PARTIAL MONTH ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY a PAY THIS AMOUNT 00 m 00 5343 53.43 i�hiwrt to twrms nn rwvwrcw sirlw 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.icemountain.com. 6661 DIXIE IIWY., 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 sheet about a transaction on your bill, write us on a separate SAMPLE INVOICE sheet of f 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. tze+s6ie90 The dollar amount of the suspected error. I 0 0 1oo 100-00j0°j°° Describe the error and explain if you can, why you believe there is 1II 56799 an error. M« a 9 Your Account Number You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being T UE C Ts 5er.+<e'. 1'BW- <T298BB investigated. During the investigation, we cannot report your account as IIIA1 1 111 h, ,nud,mb. ^um ^a ^a•t,m Custorr<, Watch here for a as delinquent or take any action to collect the amount in question. i� ,21 M in 5` a personalized account Im GENERAL INFORMATION p u.".11 message message 1. Payments received` after the billing (INVOICE) date will appear on news and ��roTr^T °m Your next invoice, fast due invoices (not paid within 30 days of offers T �+•en�E wm wwrQ,m+<T� ,«k<xeme0.nu1. ar. u.vw<,v9rw9� "•1'� "w'^+�54:,*uc6 billing date) may be assessed a late fee as allowed by law not to anN<mA9�r 1 m exceed S20 per month. Additionally, third party collection/attorney Pay electronically "q,,9..>= expenses may be assessed at a rate not to exceed 100% of the AccouNTArnvrtr unpaid balance or the maximum allowed by law. Make sure this ,r3m,i ^s Eons"F<pppp° DeiN<n Aeeres: wn^ o°< x.99 2. Each returned check is subject to a service charge subject to the "K< •],5 amount has been it tivy c E6„6Yw so.9n maximum check return charge allowable in your State. Ac 0 •90 N ,,,,,,ISw�^9w .5°� paid in frill t0 since our �F,1 E„�S 3. All bottle and equipment deposits are shown as CURRENT Y 'I«M� •1n avoid late fees ACTIVITY. last invoice o9 Fuas<' N' 4. Equipment replacement costs will be charged for bottles lost, wn: 1+0'97 5'.9 stolen, damaged or not returned. TUTU Monthly Oil 5. In accordance with N WNA's Terms and Conditions "T &C your Surcharge, Fuel Equipment Lease and /or Service Agreement account may be <vwM.<mmY '"Y 1M1S 'si.9 subject to minimum monthly purchases and/or early cancellation Your new v ..E°b° ,FAN<T Surcharge or Delivery delivery Fee (see #6 under fees (A complete version of the current T &C may be viewed on the ACCOUNr6uMMA X., su+k +9� website listed below) Upon service discontinuation, rent for the calendar. MyDelivedes A c<aFOX °""o-° 56°90 "General Leased Equipment is charged through the end of the billing cycle c Information indicates in which service is discontinued U 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled ,So n ':o•" n »nr delivery n Delivery Fee as described in your T &C. Only one of these fees o, will apply to each account. The fee that applies to your account is stated on the front ofthe invoice. For further information please y ;,o;, ;,c•. Xvann visit the website listed below or contact our customer service �;•o center. Payment stub --E-- 0.Y SAMOUNE 7. Asa food product, bottled water is subject to the rules and „,..�,e.w+^ AccounrNUMSU` wtwtw Amount due regulations promulgated by the Federal Food and Drug e9° 8E s,,NC DATE A NCLOSED INVOICE NUM0. oo,.Iw Administration (FDA). u3s6Te 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, D42a096307 09262912619 00039sa9'+ zOasoTOS6 Submit your redemption fees, and any dispenser charges. All future invoices will pD°< m s payment by reflect charges for water delivered and dispenser rental, bottle icE oaNNU�NwATEncoMw•EA• 1 E w n w �,,,,,,,,,...H. c;, o000o this date deposits and credits plus charges for any additional products Fa,CO5.9MF.5E•YI <E<U °o0'' 9 ordered by you. Deliveries are made every three or four weeks, for a,, i„ d. dn. ..,n.,••t6•,tt ^6n,a.,dddd 0 u M a total of 16 -17 deliveries per year. You will only receive invoices 9<X°°w•FWE� °I 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 0 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 708 5/08 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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. 01/16/09 ALLOWED 20 .Ice Mountain IN SUM OF P.O. Box 856680 Louisville, KY 40285 -6680 $53.43 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1205 Administration Board Members PO# or D PT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the .43 materials or services itemized thereon for which charge is made were ordered and received except 20 Sig ure Title Cost distribution ledger classification if claim paid motor vehicle highway fund t w o 720106 12/01 /08 -12/31/08 081_7220327048 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com TUE- JAN 20 7220327048 IIII I�� ICI 198 III III 01181 BSI 118II� �I IID I01 THU- FEB 19 THU- MAR 19 #BWNNWYR FRI- APR 17 #0400072203270488# CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 472 -9888 ANN DAVIS 1 CIVIC SO Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery! We value your business. Enjoy special savings! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery, save $2/box on Nestea Flavored Tea Sticks. Limit offer to 6 of each per delivery, expires 2/27/09. More info. go to service.icemountain or call 800 472 9888. a 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 OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 19.67 1/04 312724 PAYMENT -THANK YOU -19.67 12/15 0597615590 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 12/31 0601026784 1 OIL /FUEL SURCHARGE 2.52 L6817679 RENT 3.99 TOTAL 12.99 ACCOUNT SUMMARY I PREVIOUS BALANCE o PAY MENT!ADJUSTMENT+ CURRENT ACTIVITY o PAY THIS AMOUNT 19.67 19.67 12.99 12.99 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER r IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR I. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 -800- 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE DIOUNTAIN SPRING NNATER 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.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate SAMPLE INVOICE ol�/� 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. �Zy,56�e90 The dollar amount of the suspected error. �tppjm ppjppj00 Describe the error and explain if you can, why you believe there is 123+567690 an error. iN6 You are obligated to pay the parts of your bill that are not in question. w 6NW Your Account Number You do not have to pay the disputed amount while it is being iOE pEe g g g P Y n, n.,. m„ m, dnu,t,,,nua,wt,,,,tntt „it.,naan rpl -8pp 0 &9888 mvesu uteri. Dunn the mvestt anon, we cannot re ort our account °+B•9 n.mw,w^v^^„n, as delinquent or take any action to collect the amount in question. Watch here for a 131 MS^bt personalized account GENERAL INFORMATION Important message i,; o' tsi „t:,aoo„ o,,u,.,n„t,n,a,,,t,i,ta,a„n 1. Payments received afler the billing (INVOICE) date will appear on news and'°'" your next invoice. Past due invoices (not paid within 30 days of offers billing chute) 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 Ac >.,w• `.f unpaid balance or the maximum allowed by law. ox ^s ""c"�'Sp1 aooae Make sure this De1Wery b�d'n•' 1199 2. Each returned check is subject to a service charge subject to the g y v amount has been Te,ea,n<. paid in full to axs maximum check return charge allowable in our State. Activity since our G•emN.wn W ^9w.<� z <M', 3. All bottle and equipment deposits are shown as CURRENT y WWI— s sue avoid late fees ACTIVITY. last invoice o9” wdb,mn,m•,`' ',.l 4. Equipment replacement costs will be charged for bottles lost, wa 1710 stolen, damaged or not returned. T r L Monthly Oil 5. In accordance with NN'NA's Terms and Conditions "T &C" your y Equipment Lease and /or Service Agreement account may be .,..m,,• wM Surcharge, Fuel subject to minimum monthly purchases and/or early cancellation Your new v .k..a+° Surcharge or Delivery �CCOUM,UMMM Uum Fee (see #6 under fees. (A complete version of the current T &C may be viewed on the delivery =•-f•^ "C- ,gip 11 website listed below) Upon service discontinuation, rent for the calendar. Deliveries 'j "General Leased Equipment is charged through the end of the billing cycle `D' indicates Information in which service is discontinued. 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a scheduled ,,,o ho�.;;n s lam• ^8Y delivery n v w 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 pleased;,;,;. visit the website listed below or contact our customer service center. Payment stub TM?�nMOUNr 7. As a food product, bottled water is subject to the rules and s m„, 4 ccwN* +u""� 1. Amount due regulations promulgated by the Federal Food and Drug iNVO EN .W BI.NG DI, s Naosro Administration (FDA). ,z3s67 �taa 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, orz0o963a9 09282712619 0oo391aV9 zo0909as Submit your redemption fees, and any dispenser charges. All future invoices will pn„ s payment by reflect charges for water delivered and dispenser rental, bottle Ke oumaN” c K e this date deposits and credits plus charges for any additional products 72.9W ordered by you. Deliveries are made every three or four weeks, for t t ut, t,,, i„ m„. a a .dt ^dt ^t'i °t 9n" a total of 16 -17 deliveries per year. You will only receive invoices 0,wN ^.f^""p °gyp 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 5 108 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 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 LtLx"u, 6 �a 55- ON ACCOUNT OF APPROPRIATION FOR Board Members PO# EP or EPT. INVOICE NO. ACCT #/TITLE AMOUNT D I hereby certify that the attached invoice(s), or �u�lJ�f� 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 i I 720106 Mul VA 1 1 3 a 12/01/08 12/31/08 08LO117821082 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 r g M r service. icemountain.com TUE- JAN 27 0117821082 IN III 1111111111111111111111111111111111111 WED- FEB 25 THU- MAR 26 FRI- APR 24 #BWNNWYR #0400001178210823# Customer Service: 1- 800 472 -9888 CITY OF CARMEL STREET DEPATMEN 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 I I��II 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! Save $3 /case on 700mL Sport Top Bottles. Also, add a little flavor to your delivery $27box on Nestea Flavored Tea Sticks. Limit offer to S of each per delivery, expires 2/27/09. Dore into. go s i:v1M.1gemountainwat or c all 8 00 472 9888. 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 STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074 PREVIOUS BALANCE 122.37 12/07 176151 PAYMENT -THANK YOU -32.71 1/04 312721 PAYMENT -THANK YOU -44.66 12/22 0598875201 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 12/29 0600428635 1 LATE FEE 15.00 12/31 0600974109 1 OIL /FUEL SURCHARGE 2.52 L6781632 RENT 3.99 TOTAL 79.97 ACCOUNT SUMMARY �"E.'OUG &AL;,%CE PAY67ENT /AD::UST:AEt.T L CUFZRIE JT .ACTtVtTY PAY Tli1S— A "iO'JST bject to terms on reverse side. 122.37 77.37 T v 34.97 79.97 My S ACCOUNT NUMBER: 0117821082 Customer Service: 1- 800 472 -9888 tbu3/ service. icemountain.com rr445 y 2009 February 2009 March 2009 April 2009 May 2009 June 2009 MRW( o tNfuD5thInta tNQNafn�b rV�mTh fll;�2D ftnmMwEftb @n M%M%It?m; 1 2 3 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 1 2 1 2 3 4 5 6 7 8 9 10 8 9 10 11 12 13 14 8 9 10 11 12 13 14 5 6 7 8 9 10 11 3 4 5 6 7 8 9 7 8 9 10 11 12 13 11 12 13 14 15 16 17 15 16 17 18 19 20 21 15 16 17 18 19 20 21 12 13 14 15 16 17 18 10 11 12 13 14 15 16 14 15 16 17 18 19 20 18 19 20 21 22 23 24 22 23 24 0 26 27 28 22 23 24 25 0 27 28 19 20 21 22 23 0 25 17 18 19 20 21 22 23 21 22 23 0 25 26 27 25 26 0 28 29 30 31 29 30 31 26 27 28 29 30 24 25 27 28 29 30 28 29 30 1 31 July 2009 August 2009 September 2009 October 2009 November 2009 December 2009 1 2 3 4 1 1 2 3 4 5 1 2 3 1 2 3 4 5 6 7 1 2 3 4 5 5 6 7 8 9 1011 2 3 4 5 6 7 8 6 7 8 9 1011 12 4 5 6 7 8 9 10 8 9 1011 12 1314 6 7 8 9 1011 12 12 13 14 15 16 17 18 9 10 11 12 13 14 15 13 14 15 16 17 18 19 11 12 13 14 15 16 17 15 16 17 18 19 0 21 13 14 15 16 17 18 19 19 20 21 22 23 0 25 16 17 18 19 20 21 22 20 21 22 0 24 25 26 18 19 20 21 0 23 24 22 23 24 25 26 27 28 20 21 22 0 24 25 26 26 27 28 29 30 31 23 0 2526 27 28 29 27 28 29 30 25 26 27 28 29 30 31 2930 27 28 29 30 31 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 I -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 W17'ER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. If you 9216 prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong. or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in 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. iz3ss]g90 The dollar amount of the suspected error. 00 tppj 00 OOt00100 Describe the error and explain if you can, why you believe there is 123456] an error. ripOQ MONOCT r9 You are obligated to pay the parts of your bill that are not in question wEaNw Your Account Number You do not have to pay the disputed amount while it is being mE oE<,B E g g P Y n, n,., m, au „un66 „iot,6nn,,,,tiitt•,n „n.t.m Custwe.r XrvKea- BW-,lE.988B investi Durin the investi we cannot re port our account Watch here for a as delinquent or take any action to collect the amount in question. I °nn 0 o` 23 M ,mn personalized account P I lila 11 Important 6,ant n.,,,n n rn t I•II•t I II GENERAL INFORMATION message I. Payments received after the billing (INVOICE) date will appear on news and I RP your next invoice. Past due invoices (not paid within 30 days of offers 1 Y M 1 billing date) may be assessed a late fee as allowed by law not to ax�. exceed $20 per month. Additionally, third party collection /attorney „„K,M•� Pay electronically expenses may be assessed at a rate not to exceed 100% of the n�cour+rACm9t`' w••+°•^”` unpaid balance or the maximum allowed by law. eac bn ^oce.123 s cm' ppp00 Make sure this oellwn ,,.w 2. Each returned check is subject to a service charge subject to the 9 ,•.w,asu�.� amount has been maximum check return charge allowable in your State. Activity g9a v.ym•^�'"'^ paid in full to our "BBB'W �sw10P°` 3. All bottle and equipment deposits are shown as CURRENT since Y ,,,BBS149•^ s ;MSCaan.^ avoid late fees ACTIVITY. last invoice 31]8851 09/12 '1B263BB11 Pe^t 4. Equipment replacement costs will be charged for bottles lost, stolen, damaged or not returned. ro ^E Monthly Oil 5. In accordance with NWNA's Terms and Conditions "T &C your ",,,,,,,p„M Surcharge, Fuel Equipment Lease and/or Service Agreement account may be ,g..w,+^ sea subject to minimum monthly purchases and/or early cancellation Your new „w° �.ti. i Surcharge or Delivery Fee (see #6 under fees. (A complete version of the current T &C may be viewed on the delivery AccouNr suM o. W.._,. """�rv.• q Via. website listed below) Upon service discontinuation, rent for the Calendar. •Deliveries Km„N,gawOE xv "General Leased Equipment is charged through the end of the billing cycle Information' indicates in which service is discontinued. 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 is stated on the front of the invoice. For further information please ;,o;,,,;. s visit the website listed below or contact our customer service ;v center. Payment stub .v n PAY ,1 p "xTM Amount due 7. As a food product, bottled water is subject to the rules and �nBm.wef^^^^'"""'w°m^••^ AccouNrNUAtBER wloOtoB regulations promulgated by the Federal Food and Drug ,23456,890 mwNC OArE s NCEOSEO INVOICE NUMBFB W1.1w Administration (FDA). 12b 567890 8. Your first invoice indicates the products delivered on your first delivery. along with any applicable bottle and account deposits, 092009630? 09282712619 000391049 20090�01g Submit your redemption fees, and any dispenser charges. All future invoices will payment by reflect char es for water delivered and dispenser rental bottle IcEMOuNrur+wA,E°coMw,N+ 2'"jin3t g p ory,s�le 000Be this date deposits and credits plus charges for any additional products o c no MC °sEINICEUEE' ordered by you. Deliveries are made every three or four weeks, for t Dt, it„ nt.,,, •n••••tt• ^D'•�•tt"t 1' ill °1 tt o..^•^+r^•^^ a total of 16 -17 deliveries per year. You will only receive invoices p ,w °g•w °^�E'D 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 2008 Ice Mountain Spring Water Comparty, a Division of Nestle Waters North America Inc. Form No. NW 708 11108 service. ice mountain.com N O tSD W C. m< <mc -n 2) p° mnG7p X01 ,C U2 a3 N fD O G N O 7 d O C» 7(D 0 0 0 f rL tD c m m CL 3 m O N O c a d O tD UJ M M� Q c :r o O �'ay»ma, m to 0'0 H CD X o N 3 y m s m to n to n 2 Cn o o x y m m tD o f a O 3� x� o� mn C r oj° <°i< CL d m� O m °y °aopO'��o� O ��o G F CL eg x tc ca n t31 vCD CDD .O 3 m <<t c (n c o 2 f m m v m o 7 m2 Oo -•o c /A T 0 OO 0 C. .G yd d c d N C rh G 3D N f a il n A O N ,Y 0 d< n -3- A� (a c 'D c o O -ffl— ZI (b o< o_ a m O- or 0 3 3 E 0 m r� o o= rD H m N e v.= m p e n o» 0 M M 'o a nm a 'o c fD a a f y.m ay'3 o �Q <0)i COCO to 3tD O� U) H G tD m >r 3 4 s a lA m c ,v o� y o mm' 35 0 o>v m ii oy0m C d».03 0' O 3 A rn m c1 CD Sr m m m m a 0, !7 (1) a) M o• m z c o n 0 d D o D' m G1 m 03 n to cL 3 C1 o O m a lb k 0 c H m �D a y U) o a o° 3 C �i c o 0 0 m W C O m c m 3 0 to g c m D a m v w C tc m p1 H y fD G N c CD D 1° C e n w H v w rt m 7 TI 3 O o v 0 0 0 m° O �3 N CL n m n N a tD p y JO. WARR NO. Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER i IN SUM OF CITY OF CARMEL 16680 An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by 40285 -6680 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. $34.97 Payee Purchase Order No. UNT OF APPROPRIATION FOR Terms nel Street Department Date Due Invoice Invoice Description Amount VOICE NO. ACCT /TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s)) 0117821082 42 389.00 $34.97 1 hereby certify that the attached invoice(s), or 01/06/08 08LO117821082 $34.97 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 4 Sa rday, J r�ar�'1�7 2009 Strel Commissioner treat w iuf for Title r ribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance id motor vehicle highway fund with IC 5- 11- 10 -1.6 20 Clerk- Treasurer a