179712 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $221.82
PO BOX 856680
CHECK NUMBER: 179712
LOUISVILLE KY 40285680
CHECK DATE: 11/24/2009
DEP ARTMENT ACC OUNT PO NUMBER INVOICE NUMBER AMOUNT DES
902 4239099 09I012022391 X 3.60 OTHER MISCELLANOUS
902 4239099 09I012197559 X24.08 OTHER MISCELLANOUS
2201 4238900 09JO11782108 /32.07 OTHER MAINT SUPPLIES
2200 4239099 09JO12004852 17.45 OTHER MISCELLANOUS
1125 4353099 09JO12009535 --21.10 OTHER RENTAL LEASES
902 4239099 09JO12022391 x .3.99 OTHER MISCELLANOUS
1047 4353099 09JO12120276 X22.90 OTHER RENTAL LEASES
1205 4239099 09JO12177619 --22.12 OTHER MISCELLANOUS
902 4239099 09JO12197559 /12.83 OTHER MISCELLANOUS
920 4239099 09JO12220610 /28.11 OTHER MISCELLANOUS
2201 4238900 09KO11925282 '16.12 OTHER MAINT SUPPLIES
2200 4239099 19HO12004852 17.45 OTHER MISCELLANOUS
service. icemountain.com
#215 6661 DIXIE HWY, SUITE 4 r g
0 LOUISVILLE KY 40258 10/01/09 10/31/09 09JO120095351
ADDRESS SERVICE REQUESTED 0 e
WED- NOV 25 0120095351
III 1801 IN I III H N I HN INI III I HN M I I HIN TUE- DEC 29
FRI- JAN 29
MON- MAR 01
0 200953515# O�
CARMEL CLAY PARKS AND REC DEPT
AUDREY KOSTRZEWA Customer Service: 1- 800 472 -9888
1411 E 116TH ST Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -3455 Delivery! We value your business.
I�Il�llllll��l�illlllll"' I' IIII�I '�'lll���l�'lilrl
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
1.6 million Ibs of plastic out oUIandfills. q
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
Delivery address: P CARMEL CLAY PARKS AND REC DE, 1427 E 116TH ST, CARMEL IN 46032
PREVIOUS BALANCE 20.04
10/25 916688 PAYMENT -THANK YOU -20.04
10/27 0644975757 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 11.97
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
BOTTLE DEPOSIT: 3 CHARGED, 4 CREDITED -6.00
10/31 0646853697 1 OIL /FUEL SURCHARGE 2.16
J8237563 RENT 9.98
TOTAL 21.10
o ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CYRAENT a IVITY PAY THIS AMOUNT I
ihiart to twrmc nn rwvwrcw airla, 20.04 20.04 21.10 21.10
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER T
IN CASs OF ERRORS OR QUI rIONS 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 WA "rER QUALITY AND INFORNIATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is Charged one month in advance. That means
GALL 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.
'216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE IIWY.. SUITI4
LOUISVILLE. Kl' 40258 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill, write us on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SAM
sent you the first bill on which the error or problem appeared. You can
telephone us, but doing so will not preserve your rights. In your letter.
give its the following information:
Your name, address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can. why you believe there is
an error.
)oil arc obligated to pay the parts ofyour bill that arc not in question. 12346678 Your Account Number
You do not have to pay the disputed amount while it is being f 00100100 001 100
investigated. During the investigation. we cannot report your account 12;46678
as delinquent or take any action to collect the amount in question.
MoN -oa Watch here for a
WEO -NOV
GENERAL INFORMATION 'LE DEC 8 personalized account
I. payments received after the billin INVOICE f ear on Important
Y INVOICE) will appear 11,11,.,111 „III, Ault, L.�Illl,l,llll,,,,llul „u „u,lpl crammerservme:,- 8o0°R988 mess
your nest invoice: Past due invoices (not paid within 30 days of news and 16 1 uun9 _W, prndpre.
loan Oce ,nn
billing (late) may be assessed a late fee as allowed by law not to offers 123Ma
exceed S20 per month. Additionally, third party eollection/atiorney c,r.aal< 00000
"YS '.I„ III n
expenses may be assessed at it rate not to exceed 100% of the
m<.Yw�y61HmMYIOgol, eo ow pr
unpaid balance or the maximum allowed allowed by law. omm9
T an�oc,, wu9a.l Y^�” Pay electronically
q m oalas,a^d ,ai,,m o re
3. Each returned check Is subject to a service charge subject to the
maximum check return charge allowable in your State ro- s—
Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
your amount has been
ACTIVITY. since your ACCOUNT ACTIV a
M.e.•r.k aid in full to
nsm s,ce,.a,y,s cn,<oouoo „sv
4. Equipment replacement costs will be charged for bottles lost. o eliv ery Add�eac� °o p
last invoice
stolen. damaged or not returned. <r;n ^,��l�nce s�o.00 avoid late fees
parmemrna�EVw wa,e
In accordance with NWNA's "Icrnls and Conditions "TRC your oars 46' s scannn Naw soil ^9 woo
11 3,7086,°11e Ice M^untainSGa, Deposit 396
Equipment Lease and /or Service Agreement account may be 3oeevagan s Mmswlpemrn 99 Monthly Oil
Surchar
subject to m m inimu monthly purchases and /or early cancellation °9�n r reMS�ma9e g
99, a 6J e, Fuel
fees. (A complete version of the current TSC may be viewed on the o9 ,6e,og97
Surcharge or Delivery
website listed below) Upon service discontinuation. rent for the To7u Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued n.uN..<TM'TM
Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or e9 „ate
rY y
Delivery Fee as described in your TSC. Onh one of these fees Pa y ment stub ACCOUNT SUMMARY 1[
ppy THIS AMOUNT
will apply to each acemm[. The fee that applies to your account „n p; e,�,���.�r�r�^0^•^' ACCOUNT NU "AY g szlo
0o 0o 00
is stated on the front of the invoice. For further information please 345 °jg90 R,EUNC DATE MT. ENCLOSED
,NVOICE NUM9E0. DDtootoo
visit the website listed below or contact our customer service ,2345678
center. zoos
le
7. As a food product, bottled water is subject to the rules and 0420096307 042612619 000391019
21' Amount due
regulations promulgated by the Federal Food and Drug loran Dn<
Administration (FDA). ,CE MOUNIA,N WATE0. OMM, "A' CryM[a` <Sh�oO
omuo� o,,,.,,k
N Submit your
8. Your first invoice indicates the products delivered on your first oxSeRV,cECUU- sod =9 <M
delivery, along with any applicable bottle and account deposits, c °nDMER p ayment by this
I. 111�1�,. II.III.I,�.I�I.IA�.1�.11 'X Sae pram acv cn"`9 :on xe p
redemption fees, and any dispenser charges. All I "unire Invoices sl�Vero ^raEE4m °e >.,:'9nvp9pw��� date
will reflect charges for water delivered and dispenser rental, bottle
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks, for
a total of 16 -17 deliveries per year. You will only receive invoices
12 tines 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 709 5/08
I—
service.icemountain.com
#215 6661 DIXIE HWY, SUITE 4
LOUISVILLE KY 40258 10/01/09 10/31/09 09JU1 2120 2 766
ADDRESS SERVICE REQUESTED 6
II
III I��I I �IID ICI I NMI N II�II I Mill DI DPI DI TUE- NOV 10 0121202766
FRI- DEC 11
NOV 1 O 2009 WED- JAN 13
#BWNNWYR FRI- FEB 12
#0400001212027662#
CITY OF CARMEL PARKS DEPARTMEN
MANDY SPADY Customer Service: 1 800 472 9888
1411 E 116TH ST Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -3455 Delivery! We value your business.
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned overto
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
I t.6 million, lbs of plastic out of landfills.
i
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800 472 -9888. It's free!
Delivery a ress:
PREVIOUS BALANCE 36.91
10/25 916689 PAYMENT -THANK YOU -36.91
10112 0642000970 7 5 GAL ICE MOUNTAIN DRK W /HANDLE 27.93
2 9 OZ PLASTIC UP 50C /SLEEVE 5.98
BOTTLE DEPOSIT: 7 CHARGED, 10 CREDITED 1n -18.00
10/31 0646787010 1 OIL /FUEL SURCHARGE Purchase D�[ a rvY 2.00
J8307121 RENT Descriptlon 4.99
TOTAL P.O. nn P or F 22.90
G.L. I ��-I I U� f
Budget
Line Descr
Purchaser Date
Approv Date
ACCOUNT SUMMARY PREVIOUS BALANCE m PAYMENT /ADJUSTMENT CU VITY PAY THIS AMOUNT I
�bject to terms on reverse side. 36.91 36.91 22.90 n
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BI LL. 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 INFORNIAnON, 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 Ar: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING )),+TER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
=216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE IDWY., SUITE 4
LOUISVILLE, KY 40255 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill. write us on a separate sheet of paper. we
must hear from you in writing later than thirty (30) days after we SAM I NVOIC E
sent you the first bill on which the he error or problem appeared. You can
telephone us. but doing so will not preserve Your rights. In your letter.
give its the following information:
Your name, address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
)'on are obligated to Mp�„
ry the Iris of our bill that are not in uestion. NON
P P y q z3as6]69 Your Account Number
You do not have to pay the disputed ❑mount while it is being oolooloo- oolooloo
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. TNB� w
12345fi]
MON.DET 19 Watch here for a
WED NOV 11
GENERAL INFORMATION UE DK IB personalized account
IhII „.IIL, III„ 111111 „alLl,llp,,..IIIIhIh.ILLIII e� :wmer sxaee:l- BW4n -96ae
I. Payments received after the belling (INVOICE) date well appear on Important
message
your next invoice. Past due invoices (not paid within 30 days of news and Iv ,,,a ^ye4rminglr•M«' °Inpr9a "erg g
Doe
billing date) may be assessed a late fee as allowed by law not to offers 1]3 Mate St
exceed $20 per month. Additionally, third party collection /attorney onsale 0000
L.,IILL.Ld11,.,. ILA „IL.II.dIIL,hI,1,1,.1.1
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. Pay electronically
2. Each returned check Is subject to a service charge subject to the x ce^'"'” by w,aewa_�_r�vg°dacs'antln"'rn an^�
y
masinuun check rennin charge allowable m your State w Make Sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount has been
ACTIVITY. since your AC COUNT ACTIVITY d
d. Equipment g
re r costs will be charged for bottles lost. �i, Veygaafe "IONnD"e.113Ma�nzlrel,clys le ooBOO „9� paid in full to
P last invoice
stolen, damaged or not returned. prm.;nusBala ^a SAS avoid late fees
paymenr -Tha^4V"" SOW
5. In accordance with NWNA's Terms and Conditions ('`F&C your oBI31 ,w1s96 s scaim "Nat o a'sv W01ef soW
9,n 3vees14 mea^uma;nseal Devo+;1 z95
I quipmcnl Lease and /or Service Agreement account may be v]Bes14s� s mamswiBewln ne9 MOnth Oil
091111 31]885 s
subject to minimum Fuel8urc1+a�9e
m monthly purchases and /or early cancellation Wn7 3,BZ636611 e 1 Surcharge, Fuel
fees. (A complete version of the current TRC may be viewed on the azru lewoa9, szw Surcharge or Delivery
webvitc listed below) Upon service discontinuation, rent for the Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle
"General
in which service is discontinued. uN,.rnYm p „oArsoD0
ti °PeN
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or information
9e
Deliver Fee as described in y our TSC. Onh• one of these fees Pay ment stub ACCOUNT SUMMARY
PAY BY XY THIS
Delivery p AMOUNT
eo a• o.ege w- 5740
will apply to each account. The fee tha applies to your account nen,lun u,y, ,,,."I�rW'vmM'” ACCWNT NUMBFIt WIWIW
is stated on the front of the invoice. For further information please 1 1234500tt BImNCDA E MT. ENccoseo
visit tire w
e ebsim listed below or contact our 1 23456]8 90
customer service INV211108,N W WIW
1
center. w- .�...r•m..a +..s.smr.a. .r.....�m..w�,�.s
p f cet t 0420096307 04282712619 ❑00391049 2004 16
Z As a food roduct, bottled water is sub�. o� the rules and Amount due
regulations promulgated by the Fcderal Food-and- Drug- '-°Q- I"hn DOa
Administration (FDA). IcE MOUNTAIN WATER CoaMVpAoy cly zta e Nwo
first invoice indicates the products delivered- on— w� pay P Ion cunoMr6 sEmlccuu o-eW.4m96ee
Submit your
R. our
„•s;a ayment by t
delivery, along with any applicable bottle and account deposits. L.. uLl, bdn, ..n.,.a6,dl,a,u „1,,,61,ta..6.11 p,^ °YCti "9wo„a..• date
redemption fees, and any dispenser charges.. All_future..imvoicQs_ rw�..a... pI BI 1 ro p "YIN9 ^on6�
will reflect charges for water delivered and dispenser rental, bottle Cl sue°
deposits and credits plus charges for any additional products.....,,...,
ordered by you. Deliveries are made every three or four weeks. for 1..
a total of 16 -17 deliveries per year. You will receive invtl (CP5
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 709 5/08
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
11/4/09 09JO120095351 Water cooler lease 21.10
11/4/09 9JO121202766 Water cooler lease 22.90
Total 44.00
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
44.00
ON ACCOUNT OF APPROPRIATION FOR
101 General 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 09JO120095351 4353099 21.10 1 hereby certify that the attached invoice(s), or
1047 9JO121202766 4353099 22.90 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
19 -Nov 2009
Signature
44.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
t7 service. icemoun tai n.com
o #215 6661 DIXIE HWY, SUITE 4 6 8
0 LOUISVILLE KY 40258 10/01/09 10/31/09 09JO120048525
ADDRESS SERVICE REQUESTED
FRI- NOV 13 0120048525
III IIII III 1 IN II 1 II III II Hill I IN BI II III H WED- DEC 16
TUE- JAN 19
#BWNNWYR THLI- FEB 18
#0400001200485252#
CITY OF CARMEL DEPT OF ENGINEE Customer Service: 1- 800 472 -9888
LISA SCOTT OR JUDY STOHLER
1 CIVIC so YOUR ACCOUNT IS PAST DUE and is subject to
CARMEL IN 46032 -2584 additional late fees. Water delivery service may be
r I I� II I 1 Illr III Ili II interrupted. Please make your payment today. For
your convenience, pay online:
icemountainwater.com/service. If payment has been
made, we thank you.
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
1.6 million Ibs of plastic out of landfills.
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800 472 -9888. It's free!
Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 41.88
10/15 0643021223 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
1 9 OZ PLASTIC UP 5OC /SLEEVE 5 r o 7 8 9 707 2.99
10/25 0645735705 1 LATE FEE j 0
10/31 J8223029 RENT
r-
TOTAL r, NOV 74.33
c
CCOUNT SUMMARY
PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY a PAY THIS AMOUNT
taik eblect to terms on reverse side. 41.ii 00 3Y45 74.33
I
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-e888 OR warrE us AF: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
#216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE HWY- SUITE 4
LOUISVILLE, KY 40- 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong. or if you need more informmtion about
a transaction on your bill, write its on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SAM I NVOIC E
s n ent you the first bill o which the error or problem appeared. You can
telephone us. but doing so Tvill not preserve your rights. fn your letter.
give us the following information:
Your name. address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can. why you believe there is
an error.
You are obligated to pay the parts of your bill that are not in question. 1234567 Your Account Number
YOU do not have to pay the disputed amount while it is being Doto0lOO.
investigated During the investigation, we cannot report your account i
as delinquent of take anv action to collect the amount in question. T „R -DO a
123456
DN.aT 79 Watch here for a
wEO Nov x+
GENERAL INFORMATION UEC18 personalized account
I. Payments received a I 988
at the billing I IN VOICEI elate well appear on P message
P ast II,II,,,111 „III,�IIIIIA. •1111,1.1111 „•Allll „a.11,1.111 c ^,tome)xrn ^'00 v,oe�J*
your next invoice. 1 ast due invo (not pa within 3U days of news and ThanErn�l
o Doe
billing (late) may be assessed a late fee as allowed by 183v not to offers I 1 z3 Mal „n
exceed $20 per month. Additionally, third party collection /attorney aystate 00000
1...111.1 -I, 111,... AIL ,,11 „,11.,1,11,1„I,I,I,IA „11
expenses may be assessed at a rate not to exceed 100% of the Y .o-USe.xDZ 4 eR t
unpaid balance or the maximum allowed by law i Y By 4 em� °a°"'” Pay eleetrOnicallV
2. Each returned check is subject to it service charge subject to the
maximum check return charge allowable In your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount has been
ACTIVITY. since your AccouNTArnvm oUD9U „99 paid in full to
tl,esz: )^hnoce. 123 Maln St,eet C'y5
4- Equipment replacement costs w Ad
ill be charged for bottles lost. last invoice °eI' Y nz9s avoid late fees
stolen, damaged or not returned.
varmem rnan was sU.o9
5. In accordance with NWNA:s Terms and Conditions ("T &C"). your 98x1 a61R99 scalmn NamNl solln9s
5
9111 lt]86514ad4 Ile Mountain Seal DeWZrt 3.'rt
Equipment Lease and /or Service Agreement account may be U 1 m°est4°+4 t Mnanm;nscalRetU,n ne9 Monthly Oil
1 3t7885 peel Srvtha
subject to minimum monthly purchases and /or early cancellation 0911� 3 ,e26368n flen Surcharge, Fuel
fees. (A complete version ofthe current may be viewed on the 99n2 1�ipa97 5,w Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TorAE Fee (see #6 under
Leased Equipment is charged through the end of the hitting cycle
in which service is discontinued. P „,,,,NOUN[
Information
6. You will be charged it monthly Oil Surcharge, Fuel Surcharge or
Delivery described in T&C. Only one of these fees Pa Stub A ccouNTSUMMAR Y F M ^x
Fee as y our Pa y ment PAy-oll AMOUNT
BY
a+•ro PAY
3vill apply to each account. The fee that applies to your account a�wl^ ACCOUN5N890 5740
w1w
is stated oil the front of the invoice. For further information please 1234567 °90 81EEIN0 DATE MT. ENCLOSED
INVOICE NUMBER 00100100
visit the wcbsitc listed below or contact our customer service 1234567
center. se
7. As a food product, bottled water is subject to the rules and 0420096307 o926eT32619 Doo39>' 2pp° Amount due
regulations promulgated by the Federal Food and Drug IUhnD..
Administration (FDA). ICE MOUNTAIN `HATER C PANYx ��ty 5tate
o Submit your
R. )out first invoice indicates the products delivered on your first EoR CUSEOMER S ERVI<E Gnu t- Boo -9
delivery, alone with any applicable bottle and account deposits. payment by this
o ,....,n
1.,. ul. L, ah,.a „LU.,I „aa,1,1..6. date
rcElcmpuon fccs.:md any Japenser charges. All future Involecs a+oe Oe RIEN UroPa nee
will reflect charges for water dclivered and dispenser rental, bottle
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks, for
it total of I6 -17 deliveries per year. You will only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 5 /08
D 720806
0 8/01/09 8/31/09 19HO120048525
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
WED- SEP 16 0120048525
IIII lil IIII II I II III II IN III IN 11 11111 H FRI- NO 15
RI- NOV 13
#BWNNWYR WED- DEC 16
#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.
Have you gotten your SAVINGS ADVANTAGE? Out two or more cases of Ice Mountain 1/2 Liter in your'My
Regular Order' and pay just $4.99 case DELIVERED! Call 800 -472 -9888 or visit www.icemountain.com to take
of the new,, l ower prices.
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. It's free!
Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 31.41
8/09 499189 PAYMENT -THANK YOU -13.96
8/30 612155 PAYMENT -THANK YOU -17.45
8/17 0633874243 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99
8/31 H7934613 RENT y 6� B91011 3.99
TOTAL 17.45
Irv=
ACCOUNT SUMMARY PREVIOUS BALANCE m PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
�biect to terms on reverse side. 31.41 31.41 17.45 m 17.45
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS A13OUT 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 INFORMA'T'ION. 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.
#216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE. HWY., SUITE 4
LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill, write us on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SA MPLE IN
sent you the first bill on which the error or problem appeared. You can
telephone us, but doing so will not preserve your rights. In your letter.
give us the following information:
Yourname, address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
You are obligated to pay the parts of your bill that are not in question. 1z34s6789 Your Account Number
You do not have to pay the disputed amount while it is being 00100100 00 0 0100
investigated. During the investigation, we cannot report your account
123456
as delinquent or take any action to collect the amount in question. TNe -a
MONOCT 29 Watch here for a
GENERAL INFORMATION WED ND9
TAE- oEC 18 personalized account
1. Payments received after the billing (INVOICE) date will appear on Important
Customer Serrice. 1 4]2
aid within 30 days of news and 908
your next invoice. Past due invoices (not p' II,11.�. 111„ III, �IIIII ,I,,,pad,1a16dL,11,L111 message
Tn,nE r
date m be assessed a late fee as allowed by law not to 1 123 o i 'nd
billing Y offers 3 M 5
t
exceed $20 per month. Additionally, third party collection /attorney I IR A to o�
6,4161I. „1.1,1,1,.1 „11
expenses may be assessed at a rate not to exceed 100% of the
ro, m9 Pay electronically
unpaid balance or the maximum allowed by law. m.ro°c 4nxLw a��'m m "mm«e1
fe-- r�mnnax rW.a<
2. Each returned check is subject to a service charge subject to the^fr
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. since your ACCOuNTACTIvm
amount has been
Addreu' 1°Isn Doe. 173 Main Sheet C ry Slate 00090 paid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice .0 -„99
stolen, damaged or not returned. a, °sea�ana avoid late fees
y 08/31 x61898 PaymentTlwn4V°u Whte� 50.E
5. In accordance with NWNA'sTerms and Conditions T &C' our s s c a mnNat 50
9111 31]80516x44 Ace Mountains W�ceP
Equipment Lease and/or Service Agreement account may be 3vee5t s ns9 Monthly Oil
subject to minimum month) urchases and/or earl cancellation o9 3 e's "e`
Y P Y 6 een Surcharge, Fuel
fees. (A complete version of the current T &C maybe viewed on the 09 1 `ifi 2 ,97 9e 5]40
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TOTAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. E cww4t.�w^Y
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 11 9'" Information
SUMMARY 9
Deliver Fee as described in our T &C. Only one of these fees Pa Stub AccouNr
Y Y F0 THIS AMOUNT
will apply to each account. The fee that applies to your account _____n,um �„H,aNw^t. PAr eY
o...... w.. NUMeFR 5740
ACCOUNT pp100100
is stated on the front of the invoice. For further information please 123456]090 81LLING OATS MT. ENCLOSED
'Wo'cE NUMBER 00100100
visit the website listed below or contact our customer service 1 234567890
ccmer.
7. As a food product, bottled water is subject to the rules and 042D0963D7 09202712619 000391049 2009 1 Amount due
regulations promulgated by the Federal Food and Drug IDnn D«
Administration (FDA). SCE MOUNTAIN WATEN OM ANV� C YMIZleSt0009O
8. Your first invoice indicates the products delivered on your first "'w' Submit your
delivery, along with any applicable bottle and account deposits, voP CUSroMEe sEev�cE U",soo- >2-9B8e payment by this
I,..111,JI,J,a „1..,66M,a,J :aye ^,4m cn, ^9e~o„
redemption fees, and any dispenser charges. All future invoices ces date .n 4.5 0 n
will reflect charges for water delivered and dispenser rental, bottle s�N °P FOR FRiE
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks, for
a total of 16 -17 deliveries per year. You will only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
0 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 5)08
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.
Ice Mountain Payee
Purchase Order No.
OX
Terms
Louisville, KY 40285 -6680
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/06/09 9.10E +11 Rent and Service August and October, 2009 $34.90
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
Ice Mountain IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
$34.90
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #!TITLE OUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
a
materials or services itemized thereon for
19H NG 4239099 $17.45 which charge is made were ordered and
received except
1t12o 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
service. icemountain.com
0 #215 6661 DIXIE HWY, SUITE 4 8 0
p LOUISVILLE KY 40258 10/01/09 10/31/09 09JO122206105
ADDRESS SERVICE REQUESTED
FRI- NOV 13 0122206105
1111 II III III 1 II IN 1 II 111111 IN II III II II WED- DEC 16
TUE- JAN 19
#BWNNWYR THU- FEB 18
#0400001222061057#
CITY OF CARMEL ENGINEERING 11ST
KAREN NOLAN Customer Service: 1- 800 472 -9888
1 civic S IN 46032 -2584 Did you forget about us? Kindly pay upon receipt.
Remember, past due accounts are subject to a late
fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com/service. If payment has been
made, we thank you.
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
1.6 million Ibs of plastic out of landfills.
t..:
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 ENGINEERING, 130 1ST AVENUE SOUTHWEST, CARMEL IN 46032
PREVIOUS BALANCE 84.77
10/11 844546 PAYMENT -THANK YOU -58.71
10/15 0643021520 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98
1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99
1 .5 L NATURAL SPRING WATER ICE MTN 5.99
BOTTLE DEPOSIT: 2 CHARGED, 1 CRED�-D 18 1 6.00
10/31 0646700393 1 OIL /FUEL SURCHARGE tip 2.16
J8212670 RENT 3.99
SALES TAX
x .49
TOTAL NOV 2= 54.66
CARiAte"�. 1
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT JL CURRENT CTIVITY PA
84.77 58.71 P°
�blect to terms on reverse side. g�,rnr ar
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUTYOUR BILL. OR FOR I. Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUAI_l fY 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 Ac your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE NIOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
#216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE I MY. SUITE- 4
LOUISVILLE, KN' 40258 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill, write us on a separate sheet of paper. We
must hear from you in writing no later than thing (30) day n s after we SAMPLE I N M' =E
sent you the first bill on which the error or problem appeared. You ca
telephone us, but doing so will not preserve your rights. In your letter.
give us the following infornation:
Your name, address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
You are obligated to pay the parts of your bill that are not in question. ia3asb2s9 Your Account Number
)'oil do not have to pay the disputed amount while it is being oolootoo oolootoo
investigated. During the investigation, we cannot report your account r 1
123456
as delinquent or take any action to collect the amount in question. TNP -o" O
btON -DCr T9 Watch here for a
WED NOV
21
GENERAL INFORMATION v'.DIC personalized account
I m p ortant „om. xry a: a
I. Payments received after the bilking (INVOICE) date will appear on P ortant 0172 9W messag
your next invoice. fast due invoices (not paid within 30 days of news and m. ^Er "`M°°m.m a.� °�T. g
billin date) may be assessed a late fee as allowed b law not to
Y offers ctv M=t sooaao
exceed $20 per month. Additionally. third party collection /attorney n
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. Ty vta ,aa�wwia� <.+ece�t Pay electronically
2- Each returned check is subject to a service charge subject to the r we „My Ptw� niJC °G
0
maximum check return charge allowable in your State- Make sure this
r
3. All bottle and equipment deposits are shown as CURRENT Activity a. amount has been
ACTIVITY. since your ACCOUNT ACTIVITY s ¢Y.Btne WeW'
paid in full to
4. Equipment replacement costs w be charged lot bottles lost, last invoice PD <n <ry Add .n.99
S damaged or not returned. P �,e,�4^« <s avoid late fees
5. In accordance with NWNA's Tel ms and Conditions °T &C'), your iii, �,e� 9 s"' son
3 Taen+"4 cu ^Naw sP�� ^ew4 so.00
Equipment Lease and/or Service Agreement account may be Nees,
9 Monthly Oil
subje to minimum month) o9m 3neas �F 1s�«n4
I y purchases and /or earl Y cancellation 09 „eTb3ee Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on Z9 the 5740
Surcharge or Delivery
websitc listed below) Upon service discontinuation, rent for the Torn Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. m CO•"` T..,H,.� °T In forma t ion")
Ru<
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or
y Fee as described in your T&C. Only one of these fees Pay ment stub ACCOUNT SUMMARY
Deliver .W
Delivery y PAT THIS AMOUNT
will apply to each account. o fee that applies to your account "w,�f,a�o^` ACCOUNT NUMBER PAT By 5j ao
00 oohs
23406J0 MT. ENCLOSED
is stated on the front of the invoice. For funkier information please uv eiwNC DAn
,NVOICENUMBER W1 I-
visit the websitc listed below or contact our customer service 11410W W1
7. As a food product bottled water is subject to the rules and G42CO96307 ,42&2,12619 UD039 2DD° Amount due
regulations promulgated by the Federal Food and Drug I —Dce
Administration(FDA). ,CE MDUN", wATEP COOPA^ orMia°es,°0°°°
8. Your first invoice indicates the products delivered on your first Submit your
,OeCDnDMEesEe��CE�A�L1B0p4 °°Be p ayment by this
delivery along with any applicable bottle and account deposits, P ",.Tn,�n "aP•e 5 i tle
6,e..e,,,.s
redemption Ices. and am' dispenser charges. es. All future invoices �s -u.. °e Pew 0P.nWUPw `D date
will reflect charges for water delivered and dispenser rental. bottle
deposits and credits plus charges for any additional products
ordered by you. Deliveries arc made every three or four weeks. for
a total of 16-17 deliveries per year. You will only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
Form No. NW 709 5/08
2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc.
Prescribed by Slate 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))
10/06/09 09JO122206105 Keystone Reconstruction Project $28.11
Miscellaneous
Project 07 -08
1
Total $28.11
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
T J
VOUCHER NO. WARRANT NO.
Ice Mountain Direct ALLOWED 20
PO Box 856680 IN THE SUM OF
Louisville, KY 40258 -6680
28.11
ON ACCOUNT OF APPROPRIATION FOR
Ice Mountain Direct
PO# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
DEPT.#
NA 09JO122206105 4239099 $28.11
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
23 -Nov 20 09
Total $28.11 Signature
Cost distribution ledger classification if Cit En
claim paid motor vehicle highway fund Title
service.icemountain.com
#215 6661 DIXIE HWY, SUITE 4
LOUISVILLE KY 40258 10/01/09 10/31/09 09JO121975593
ADDRESS SERVICE REQUESTED
FRI- NOV 13 0121975593
11111111 IN 1111111111111111111 IN 111 RE 11 WED- DEC 16
TUE- JAN 19
#BWNNWYR THU- FEB 18
#0400001219755935#
CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 472 -9888
SHERRY MIELKE
111 W MAIN ST STE 140 Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -1905 Remember, past due accounts are subject to a late
fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com /service. If payment has been
made, we thank you.
7___ keep'
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned ov
1 '1;' a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to
1.6 million Ibs of plasti out o f landfills.
j 9
ACCOUNT ACTIVITY Pay your bill online at: service. icemoun tai n.com or by phone at: 1 -800- 472 -9888. It's free!
Delivery address: CARMEL REDEVELOPMENT COMMISION, 30 W MAIN ST STE 220, CARMEL IN 46032
PREVIOUS BALANCE
10/15 0643021447 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 5.99
1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 6.00
1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99
2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00
10/29 0646392670 1 LATE FEE 15
10/31 0646917831 1 OIL /FUEL SURCHARGE 2.16
J8275541 RENT 6.99
SALES TAX .70
TOTAL 54.01
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
�biect to terms on reverse side. 26.18 .00 27.83 54.01
'a
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BI LL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUALrrY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means
CALL 1- 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 NVATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
#216 if you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE FIWY., 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 y hi ou in writing no later than thirty (30) days after we Sent SAM I NVOI CE
sent you the first bill on 3vch the error or problem appeared. You can
telephone us, but doing so will not preserve your rights. In your letter.
give us the following information:
Your name. address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
)'oil are obligated to pay the parts of your bill that are not in question. 1234567e9 Your Account Number
You do not have to pay the disputed amount while it is being 00100100- 00100100
investigated. During the investigation, we cannot report your account
234567
aT
as delinquent or take any action to collect the amount in question. TNR OCI
MoN 79 Watch here for a
GENERAL INFORMATION a' .NDy21
TUE. Dec III personalized account
I. Payments received after the billing (INVOICE date will appear on Important ILA,., ul„ nl,. nmd ,,,pad,llp,,,,plll „IL,II,I,nt eu „9maxm message
e< .1.g00.4 7 z 9888
your next invoice_ Past duc invoices (not paid ,vithin 30 days of news and Tb my
billing date) may be assessed a late fee as allowed b y la,v not to offers ^a
C11 ^n
exceed S20 per month. Additionally, third party collection /attorney a 00000
I ,,III r L r dr. Illy. r.. 1 rrll. „IIlr,l„LII1..1..
unpai balance or the maximum allo„ICdtb�laneed 100% of the Pay electronically
2. Each returned check is subject to II service charge subject to the
maximum check return charge allowable in your State. am�NeR
Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount has been
ACTIVITY. since our ACCOUNT ACT Vary C; ys 00000
4. Equipment replacement costs will be charged for bottles lost. y •cellerr �ade Ion ^09<.I71 ^sv 71111
paid in full to
last invoice
stolen, damaged or not returned. P,<,, ^Ce 424s avoid late fees
Pavmem- rna ^v, r so0.00
5. In accordance with NWNA's Terms' and Conditions TRC your ggpl <61g9e s s�au ^Na,<ralsv ^9'""<` -s .00
Equip Lease and/or Service Agreement account may be n s»eas' ,I ^s0alceo^+ z�
g Y o�lnl 7ggs14.w4 s a; sr>alRemm .9 Monthly Oil
09111 31Jgg el BU CMr9e
subject to minimum monthly purchases and/or early cancellation g,g7638Bn ee Surcharge, Fuel
fees. (A complete version of the current T CC may be viewed on the o9ra 16640497 sz40
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the rorAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle
A mm S <oT "General
in which service is discontinued. �0gu ,R J
I n f orma ti on
6. You will be charged a monthly Oil Surcharge, fuel Surcharge or
Delivery F ee its described 111 voter T&C. Otdy one of these fe'e's Payment stub ACCOUNT SUMMARY o L cu. E.ou-
PAYBY PPY SISAMOUN
oo�a +e,x.e_ T 7,
will apph to each account. The fee that applies to,vour account „�y«�r w I�.a�P.v mm ACCOUNT NUMSIiR OpIm 00
is stated on the front of the invoice. for further information please 123466J890 gILLINO DATE MT. ENCLOSED
INVOICE NUMBER 0010000
visit the website listed below or contact our customer service 1734667
center.
p J 0420096307 U4282712619 000391049 200 1
7. Asa food roduct, boated water Ii subje to the rules and Amount due
regulations promulgated by the federal food and Drug I n ^Dce
Administration O0°° Submit your
ICE MOUNTAIN WATER COMPANY 133 Main St
S. Your first Invoice indicates the products delivered o your first ,a„,w,mN.•rl�w ^rN�A
n
delivery. applicable deposits. lORUUSTOMERSERVICECAELI�00 .J7.98B8 payment by this
along wuh any a hcable bottle and account dlc osns, 1... nr..dt.rdLa,n,d,,,1,I,l,l,d,d1
redemption fees. and any dispenser charges. All future invoices P° date
,vill reflect charges for water delivered and dispenser rental. bottle
slr.+w,oR,ReE Au ,oP,.v, sg uPg^9wietl o^ R...,�. y
deposits and credits plus charges for any additional products
orcercd by You. Deliveries arc made every three or four weeks. for
a total of 16 -17 deliveries per year. You will only receive invoices
12 times per year. so approximately 5 of those invoices ,vill reflect
I,vo deliveries.
44 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. Nw 709 5 /0e.
r,�
service.icemountain.com
#215 6661 DIXIE HWY, SUITE 4 0
p co LOUISVILLE KY 40258 10/01/09 10/31/09 09JO120223912
J
ADDRESS SERVICE REQUESTED 9 e
FRI- NOV 13 0120223912
II II III III III 1 IN 111111111 WED- DEC 16
TUE- JAN 19
#BWNNWYR THU- FEB 18
#0400001202239129#
CARMEL REDEVELOPMENT COMMISION
SHERRY MIELKE Customer Service: 1 800 472 9888
111 W MAIN ST STE 140 Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -1905 Remember, past due accounts are subject to a late
fee. Your prompt payment is appreciated. For your
convenience, pay online:
icemountainwater.com/service. If payment has been
made, we thank you.
r, a d you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
ecycling com pany? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep million Ibs of plastic out of landfills.
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800 472 -9888. It's free!
Delivery address: CARMEL REDEVELOPMENT COMMISION, 111 W MAIN ST STE 140, CARMEL IN 46032 Na
PREVIOUS BALANCE
10/29 0646393975 1 LATE FEE 1 0
10/31 J8275390 RENT 3.99
TOTAL 41
PR
Q ACCOUNT SUMMARY
PREVIOUS BALANCE
Sz;*ubiect to terms on rev 4 y NUNN
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR 1311-1, OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUALIY AND INFORMNI ION. 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 AC your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING N'A'I'ER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
#216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE 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 information about
a transaction on your bill. write us on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) (lays after we SAMPLE I NVOICE
sent you the first bill on m which the error or proble appeared You can
telephone us, but doing so will not preserve your rights. In your letter.
give Us the following infornmtion:
Your name, address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can. why you believe there is
an error.
You arc obligated to pay the parts of your bill that are not in question. 123a5e78 Your Account Number
You do not have to pay the disputed amount while it is being OWN loo owtbloo
investigated During the investigation, we cannot report your account
12345
as delinquent or take any action to collect the amount in question.
NR _«T 9P
MON NOT =9 Watch here for a
WED NOV 3
GENERAL INFORMATION OUG A personalized account
I. payments received after the billing (INVOICE) date will appear on Im message
II,11,.,IIL, 111,. IIIIII, IIII.I,IIII,,.,IIIIIAI „II,IAII mankY u1 r�.Ir,y Ne Mw .�Proe
your next invoice. past clue invoices (not paid within 30 days of news and
iahn Doe and servl.ez.
billing dale) may be assessed a late fee as allowed by law not to offers A23Mai^s` 000
exceed S20 per m n
month. Additionally. third party collection /attorney c,xs,are t
ul
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the niaailnunt allowed by law. TpMana9Sr ,pY,lp�aas „.env y eneWww 9 Pay electronically
Ypu tan U,¢cR �unN °rd mu<h.I.wch moM
2. Each returned check is subject to a service charge subject to the ,i,a r.na.vaMCVatx s
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount has been
since your ACCOUNT ACnwn avy. Srn,e 900
4. Equipment replacement costs will be charged for bottles lost. a ce° rervP�' "nDOe ",=3M s paid in full to
last invoice -.1
stolen. damaged or not returned w^°e ^c= avoid late fees
va vme -ThaAa roe sea e, soon
5. In accordance with NWNA's Terms and Conditions TRC your Deal a61e9e sGanoA Na,ural sp„ ^9 -5o.00
Equipment Lease and /or Service A recment account ma be vn 3i�aas 5 Ire ,a, ^sGaloeP��
g y eas,aaaa s si ^5wlecl^r° Monthly Oil
09111 )I I°°S r,,el5urchar9e
subject to minimum moinhly purchases and /or early cancellation Surcharge, Fuel
fees. IA complete version of the current TS.0 may be viewed on the �I'= 'c' 5
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TOTAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued
RM.M Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or
Delivery Fee as describe(] in your T &C. Only one of these tees Payment stub ACCOUNTSUMMARY 99 PA y TNIS AMOUNT
will ripply to each account. The fee that applies to your account nun -1Cf you _ACCOUNT NUMBER pqY BY 57.X9
F
e99 WIWI�
is Stated oil the front of the invoice. For further inform INVOI
information please 121 11 ",,G DATE MT- ENCLOSED
CE NUMBER
visit the website listed below or contact our customer service 17 ,"0m WIMIM
center.
7. As a food product, bottled water is subject to the rules and 0920096302 0,262712619 0003910 2 pp 9
Amount due
regulations prontulgaled by the Federal Food and Drug Inhl—
Aditnni,mitlon( ICEMOUNTAIN WATER COMPANY ,21 Main St
^1 H «W. Na W enY.na,e o000o Submit your
S. Your first invoice indicates the products delivered on your first EoR CO :TOMB. +eA�1cE CPL' 80b 7.veae
delivery, along with any applicable bottle and account deposits, 9= O ^R. ,,.5a.. payment by this
1,,.111.1 ,.1.,IIh,,.,II „•,it X1 „i,B,a,,,l,hla,d,di e...,,es,a.. ❑on ^,amcum date
redemption fees, and any dispenser charges. All future invoices ,5 ^oPara^r�°
will reflect charges for water delivered and dispenser rental, bottle 5 N 9PF�. °EEP *�Ar-
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks, for
a total of 16 -17 deliveries per year. Y'ou will only receive invoices
�„�._1.2.imes oer_¢eaz,.a L Rpru.eimatcly 5 of those invoices will reflect
BB. 66'81
1Nf10Wtl SIHl �kVd J111/1,110y 1N3
00, 6911, Form No. NW 709 5/08
'i
Presrvibed 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.
Al" Payee
�c ����,i� Purchase Order No.
fa &'y Terms
�0 6/ /"2 e�I/IJ ('(r Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1010,1161 /o 9 7
12 .ff3
iN
Z
a�
5
Total
e -4
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. "7
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
1 ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/oa %v3 y2 399 S9 bill(s) is (are) true and correct and that the
2 y2 35� materials or services itemized thereon for
which charge is made were ordered and
received except
20
")j. KID&
Si ature
itle
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service.icemountain.com
#215 6661 DIXIE HWY, SUITE 4 A 9 9
p LOUISVILLE KY 40258 10/01 /09 10/31 /09 09JO121776199
ADDRESS SERVICE REQUESTED g
FRI- NOV 13 0121776199
111 11111 IN 111111 IN 11 11 IN 11111 II II III II WED- DEC 16
TUE- JAN 19
#BWNNWYR THU- FEB 18
#0400001217761992#
CITY OF CARMEL HUMAN RESOURCES
SHELLY LINGELBAUGH Customer Service: 1 800 472 -9888
1 CIVIC SQ Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -2584 Delivery! We value your business.
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
1.6 million Ibs of plasti out of landfills.
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1-800-472-9888. It's free!
I I N 2 K 4 Lq I MO W
Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032
PREVIOUS BALANCE 7.34
10/25 916690 PAYMENT -THANK YOU -7.06
10/15 0643021405 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99
2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98
BOTTLE DEPOSIT: 2 CHARGED, 1 CREDITED 6.00
10/31 0646886242 1 OIL /FUEL SURCHARGE 2.16
J8215267 RENT 3.99
TOTAL 22.40
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
�bject to terms on reverse side. 7.34 7.06 22.12 22.40
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 REPORF 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.
'1216 If you prefer, you can pay your bill online at senice.icemountain.com.
6661 DIXIE FIWY.. 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
it transaction on your bill, write its on it separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SAM I NVOIC E
sent you the first bill on which the error or problem appeared )Toil can
telephone us, but doing so will not preserve your rights. In your letter.
give us the following information:
Your name, address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, by you believe there is
an error.
)'on are obligated to pay the parts of your bill that are not in question. 123456789 Your Account Number
You do not have to pay the disputed amount while it is being t 00100/00 DO/ IGO
investigated. During the investigation, we cannot report your account
u3ns
as delinquent or take any action to collect the amount in question.
Mod CLa 29 Watch here for a
WED NOV 21
GENERAL INFORMATION TUE. DEC 18 personalized account
i ,.800 -47 9088
I. Payments received after the billing (INVOICE I date will appear on P m N 111111 Itltltttb,,,ptp message
your next invoice. Past due invoices (not paid within 30 days of news and Th Yy IO 1LA9 „1 ^P.^e
billing date) may be assessed a late fee as allowed by law not to offers hu S.
exceed $211 per month. Additionally. third party cullceu Ci,y,S,MA on /attorney
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. T ro mE"gh`oal�""'°`°m }°9 Pay electronically
2. Each returned cheek is sub l ect to a service charge subject to the smke�ce"fD aa„ e Y�+"en^'a°d'" aad
e`
maximum check return charge allowable in your State._ Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount has been
ACTIVITY. since your ACCOUNT ACTwnP a te
4. Equipment replacement costs will be charged for bottles last invo
lost. oell�e,yndd,ely ton "D«,,z3Ma ^meeo Clvsave000ro paid in full t0
ice
stolen, damaged or not returned. 9uaBala ^a 1 <8 avoid late fees
Paymen, -Thant YOU 5000
5. In accordance with NWNA's Terms and Conditions ("T& C"). your oem 85 1699 5000
60
9111 31]51- Ice M^untainSLal Del>o*;, 2.95
Equipment Lease and/or Service Agreement account may be },268s,wwa s I�eM ",a; ^sLal6e, "1^ n.99 Monthly0il
09111 31']6651A3°a ee ^I SU,char9e
subject to minimum monthly purchases and/or early cancellation X12 6253Ben Surcharge, Fuel
2 5]80
fees. (A complete version of the current T &C may be viewed on the 09 ,558.9] Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TarAE Fee (see 96 under
Leased Equipment is charged through the end of the billing cycle "General
AMa1NT
in which service is discontinued.
Information
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or 99 a
Deliver
Fee as described 111 ACCOUNT SUMMARY our TRC. Only one of these fees Pay ment stub 99
Y Y Y u oe�•oao•-- -o'c'F °"ice •oil.,. PAY BY PAY THIS AMOUNT
will apply to each account. The fee that applies to your account N „7�, ACCOUNT NUMBER sz
w o0
123455] MT. ENCLOSED
is stated on the from of the invoice. For further information please INVOICE NUMBER BILLING DALE
visit the website listed below or contact our CUSIOnler service p o j vo100
12}456]8
center. xB
7. As a food product, bottled water is subject to the rules and 0,20E196307 09282732619 DDD39x ap Amount due
regulations promulgated by the Federal Food and Drug IP h,,—
Administration (FDA). IcE MOUNTAINwAIEe coM ANV �ysL;1e5t0LW Submit your
8. Your first invoice indicates the products delivered on your first aOr""°"°I .Irc
°O e �pSLOME65EBV10E CALL) 808+22.9868 p ayment by this
delivery, along with any applicable bottle and account deposits, t, „Tit,i, 1,.11.,at.,t,u.,t,.dd.t.t,•t ^It ,,,,,0•e�ene51J
redemption fees. and any dispenser charges. All future invoices x date
will reflect charges for water delivered and dispenser rental. bottle
5 w uP 108 16EE Au .oPArls9^ °P en U,•a e..e�
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks, for
a total of 16 -17 deliveries per year. You will only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 s /oa
S
Presc'ribed 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
Ice Mountain Direct
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/04/09 09JO121776199 Drinking Water Service $22.40
Total $22.40
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 11231 WARRANT NO.
ALLOWED 20
Ice Mountain Direct IN SUM OF
215 6661 Dixie Hwy, Suite 4
Louisville, KY 40258
$22.40
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 General Administration
Board Members
D PT. or INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 09JO121776199 390.99 x-40 materials or services itemized thereon for
'ZZ. .Z which charge is made were ordered and
received except
20
�gna re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service. icemoun tai n.com
#215 6661 DIXIE HWY, SUITE 4 t wo LOUISVILLE KY 40258 10/01/09 10/31/09 09JO117821082
ADDRESS SERVICE REQUESTED
MON- NOV 09 0117821082
III III I IN II 11111 II THU- DEC 10
TUE- JAN 12
THU- FEB 11
#BWNNWYR
#0400001178210823#
CITY OF CARMEL STREET DEPATMEN Customer Service: 1 800 472 -9888
3400 W 131ST ST Thank you for choosing Ice Mountain Home Office
WESTFIELD IN 46074 -8267 Delivery! We value your business.
Frecy cling ow our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
lbs .otplastic- out,of landfills...
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
p 9.
Delivery address: CITY OF CARMEL STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074
PREVIOUS BALANCE 13.57
10/25 916692 PAYMENT -THANK YOU -13.57
10/09 0641845078 4 9 OZ PLASTIC UP 50C /SLEEVE 11.96
4 5 GAL ICE MOUNTAIN DRK W /HANDLE 13.96
4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 24.00
4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00
10/31 0646684340 1 OIL /FUEL SURCHARGE 2.16
J8210378 RENT 3.99
TOTAL 32.07
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY v PAY THIS AMOUNT I
to terms on reverse side. 13.57 13.57 32.07 32.07
BILLING RIGHTS SUMMARY 1111111
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 I`FORxIArION. 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 NNATER CO. 3. Kindlv fill in the amount enclosed, include your account number on your check, and do not send cash.
#216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE MVV. 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
it transaction on your bill, write us on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SAMPLE
sent you the first bill on which the error or problem appeared You can
telephone us. but doing so will not preserve your rights. In your letter,
give us the following information:
Your name, address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can. e•hy you believe there is
an error.
)'on are obligated to pay the pans ofyour bill that are not in question. 123,1567890 Your Account Number
You do not have to pay the dispu DDloolooT
uted amount while it is being t I
investigated During the Investigation. we cannot report your account i
123456]
as delinquent or take any action to collect the amount in question. R-OCI
NON OCT 29 Watch here for a
WED NO ]I
GENERAL INFORMATION DEE IR personalized account
I- Payments received after the billing (INVOICE) date will appear on Important n messag
n,., m„ nl„ ataa ,,,tltt,t,ua,,,,jltjt,.Ij „a.lau co „om� olt«: ROO P
s r�aNn g
your next Invoice. Past due Invoices (not paid within 30 days of news and manr.roo'or�
billing date) may be assessed a Tate fee as allowed by lace not to offers I IBwm s`
00000
exceed 5211 per month. Additionally, third party collection /attorney o1'r5' a
a w d„ d., n6 „.�n et u ,IJI,d „dad,I,.Ld
expenses may be assessed at a rate not to exceed 100% of slid �m o •4>p+re
unpaid balance or the maximum allowed by law. ro ;tea ra �r«»w °a Pa electronicall
T brow <a a, Y Y
2. Each returned check is subject to it service charge subject to the
maximum check return charge allowable in your State. ..n Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity ma amount has been
ACTIVITY.
since your nccourrrArnvtn' a <oo
4. Equipment replacement costs will be charged for bottles lost. Del;ve,YAadr s "99 paid in full to
last invoice
red or not returned <a +s avoid late fees
stolen, damaged
o oa
5. In T &C accordance with NWNA's Terms and Conditions your au,R9e Parma Na,wal Ina ^r. ^u z.w
SGallon SDa ^9 Wa,ei
n.9
9111 3,>RR5144an 5 ,aim 5Gal0eW+" ]96
Equipment Lease and/or Service Agreement account may be mses,nwc s ,a; ^5GnlRe,41^ 9 Monthly Oil
o9n 3veesw,aa I w <i s�1�w�R<
subject to minimum monthly purchases anal /or early cancellation ovla 31RZe3eRn Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the Z jpp0's' 57 Surcharge or Delivery
website listed below) Upon service discontinuation. rent for the TOTAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. <.mTM s]!o
!i. You will be charged a monthly Oil Surcharge, Fuel Surcharge or aa'A” 9 Information
Dclivery Fee as described in our T &C. Only one of these fees Pay stub ACCOUNT SUMMARY
y y ..orn r o�c -<o•- r AMOUNT
THIS
mill apply to each account. The fee that applies to your account y ;,N s,ao
A CCOUNT NUMBER
is stated on the front of the invoice. For further information please INV ICENUMRE 11 890 BILLINGO of ENCLOSED
OOIWI
visit the website listed below or contact our customer service 12345e7e9
center. 16
7. As it flood product, bottled water Is subject to the rules and 0420/196307 04282712639 000391049 2004 Amount due
regulations promulgated by the Federal Food and Drug stmt o«
Administration (FDA). f Ct O0000
23 Main
ICC MOUNiA1N WATER COMPANr Submit your
8. Your first invoice indicates the products delivered on your first
Nmn.
DRCO,TOMERSER91<ECArI,- =9888 p ayment by this
dcliverv. along with any applicable bottle and account deposits.
L� ^e...,_,:.1, date
I 111.1...LJII,... ILA ..O. ,II,IaI.L..1,t,lA..Lat V <,u ea<
redemption fees. and any dispenser charges. All future invoices
will reflect charges for water delivered and dispenser rental. bottle
deposits and credits plus charges for any additional products
ordered by you Deliveries are made every three or four weeks, for
a total of t6 -17 deliveries per year. You will only receive invoices
12 times per year. so approximately 5 of those invoices will reflect
two deliveries.
0 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 ei08
qlv—
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.
d.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/04/09 09JO117821082 $32.07
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
VOU NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$32.07
a ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 09JO117821082 42- 389.00 $32.07 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday November 19, 2009
G ri r
/v
VLIW Street Commiss ner
Street Corriff t!e ;loner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
A _service.icemountain.com
o x #215 6661 DIXIE HWY, SUITE 4 g
LOUISVILLE KY 40258 10/13/09 11/12/09 09KO119252823
ADDRESS SERVICE REQUESTED c
WED- DEC 16 0119252823
III 1111111111 IN 111111 II 1111 TUE- JAN 19
THU- FEB 18
#BWNNWYR THU- MAR 18
#0400001192528234#
CITY OF CARMEL STREET DEPARTME
BONNIE CALLAHAN Customer Service: 1- 800 472 -9888
3400 W 131 ST ST Thank you for choosing Ice Mountain Home Office
WESTFIELD IN 46074 -8267 Delivery! We value your business.
II'�III III' ll" I' llllllllll
Did you know our 3 and 5 gallon bottles are cleaned and refilled on average 35 times before being turned over to
a recycling company? Each year, we recycle approximately 900,000 of our 3 and 5 gallon bottles, helping to keep
1.6 million Ibs of plastic out of landfills. r
j
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 860- 472 -9888. It's free!
Delivery address: CITY OF CARMEL STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 23.10
11/06 984430 PAYMENT -THANK YOU -23.10
10/15 0643021140 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98
2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00
2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00
1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99
11112 0648836179 1 OIL /FUEL SURCHARGE 2.16
K8390417 RENT 3.99
TOTAL 16.12
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
0
il0 1 23.10 23.10 16.12 16.12
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 -900- 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 WYI'ER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
4216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE IJWY.. SUITE 4
LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill. write us on a separate sheet of paper. We
must hear from you in writing error than thirty (30) days after we SAMPLE I NVOICE
sent you the first bill on which the he error or problem appeared. You can
telephone us, but doing so will not preserve your rights. In your letter.
give us the following information:
four name, address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can, why you believe there is
an error.
You are obligated to pay the parts of your bill that are not in question. 1z34s6789D Your Account Number
You do not have to pay the disputed amount while it is being 00)00 /0 .00lootDD
invcstigated. During the investigation, we cannot report your account i
as delinquent or take any action to collect the amount in question. THE -cc, w
1234567
Mo,�DCT 79 Watch here for a
WED GENERAL INFORMATION ,E UE� D D 71
T E( ,B personalized account
I. payments received after the billing (INVOICE) (late will appear on Important
Y b( PF u. n.., nl,. m ,.nmd, „nn,t,uo,,,,ppl,dl,dtd,tu
vour next invoice. Past due invoices ([lot paid within 30 days of news and U„ Y °9l "�9H9y message
billing date) only be assessed a late fee as allowed by law offers C 51 not to 1123 --i 5' o8888
"e
a
exceed S20 per month. Additionally, third part ll���.11
y collection /attorney
I del I.1 dll,.... „I
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. I ]xY mL gem "a Pay electronically
2. Each returned check Is sub to a service charge sub to the M YpU am^aEm�
J g I �rt «raeraPnr�w
maximum check return charge allowable in your State. Make Sure this
3. All bottle and equipment deposits are shown as CURRENT Activity °°°°.�aa.� 6�
k•.•• y amount has been
ACTIVITY. since your ACCOUN CTrvm CD'SU' aid in full to
4. Equipment replacement costs will be charged for bottles lost. •ceI Y name 3 oce 1 73Ma�es p
last invoice
stolen, damaged or not returned, r,er, vsBalarue se.oa
7 cs avoid late fees
var.... na "4vo°
5. In accordance with NWNA's Terms and Conditions "T &C your 08131 461898 s S Cau Nay °Ism' "n"'°
91,1 31IBBSIa4aa ce MOUnlain Seal Dep°+it
Equipment Lease and /or Service Agreement account may be maesa4.w s M^° i 5 ealRel ,,.99 Monthly Oil
09111 31]BBSla4a4 fuel SUrcFar9e
subject to minimum monthly purchases and/or early cancellation o9n2 6380N Rao Surcharge, Fuel
fees. (A complete version Of the current T &C may be viewed on the 8911 1 fi 6 n 0a9
Surcharge or Delivery
websitc listed below) Upon service discontinuation. rent for the TOTAL M Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. cm+O silo
5 ,40 Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or .a,ol•��^^^'""°
Delivery Fee as described ill y our T &C. Only one of these fees Payment stub ACCOUNT SUMMARY
Rv,° au.cc.au PAY THIS AMOUNT
J PPY BY
will apply to each account. The fee that applies to your account ,b MU� ACCOUNT NUMBER s, ae
is stated on the front of the invoice. For further information please 1734567890 WLING OATS MT. ENCLOSED
OOIWIW
visit the N'CbSItC listed below Or contact our customer Service INVOICE NUMBER
1234567
center. product py2009630i 04262732619 00034 2004 1R
7. As a food roduct. bottled water is subject to the rules and Amount due
regulations promulgated by the Federal Food and Drug It o—
Administration (FDA). ICEMOUNTAIN WATER COMPA +VK Citl Sta1e 00000
S. Your first invoice indicates the products delivered on your first y°nntw•�H• Su bmit vour
rDRCVS]oMLR SERV <L�AL$1
delivery, along with any applicable bottle and account deposits. 729B88 a this
payment b
y
redemption fees. fees. and any dispenser charges. All future invoices
L.. utd,u,.l,u,a,,.l.l.l.l,.l.,n �R..e.us P�,,,.•,<N "9.,�,P. date
will reflect charges for water delivered and dispenser rental. bottle sw „BPlo41RLF •^TOP
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks. for
a total of e6 -17 deliveries per year. You will only receive invoices
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 809
S service. icemountain.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))
11/14/09 09KO119252823 $16.12
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 N
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$16.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 09KO119252823 42- 389.00 $16.12 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
Frida N nber20,2009
Street Commis i er
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
0 720806
.88
9/01/09 9/30/09 0910120223912
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0
service. icemou ntain.com
THU- OCT 15 0120223912
11111111111111 IN II II 111 II DEC
I FRI- 13
WED- DEC 16
#BWNNWYR TUE- JAN 19
#0400001202239129#
CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 472 -9888
SHERRY MIELKE
111 W MAIN ST STE 140 Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -1905 Delivery! We value your business.
Back to School Savings on our most popular products! Great new lower prices on cases of 1/2 L Spring Water-
j plus get $2 off each box of Nestea Tea Sticks or case of San Pellegrino Sparkling Fruit cans you add to your
__Lin mP -Only- .CALL- TO ®AY!
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800 472 -9888. Its free!
Eel ki
Delivery address: CARMEL REDEVELOPMENT COMMISION, 111 W MAIN ST STE 140, CARMEL IN 46032
PREVIOUS BALANCE 23.46
9/10 680757 PAYMENT -THANK YOU -15.48
9/20 732049 PAYMENT -THANK YOU -3.99
9/02 0637811282 1 LATE FEE 15.00
9/16 0638529024 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 3.49
1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 6.00
2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00
9/30 0642283881 1 OIL /FUEL SURCHARGE 2.12
I8131701 RENT 3.99
TOTAL 22.59
ACCOUNT SUMMARY PREVIOUS BALANCE a PAYMENT /ADJUSTMENT CURRENT ACTIVITY e PAY THIS AMOUNT
,S�Aubject to terms on reverse side. 23.46 19.47 18.60 m 22.59
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR 1311.1_. OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WAI FR QUALITY AND INFORNIM ION, 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 A'r: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE NIOUNTMN SPRING W tER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
#216
6661 DIXIE IMIK, SUITE 4 If you prefer, you can pay your bill online at service.icemountain.com.
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 its on it separate sheet of paper. We
must hear from you in writing no later than thirty (30) clays after we
sent you the first bill on which the error or problem appeared. )oil can SM M P L E INVOICE
telephone us, but doing so will not preserve your rights. In your letter,
give its the following information:
four name, address. telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the crror and explain if you can. why you believe there is
an error.
foil are obligated to pay the parts of your bill that are not in question. ,23ase2e90
Your Account Number
You do not have to pay the disputed amount while it is being ooloot�- oo[ouloo
"U�
investigated. During the investigation, we cannot report your account
as delinquent or take am• action to collect the amount in question. T "R.oa 04
123456
moN -aT 29 Match here for a
weo Nov n
GENERAL INFORMATION 'd, rig personalized account
I. Pavnncnts received after the billing (INVOICE) (late will appeal on Important
nmei se <e ,.300- 472.9R8 message
Your paid within next invoice. Past due invoices (not p 30 days of news and IIJI,,, 111,. 1u..lanA,,,aIWJaI,.dlnL,n.AWda
1nr,P one
billing date) may be assessed a late Ice as allowed by law not to offers 123 Mat SI
exceed 5211 per month. Additionally, third party collection /attorney n I it ens�a�e I i
L. ...,.,n.,,u
expenses may be asscased at a rate not to exceed 100% of the
aar s ^0 mWy!PR w. Ix°'y
unpaid balance or the mallowed nm3 allowed by last T r P v ,,,,,nau 0e.�m«e Pay electronically
3. Each returned check Is Slob eel to a service charge subject to the a Y y amdwl a m
maximunn check return charge allowable in Your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
amount has been
ACTIVITY. since your AKOUNT Aam3Y' C y s,a,e 00000
,on o0 13 "+a� s Il s9 paid in full to
4. Equipment replacement costs will be charged for bottles lost. Addre++
last InVOiCC cet v -n.v9
stolen, damaged or not returned. P,�; ^^,gala ^�r 4z4s avoid late fees
son
5. In your accordance with NWNA's Terms and Conditions r &C Deis, g618gR Save 1 SI aauon n ^9 -5000
3,7e651a444 5 n SC,aI VePO*'�
Equipment Lease and /or Service Agreement account may be ,nees,4444 s a�l ^sealRe I .99 Monthly Oil
s,7eesl44.a s IFe s�,�h
subject to mininnnn monthly purchases and/or early cancellation p91" R
3326,33„ a n4o Surcharge, Fuel
fees. (A complete version of the current "I' &C may be viewed on the o9n2 lac4o497 Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the IOTA, Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. m m s �e°ev ue..
6. You a m will be charged onth) Oil Surcharge. Fuel Surcharge or .,V�ousw "AYNog ll Information
P 1199
Delivery Fee as described in your T &C. Only one of these fees Payment stub AccouN3 suMMAar
pAV BY PAY THIS AMOUN
will apph to each account. The fee that applies to your account AceouNr NUMS[a 5740
�m r oolooto0
is stated On the front Oflhe invoice. For further information please 1234567390 31LLIN0 GATE MT. ENCLOSED
INVOICE NUMBER 001100
visit file website listed below or contact our customer service ,234567R
cellter. 619 000391099 2004 SE
7. As a fond product. bottled water is subject to the odes and 0,20096302 0,2 &2112 Amount due
regulations promulgated by the Federal Food and Drug pL,n—
Administration 1 FDA
ICE MOUNTAIN wAIER CO IPANV cily Staff 5`00000 Submit your
p�, N Nnae Wain, Nw�
S. four first invoice indicates the products delivered on your first
delivery, alone with any applicable bottle and account deposes.
y
oR 95TOMERSERYI<E< "'S3 a ment by this
m
L,. 1111. ,..�,�ll „1,,.6661 „Itl v „m u rc^ o�R
ralepu It date
on fees. and any dispenser charges. All future Invoices uP,oerRl "0PR
will reflect charges for water delivered and dispenser rental. bottle
deposits and credits plus chaILCS for any additional products
ordered h_v von. Deliveries are made cvci v three of lour 3vecks- for
a total of 16 -17 deliveries per year. You will only receive invoices
12 times pet year. so approxinnalely 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 709 S /08
0
Q 720806
g®
0 9/01/09 3
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service. icemountain.com 0 e
THU- OCT 15 0121975593
NOV
11111111 IN 1111111111111111111 IN 1//111111 WED- DEC FRI- DEC 13
16
#BWNNWYR TUE- JAN 19
#0400001219755935#
CARMEL REDEVELOPMENT COMMISION Customer Service: 1 -800- 472 -9888
SHERRY MIELKE
111 W MAIN ST STE 140 Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -1905 Delivery! We value your business.
Back to School Savings on our most popular products! Great new tower prices on cases of 1/2 L Spring water-
plus get $2 off each box of Nestea Tea Sticks or case of San Pellegrino Sparkling Fruit cans you add to your
or der. Limited Ti me Only -CALL TO DAY!
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
Delivery a ress: 30 W MAIN ST S I L 220, UAHIVILL IN 4 0
PREVIOUS BALANCE 79.42
9/10 680756 PAYMENT -THANK YOU -35.96
9/20 732050 PAYMENT -THANK YOU -42.06
9/16 0638529214 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 11.98
2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00
9/30 0642334304 1 OIL /FUEL SURCHARGE 2.12
I8131856 RENT 6.99
SALES TAX
TOTAL 216.18
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASs OF ERRORS OR QUEST IONS ABOUT YOUR 11111- 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 4720888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE eYIOUNTAIN SPRIN'C WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
ft216 If you prefer, you can pay your bill online at service.icemountain.com.
6661 DIXIE IIU'Y.. SUITE 4
LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill. write us on a separate sheet of paper. We
must hear from you in writing no later than thirty (30) days after we SAM I NVOIC E
sent you the first bill on which the error or problem appeared. YOU can
telephone us. but doing so will not preserve your rights. In your letter,
Live us the following information:
Your name, address, telephone and account numbers. Date range of this invoice
The dollar amount of the suspected error.
Describe the error and explain if you can. why you believe there is
an error.
You arc obligated to pay file pans of your bill that are not in question. 123456789 Your Account Number
You to not have to pay the disputed amount while it is being
001001 001 100
investigated. During the investigation. we cannot report your account a
123456
as delinquent or take any action to collect the amount in question.
Mor+Dc, 29 Watch here for a M
GENERAL INFORMATION wED.
roE of eb personalized account
I. Payment received after the billing (INVOICE) elate will appear on Important
IIII .I,III1 ��.1 1111 11,.11.1,111
u
s,umerServlce: 422 -gab message
II.II,,.III.. 11111. I. for o.e "9 a Moon,aen Produns
virt next invoice. Past due invoices (not paid within 30 days of news and
luhn Dcerv<
belling date) may be assessed a late ice as allowed by law nor to Offers ,23 Mal ^se
exceed S20 per month. Additionally, third party collection /attornev o"s'ate Now
1... IILI.. 1., II1..,, II. .II.,II.,I,II.,I.,,I.I.II,A „1
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or file nu.tximum allowed b law. a •am edewww"°Cp Pay electronically
r y
You ca°checkyou ref
2 Fach returned check is subject to it service charge subject to the Ile1 ,,,,u.Hdery +w� "aMVm'm�^^`°
del .r,adm
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
I'. amount has been
ACTIVITY. your ACCOUNT Act-- V P
4. Equipment replacement costs will be charged for bottles lost, �DenrenAdmess n paid in full to
last imoice
stolen. damaged or not returned. rte.�. xioo avoid late fees
P
5. In accordance with NWNA's Teens and Conditions "TSC'), your e5,e9e 5c Y, o o„H ^9wa
9111 317005,4444 Ice Mountain S Gal DeP
Equipment 395
E 317995 1 4 t Lease and /or Service Agreement account nrav be 317995s4 5 M^ mscae" 99 Monthly Oil
o9n, Bne05e4+ �ees4r� "0
_-Subject to minimum monthly purchases and /or early c ancellation 3,e25sebn Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the o9 '�i0a9 174n
Surcharge or Delivery,
website listed below) Upon service discontinuation, rent for the roTAE Fee (see #6 under
Leased Equipment is charged through the end of the billing cvcle "General
in service is discontinued. 174o
"""""'+°"I
6. You will be charged a m Information”) onthly Oil Surcharge, Fuel Surcharge or "a+A"' 9
Dclivery Pee as described in our T &C. Only one of these fees Pay ment stub AccouNTSUMMA"v ,r 9
y y
PAV BY 0
aa�•• +•�are+axoxnr- -"'o'c PAV THIS AMOU
will apple to each account. The fee that applies to your account a,.� ^mM� Ac couNrHUMSExI
almw
is slated on the front of the invoice. For further information please j ;45 °1890 OIC baurvc Dn-1 Mr. EHC+oseD
INVE rvUMBE0. WIWlw
visit the websitc listed below or contact our cusfonter service ,n4s5269
1L1t1e1 p Su 0420096302 04282212619 000391049 2009 YB
7. As it f o od p bottled +eater is to file rules and Amount due
regulations promulgated by the Federal Food and Drug loh
AJministrmiun(FDA). wA1EP COMPANr cvsTli s'oaaoo your
R. Your first invoice indicates the products delivered on your first AL �0 29888 pay Su bmi t t by
w
Po ayment by this
deliverv. along with any applicable bottle and account deposit. P^ ^moo "r..
ul. L..L. rte .'s ,,n,,.,u.,al.a,u,a,,.l,lea,a,a1 x H• date
redemption fees. and any dispenser charges. All furore invoices date
P•, °n
will elect charges for water delivered and dispenser rental. bottle sI`r,uPPDP "eEPD
deposits and credits plus charges for any additional products
ordered by you. Deliveries are made every three or four weeks. for
it total of 16 -17 deliveries per year You will only receive invoices
l 9Z 8L Z 1 Z0 8L Zb 6L ,,pis eSleAel uo swiel of toelgn�
FJLNnoiN
slH.L AVd A11N13tl -1N32 Hno T 1N3W1Sf1faV /1N3W kVd 90NVIVS SnOIA98d Aamms 1Nn000 t
Prescribedby State Board of Accounts City Form
ACCOUNTS PAYABLE VOUCHER 'rF
CITY OF CARMEL
y
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
J/ Purchase Order No.
S(G 'F0 Terms
Date Due
Invoice C��o Invoice Description Amount
ate Number (or note attachhed invoice(s)or bill(s))
U 6S ✓�3 %c� C/ /lrCr lo
�3002 —2
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in ac ordancp
th IC 5- 11- 10 -1.6.
K.
ZO C eC k� Creasvicec
TOUCHER NO. WARRANT NO.
ALLOWED
IN SUM OF
I -10 60x
ON ACCOUNT OF APPROPRIATION FOR
9�2/ y23�ay5'
3 Boarcy Me�b
PO# or er S
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached inv
4 12 35 99 bill(s) is (are) true and correct and th t
or
02 y2 ep
3903 5 2 materials or services itemized ther n for
which charge is made were ordered and
received except
20 cry
2 1995)
S nature
Director of
`ion ledger classification if Title
)tor vehicle highway fund