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177706 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 357977 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN a CARMEL, INDIANA 46032 P 0 BOX 856680 CHECK AMOUNT: $91.24 LOUISVILLE KY 40285 -6680 CHECK NUMBER: 177706 CHECK DATE: 9/2912009 DEP ACCOUNT PO NUMBER IN VOICE NUMBE AMOUNT DESCRIPTION 2201 4238900 32.53 09I0119252823 202 4350900 090HO1220610 58.71 0122206105 90 720806 p0 a 08/13/09 9/12/09 0910119252823 i #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 e service. icemountain.com 0119252823 III IIII II II II II III III 11 I IIIII 19111111 III 1 111 #BWNNWYR #0400001192528234# CITY OF CARMEL STREET DEPARTME Customer Service: 1- 800- 472 -9888 BONNIE CALLAHAN 3400 W 131ST ST Thank you for choosing Ice Mountain Home 8 Office WESTFIELD IN 460748267 Delivery! We value your business. F BBack hool Savings on our most popular products! Great new lower prices on cases of 1/2 L Spring water off each box of Nestea Tea Sticks or case of San Pellegrino Sparkling Fruit cans you add to your i Time Only -CALL TODAY? ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800 472 -9888. It's free! p6 p p pp Delivery address: CITY OF CARMEL STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 26.05 9/13 694381 PAYMENT -THANK YOU -26.05 8/17 0633874177 5 5 GAL ICE MOUNTAIN DRK W /HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 30.00 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -30.00 3 9 OZ PLASTIC UP 50C /SLEEVE 8.97 9/12 0639542398 1 OIL /FUEL SURCHARGE 2.12 I8102221 RENT 3.99 TOTAL 32.53 CCOUNT SUMMARY PREVIOUS BALANCE m PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT biect to terms on reverse side. 26.05 26.05 32.53 32.53 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU`"BETTER IN CASE of ERRORS OR QUES I IONS ABOUTYOUR 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.'rhat means CALL 1 -800 472 9888 OR WRITE 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. 9216 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) days after we SAM sent you the first bill on which the error or problem appeared. )'on can telephone us, but doing so will not preserve your rights. In your letter, give us the following information: 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 pay the pans of your bill that are not in question. tz34s6ta9 Your Account Number You do not have to pay the disputed amount while it is being 00100100 0 0 00100 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. F UR OCT oa 11 3456789 MO -W 29 Watch here for a GENERAL INFORMATION WED "DV t, TaE D EC ,B p ersonalized account I. Payments received after the billing (INVOICE) date will appear on Important 1I,n.,.111,.111,.11111. litlJJlll' ^•11111 ^11"ll'1'UI c�M SIMT message 1- BOO.a�z 9888 your next invoice. Past due invoices (not paid within 30 days of news and anRyoularusinglaMOUVtainp +a0uds fi john Dce and seM<es. billing date nrry be assessed a late fee as allowed by law not to Ma In g offers SI c,,slate 00000 exceed S20 per month. Additionally. third party collection /anorney unpaid balance or the mac mum allowed t to by la em ceed 100% of the Pay electronically To ma,M9eYwr MC pm, Ya+(An dlecE} S av e d n�vdtmu[fi 2. Each returned check Is subject to a service charge subject to the n �mmwR�^ety°'a°a maximum check return charge allowable to your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your ACCOUNTACTIVIN P 123 M'" slreetew6 eoo00o paid in full to 4. Equipment replacement costs will be charged for bottles lost, cei�n Aaare+, bhn DOe 0.99 olen, damaged or not returned. last invoice Baa ^Te avoid late fees St P�ew�o4. Payment iFZnk YOU sow 5. In accordance with NWNA's Terms and Conditions T &C your 0813, +6 s0,na "am+alsp +m9wa,e� -soon 91,1 31 1 1 aba 4 s ke MOVntains Wl DeWSi+ 1.96 Equipment Lease and /or Service Agreement account may be me 1-AA s ke ntams Wl Retn ns9 Monthly Oil 091„ 31IBBS,a4a4 Fuel SU,cM1a�9e subject to minimum monthly purchases and/or early cancellation nax63ean Ren. Surcharge, Fuel fees. A complete version of the current T &C maybe viewed on the �l,a 'N s p y 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. Information N ^Me ITM 6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or Dcliven• Fee as described in Y 5 our T &C. Only one of these fees Pay ment stub AccouNT suMMARr „_.a.a a+•ao PAY BY PAY AM will 'apply to each account. The fee that applies to your account u. ,nn 1ua a�•s m•+an W°P'/'"• ACCOUNT NUMBER 57+ 00 0010 is stated on the front ofthe invoice. For further information please 12,41089- BauNCDATE MT. ENCLOSED INVOICE NUMBER visit the website listed below or contact our customer service 1z3 563B90 center. iE 7. As a food product, bottled water is subject to the rules and 0420o963ai 042E2712619 000391049 2004 Amount due regulations promulgated by the Federal Food and Drug R ,,n— Administration (FDA). 123Mams1 ICE MOUNTAIN WATER COMPANY Submit your •p,,�vond ",ykwn.., •wnn aa.n•^' C'M1y,State 00000 S. Your first invoice indicates the products delivered on your first FoRTDSTDMtRSERVicECAtt,a6wn -9MB delivery. along with any applicable bottle and account deposits, p ayment b' this 1... u1. 1... 1.. n1,,.. ,a,,.,n..,u..1.n„1,.,1,1aa.,1„n ,Kt�. Pa�, .n,.9.,o�Re.•,u S redemption fees. and any dispenser charges. All future invoices ABC” PT P am oPar,saa^PRaRwa a pn date R 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 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 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)) 09/15/09 0910119252823 $32.53 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. ALLOWED 20 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $32.53 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 0910119252823 42- 389.00 $32.53 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 i Thursday, L mbe 2 2009 Street,Commissioner Strut Title Cost distribution ledger classification if claim paid motor vehicle highway fund 720806 co 0 8/01/09 8/31/09 09HO122206105 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service. icemountain.com WED- SEP RI- F NOV 16 0122206105 III If01 I1 II11 I11I 1 N X I I W MI IN IN M II H IN 15 RI- NOV 13 #BWNNWYR WED- DEC 16 #0400001222061057# 4i CITY OF CARMEL ENGINEERING /1ST Customer Service: 1 800 472 9888 KAREN NOLAN 1 CIVIC SO Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -2584 Delivery. We value your business. 1 Have you gotten your SAVINGS ADVANTAGE? Put two or more cases of Ice Mountain 1/2 Liter in your'My I Regular Order' and pay just $4.99 case DELIVERED! Call 800 472 -9888 or visit www.icemountain.com to take -advantage, of-the new, e I 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 AVENU SOUTHWEST, CARMEL IN 46032 PREVIOUS BALANCE 8/20 0635690845 .00 4 5 GAL ICE MOUNTAIN DRK W /HANDLE P CUP y.' 4 13.96 1 •5 L NATURAL SPRING WATER ICE MTN 00 11 BOTTLE DEPOSIT: 4 CHARGED, 0 CREDITED 96 8 063 7622481 8 045334 1 OIL /FUEL SURCHARGE 04 1 RENT(08 /20/09 08/31/09) RENT (09 /01/09 09 /30/09) 2.12 SALES TAX 1.46 3.99 TOTAL 1.22 x THIS RENT IS FOR A PARTIAL MONTH 58 7 1 Q ACCou ubjeot terrn M MAR °n reverse si PREVIOU NCEo pA yMENT /q0 ✓U STMENT CURRENr /PW �M i J 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 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 mean CALL 1- 8001172 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. �II 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 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. 60/008100'! 12W678" The dollar amount of the suspected error. r o01401 Describe the error and explain if you can, why you believe there is ,23+6 an error. Mo Your Account Number You are a obligated to the arts of our bill that are not in question. g pay P Y q You do not have to pay the disputed amount while it is being ,666 c °Homo Watch here for a investigated. During the investigation, we cannot report your account a, i,L.taot °11't"'0na'mi "'.mn,at olio m as delinquent or take any action to collect the amount in question. personalized account ,13 S+aite6 0060" Important wna,.a u „,,n, ,n.,,a message GENERAL INFORMATION 1. Payments received after the billing (INVOICE) date will appear on news and 6 tim m« vour next invoice. Past due invoices (not paid within 30 days s of offers l Pay electronically billing date) may be assessed a late fee as allowed by law not to exceed $20 per month. Additionally, third party collection/attomey -oDo expenses may be assessed at a rate not to exceed 100% of the ACCOUNrACT,VN n s o <eaoo 66 Make sure this unpaid balance or the maximum allowed by law, o<ery �eMe oo N° amount has been mm paid in full to 2. Each returned check is subject to a service charge subject to the Activity 6 s swM� sb,oro� avoid late fees maximum check return charge allowable in your State. since your 3. All bottle and equipment deposits are shown as CURRENT IeSt InVO1Ce 6 nz nez636s gem mm• ACTIVITY. Monthly Oil 4. Equipment replacement costs wilt be charged for bottles lost, ,bPni Surcharge, Fuel M J out returned. stolen. dams` Surcharge or Delivery In accordance with AIWNA's Terms and Conditions "T &C your Fee (see #6 under Equipment Lease and/or Service Agreement account may be new General Your n PCCOUNrSUMMARY c•.w cc ai a „ceuation tion subject to minimum monthly Dumb— be viewed on the delivery ..t t: information”) ne currant TS C utaY peitverles IeCS. Q rn» t for the calendar. HrM castle hc[ed below} Upou service discontinuation, m t g Yeie D' indicates Leased Equipment is charged through the end of the billing cycle scheduled which service is discontinued. .,rct,arge, Fuet Stttcharge or You will by C o s¢ tees Fcc as described in yourT &C. ;i s delivery ;.ng h2rged a monthly o o;,; 'n'K On ne of the ue r r. Y account h m': 'mm'm a at due to each CtllR applies to your li, The See tt[at a Lc rnrms 6uNr Amon W1�taDply a ahon please Han v.Y6Y nw lS Stattd Otlthe front of t1 A rat fu[tnet mfortn y rv[ce payment stub "M np Aa NuM+E+ A NaosEo nn,ac, o .•n w•vn^'"' 6iwNC baE below or 1v C NU 56,8 NISil the website listed and p OIE $go 66160 +00 rules a 123V669890 z66Ya9616 suvmit Your prouuct, bottled water is subject to the 000391o�” paY me by tomulgated by the Federal Food and Drug 6 "eez 1ab1" th \d :s date egulations p pu?Ua9051 o� ministration (FDA). Cast'" COMPiT C"Y SUie „epo� 'our first invoice indicates the products delivered on y our licable bottle and aCCOnnt dCpoStts, waEVr n"�`;xd ,livery, along with any app to 1nv0iceswill CFMU v w O es. All Tutu 9�•. aQ111�11onFees, and any dispense[ cha[g ��1 bottle 70 9 t „at P 'x oa �lov. ^sm °O Foctn No N ��on W <o��°\�� o \�1 l�� Predcribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Ice Mountain Payee Purchase Order No. OX Terms Louisville, KY 40285 -6680 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/03/09 09H0122206105 Rent and Service, Keystone field office $58.71 ccn 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 ti w %Vc PCHER NO. WARRANT NO. ALLOWED 20 Icy- Mountain 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 na materials or services itemized thereon for A cnt 0122206105 which charge is made were ordered and received except q� 2.q: 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund