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Home My WebLink About176274 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 357977 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN CARMEL, INDIANA 46032 P O BOX 856680 CHECK AMOUNT: $65.32 pN �a LOUISVILLE KY 40285 -6680 CHECK NUMBER: 176274 CHECK DATE: 8/19/2009 DEPA RTMENT ACCOUNT PO NUM BER INVOICE NUMBER AM OUNT DES 2701 4239099 15.96 09H7220327048 2200 4239099 17.45 09HO120048525 42201 4238900 09HO11782108 31.91 09HO117821082 720805 NO ®c 7/01/09 7/31/09 09H7220327048 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 D service.icemountain.com MON- AUG 17 7220327048 IIII III III I III Ill iII l II lIi OIIII I III II I III III WED- sEP 16 THU- OCT 15 #BINNNWYR FRI- NOV 13 #0400072203270488# CITY OF CARMEL OFFICE OF THE C Customer Service: 1 -800- 472 -9888 ANN DAVIS 1 CIVIC SQ Did you forget about us? Kindly pay upon receipt. CARMEL IN 46032 -2584 Remember, past due accounts are subject to a late I.L. I.11iIIIIIIIIIIIIJ' IIII11Id11111111111111111111111111111 fee. Your prompt payment is ilppreciated. For your convenience, pay online: icemountainwater.com/sery ice. If payment has been made, we thank you. Introducing NEW NESTEA LEMONADE flavored tea sticks! For a limited time, take $2 off each box of Lemonade, I Citrus Tea, Mixed Berry, Summer Peach or Tangerine Tea sticks you buy. Call or go online to add to your order. Offer e Au gust 31, 2009. x ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9688. It's tree! Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 15.96 7/17 0629712084 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99 7/31 0633126180 1 OIL /FUEL SURCHARGE 2.00 G7815422 RENT 3.99 TOTAL 31.92 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CUR?fWT__ACTIVITY m PAY THIS AMOUNT 15.96 .00 15.95,-" 31.92 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL I- 800 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #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 you in writing no later than thirty (30) days after we SAM I NVOICE 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, why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. 1� 123 4567890 Your Account Number You do not have to pay the disputed amount while it is being 00100100- 0 0 1 0010o investigated. During the investigation, we cannot report your account 1234567 as delinquent or take any action to collect the amount in question. MON -OGT 29 Watch here for a GENERAL INFORMATION W ED NDY 2 TuE -OEC 11 personalized account I. Payments received after the billing (INVOICE) date will appear on Important Customer Service'. 1.8004J2988 your next invoice. Past due invoices (not paid within 30 days of news and ILIL�,nl,d11 ^11111,1 1111 '1'1111 „•,IIIII,II,.ILL01 message Thank You IRr u>ir5 ke doh^ Dce a a services. billing date) may be assessed a late fee as allowed by law not to offers 123 M10 s 1 oo1O exceed $20 per month. Additionally, third party collection /attorney arY,5sa1e o 111.,•.11. ,11 ,,11 „I,II„ unpaid ba alan e or the ma mmm allowed by laµceed 100 of the Pay electronically J tomma9R Y mn<om Yw ran eFnRY° o y mueh.muc6 morel 2. Each returned check is subject to a service charge subject to the ta«R Ww �7drr maximum check return charge allowable in your State. i Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your A ccouNTArnvIT Y n- 23 Mai ^s,r rs 11.99 aid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice 4,45 o,,1_ Add nDpe 1,99 11.99 p aid damaged or not returned. RrewipOZB�k so o9 avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C your Den, .MR91 Pavme .wro g 718514aM 5 SGallon Nawral SOring Water <e Mountain 5 GalOePR*° I.9fi Equipment Lease and/or Service Agreement account may be 3neRSa444 5 ikeMOUntainSGalRetmn 1199 Monthly Oil p91,1 31]005, 4444 fuel5urchar9e subject to minimum monthly purchases and/or early cancellation Re complete version of the current T &C may Surcharge, Fuel fees. (A com o sJ p y be viewed on the 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. ,,,,.r.c <MTM e aT Inf ormation") n ormation 6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or i Deliver Fee as described in our T &C. Only one of these fees Pay ment stub Accourrr SUMMARY 99 Delivery y Y ..__.oc. THIS AMOUNT will apply to each account. The fee that applies to your account ,,,,,w,^`^� AGCOUNrNUMeER M M sz is stated on the front of the invoice. For further information please 1234567890 eIWNG DATE MT. ENCLOSED INVOICE NUMBER 00100100 visit the website listed below or contact our customer service ,234567 center. 004 1 7. As a food product, bottled water is subject to the rules and 04200963a2 04212212619 000391049 2 Amount due regulations promulgated by the Federal Food and Drug ien ^O« Administration (FDA). ICE M�OUNTAJN WATER an s� o°Oo 8. Your first invoice indicates the products delivered on your first Submit your AI „td, „I delivery, along with any applicable bottle and account deposits. FOR C USTOMER s`WCE CALL ,Q80 411-9s payment by this L,. n1, ,,.9i4. D r"m E6a^9a,�,R�.�r, date redemption fees, and any dispenser charges. All future invoices 9R4+ OefORfRfEwlOe „s,g °,R.,w��aO 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 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 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee ftych MA Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 ,M 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 l 0 6 Do q 1 1 5, qlo 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 r 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund o 720806 L 7/01/09 7/31/09 09HO120048525 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 g service.icemountain.com MON- AUG 17 0120048525 III I�BI ICI I �IIO II III DI I�II�� I IID DI I I08 IaI WED- SEP 16 THU- OCT 15 #BWNNWYR FRI- NOV 13 #0400001200485252# CITY OF CARMEL DEPT OF ENGINEE Customer Service: 1- 800 472 -9888 LISA SCOTT OR JUDY STOHLER 1 CIVIC SQ Did you forget about us? Kindly pay upon receipt. CARMEL IN 46032 -2584 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. Introducing NEWNESTEA LEMONADE flavored tea °'sucks! For -a iimiti�d-tl ne, ta ke $2 o box of Lemon Citrus Tea, Mixed Berry, Summer Peach or Tangerine Tea sticks you buy. Call or go online to add to your order. Offer ends August 31, 2 009. ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It free! Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 13.96 7/17 0629711805 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 50C /SLEEVE 2.99 7/31 G7789204 RENT n 1q�a 101,7 18192 3.99 TOTAL Z) Q 31.41 ZL ti ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU ENT PAY THIS AMOUNT ihinrf M f.— rnvn ci A. 13.96 .OD 17.45 1 31.41 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 A REPORT ON WATER QUALI AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL I- soo a7z ysss OR WRITE wRrrE us Ac your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING "INFER 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) days after we SAMPLE 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. 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. 1234se789 Your Account Number You do not have to pay the disputed amount while it is being 00100100 00 investigated. During the investigation, we cannot report your account 1234567 as delinquent or take any action to collect the amount in question. TOR exr moN -ocT =R Watch here for a =1 GENERAL INFORMATION Wf6 NOV .1C 1s personalized account I. Payments received after the billing (INVOICE) date will appear on Important message II�11,., 111„111. 111166, IIII ,1,1I11,,11111.11,.11.1.111 cc�somec zervma:3- RR�.4zz.s your next invoice. Past due Invoices (not paid within 30 days of news and Th,"k Y^"i billing date) may be assessed a talc fee as allowed by law not to offers 113M� Su exceed S20 per month. Additionally, third party collection /attorney °ry's"te 00000 expenses u unpaid balance or the allowedtbolawcccd 100% of the _r a W "Y7 "Tf'a'y s9 nt z.R+wY ,,�;�..wo "ce Pay electronically am4a. K 2. Each returned check is subject to a 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 ii l. amount has been ACTIVITY. since your Accourrr AcnVITY a ary usce p0000 4. Equipment replacement costs will be charged for bottles lost, ml A d »n" 1 23Na s I� paid in full to last invoice stolen, damaged or not returned. avoid late fees 5. In accordance with NWNA's Terms and Conditions TRC your zcalm "Nawcs sv'� ^9`^'" som m sysesl"au me MO "c,; "swlom°'a z.R6 Equipment Lease and /or Service Agreement account may be Monthly Oil 1❑ 3TZSav A s swlRe' "'Y subject to minimum month) p urchases and/or earl cancellation ovn >11�s "4" s wets ",ma,Re y p y ovnz 31 za3es„ Re" Surcharge, Fuel fees. (A complete version of the current TRC may be viewed on the oR1IZ 1W6 17 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the To Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 57A Information") 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or sfc a °tea sa Delivery Fee as described in Y S our TRC. Only one of these fees Pa stub ACCOUNT SUMMARY Rv PAY THIS AMOUNT will apply In each account. The fee that applies to your account „,�,�.R•„^•^' w /omoo A��pONT NUMBER 11"1 is stated on the front of the invoice. For further information please INVOI 12345Bj890 WER BWJNG DATE MT. ENCLOSED o CE NU WIWI visit the wcbsite listed below or contact our Customer service center. P sub 000391049 200 1 0420096307 04262712 7. Asa food product, bottled hater is sub�ect to the rules and Amount due regulations promulgated by the Federal Food and Drug 1 n "Doe Administration (FDA). "I WUNTnINwareR o vANr �lysiates'00000 Submit your a W.,m" K. Your first invoice indicates the products delivered on your firs) CUSroMCRSfRVlcfcnu'- 600'13 -Hasa delivery, along with alp- applicable bottle and account deposits, .1..,1,661 „I••II p ayment by this 1.,.1161.Lalh,,.,IL.,11.;,11 „I,p, 'X See. v„m a ^R• ^y51de. redemption fees, and any dispenser charges. All future invoices swN OP REC.woR "x144 Rro °�.°o ^R. will reflect charges for water delivered and dispenser rental, bottle date 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 cos 5108 S Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL .An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Ice Mountain Payee 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)) 08/07/09 09HO120048525 Rent and Service -July, 2009 $17.45 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF P.O. Box 856680 Louisville, KY 40285 -6680 $17.45 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the n a 239099 1 7.45 materials or services itemized thereon for A cnt 0120048525 which charge is made were ordered and received except 2004 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund D 720800 7/01/09 7/31/09 09HO117821082 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com RI- TUE- AUG 11 0117821082 111 11111 Ell 111 III III I III f!I III1 I III 11 I 1 Hill F SET 10 RI- OCT 09 MON- NOV 09 #BWNNWYR #0400001178210823# Customer Service: 1- 800 -472 -9888 CITY OF CARMEL STREET DEPATMEN 3400 W 131ST ST Did you forget about us? Kindly pay upon receipt. WESTFIELD IN 46074 -8267 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. Introducing NEW NESTER LEMONADE flavored ten sticks! For a limited time, take $2 off each box of Lemonade, r Citrus Tea Mixed Berry, Summer Peach or Tangerine Tea sticks you buy. Call or go online to add to you_ r order. Offer ends August 31, 2009, c. ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800 472 -9888. It's free! MR e e Delivery address: CITY OF CARMEL STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074 PREVIOUS BALANCE 37.91 7/13 0628630345 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 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 7/31 0633076567 1 OIL /FUEL SURCHARGE 2.00 G7778281 RENT 3.99 TOTAL 69.82 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR l Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION. PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 -800- 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #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) days after we SAMPLE INVOICE 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, why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. Iz3ase7e90 Your Account Number You do not have to pay the disputed amount while it is being 00100 /oo- 00100/00 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. TeR aT oa Iz3 ass7s9 MDN -Da 39 Watch here for a GENERAL INFORMATION TaE WED.1c 31 DEC I0. personalized account Inv -'7 90.0.0. I. Payments received after the billing (INVOICE) date will appear on I II 10 111 Ilan Illlldlll.,,,plp „n „udau c °me,servK B° 0 your next invoice. Past due invoices (not paid within 30 days of news and rn• ^EV Inv Mwnuin peodu<u message doh^ D and services. billing date) may be assessed it laic fee as allowed by law not to offers I23Ma1^sl exceed $20 per month. Additionally, third party collection /attorney a 00000 III,,.,.11 II.,,11 „1,11 „1. „1,1,16A „II expenses may be assessed at it rate not to exceed 100% of the unpaid balance or the maximum allowed by law. m .d rW "g Pay electronically I manage ounti h YOU thedYVUla ndmucYvmVCi ^bi 2. Each returned check is subject to a service charge subject to the se�°`"' e maximum check return charge allowable in our State. g Y Make sure this 3. All bottle and equipment deposits are, shown as CURRENT Activity ACTIVITY. amount has been since our AccouNT ACnwT e ooBOo 4. Equipment replacement costs will be charged for bottles lost. y De l; °e,yAame >on ^D°°13"'� °s` paid in full to last invoice stolen, damaged or not returned. °,rvm °,Bala avoid late fees s0 5. In accordance with NWNA's Terms and Conditions T &C” pa "mem.T m your 1898 0918 SGall°n Nanu Spnn9wa {p1 -S0 9111 3t10091anaa S He MOYnwlns WlDepos;t 19 Equipment Lease and/or Service Agreement account may be 0 1 B „99sIaaN1 s sealne. °m II Monthly Oil subject to minimum monthly purchases and/or early cancellation 99111 WWI' 1 g og 3192639811 Renl Surchar e, Fuel fees. (A complete version of the current T &C may be viewed on the .112 '�a009 s,a�) Surcharge or Delivery website listed below) Upon service discontinuation, rent for the roTAL Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or Information Delivery ee as described in our T &C. Only one of these fees Pa stub ACCOUNT SUMMARY rY Y Pa TNIS AMOUM will apply to each account. The fee that applies to your account AccouNTNOMBEn pAYB sT m. w win 9 B B°1oo is stated on the front of the invoice. For further information please 3z3 as57990 BER BILL ING DATE IC MT. ENCLOSED INVO NUM visit the website listed below or contact our customer service I1.;a56r990 E w /00108 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 OD03910V9 oo° 1 z Amount due regulations promulgated by the Federal Food and Drug ion Administration (FDA). ICE" ooUNTNN N'ATEN ON'An�rcA :Yy,L ysla `,U Submit your px.ae w•,en S. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits. nv fOR° °sT OME SERVKE <AL�Ia�+j9BB0 payment by this 1,.. 111, I,. l,aal „I,,,I,la.l,d „n side. ^.<�^9•,on Re.e „eslde. redemption fees, and any dispenser charges. All future Ioices „pRe9N edD ^R� date will reflect charges for water delivered and dispenser rental, bottle 3�1.,,aEDR1REE.01D °..i 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. Z2'69 00' 1,61C epi5 rn�dnd� uu stwel of toalyr I� p I Rln^IAIM Ctr, 1 110-3 t tnt t 1H t nl�LVn i ntaw l enrn i tU�w 1WA =i imw do cnnIA...� AdviN iN ns lNn000 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)) 08/07/09 09HO117821082 $31.91 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 N W ARRANT N O. ALLOWED 20 Ice Mountain IN SUM OF P. O. Box 856680 J- ouisville, KY 40285 -6680 $31.91 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member 2201 09HO117821082 42- 389.00 $31.91 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 a nda ugust 17, 200E UW Street Commi s' ner stleC n EN Title Cost distribution ledger classification if claim paid motor vehicle highway fund