174929 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
I: ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $188.60
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680
CHECK NUMBER: 174929
LOUISVILLE KY 40285 -6680
CHECK DATE: 7/2212009
DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIP
2201 4238900 09FO11782108 X37.91 OTHER MAINT SUPPLIES
2200 4239099 09FO12004852 X13.96 OTHER MISCELLANOUS
1125 4353099 09F012009535 /60.90 OTHER RENTAL LEASES
1047 4353099 09FO12120276 /37.91 OTHER RENTAL LEASES
1205 4239099 09FO12177619 /21.96 OTHER MISCELLANOUS
1701 4239099 09F722032704 15.96 OTHER MISCELLANOUS
A/ 720806
M —MEW 6/01/09 6/30/09 09F7220327048
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 e e
service.icemountain.com
FRI- JUL 17 7220327048
IIII III I III III III' II III III I IIIII II III MON- AUG 17
WED- SEP 16
#BWNNVVYR THU- OCT 15
#0400072203270488#
CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 -472 -9888
ANN DAVIS
1 CIVIC SQ Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -2584 Delivery! We value your business.
NEW Savings Advantage! Ice Mountain Direct now delivers more savings than ever. Ice Mountain half liter cases.
for as low as $4.99 /case. Yesi As low as $4:99 a case DELIVERED' Call 800- 472 -9888 or visit
lceMourtainwater.com/servicetota our new lower prices_
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. Its free!
g
Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 15.96
6/21 249810 PAYMENT -THANK YOU -15.96
6/17 0625215553 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 50C /SLEEVE 2.99
6/30 0628482630 1 OIL /FUEL SURCHARGE 2.00
F7672926 RENT 3.99
TOTAL 15.96
Q ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU ENT TIVITY PAY THIS AMOUNT
15.96 15.96 15.96 15.96
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 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 bIOUNTAIN 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 FIN 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
sent you the first bill on which the error or problem appeared You can SPA M P L E INVOICE
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.
You are obligated to pay the parts of your bill that are not in question. ,234ss7a9 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 A
123456
as delinquent or take any action to collect the amount in question.
moN 00 74 Watch here for a
GENERAL INFORMATION WED me
TDE DEC ,a personalized account
I. Payments received after the billing (INVOICE) date will appear on Important
Il. il,„ IIIIII. allll, I,„ IIII .11111.11111,11,.11,1111 a "Home Serv;ce�.l- Boo >7z -9e
message
your next invoice. Past due invoices (not paid within 30 days of news and IP ir ^5 5
Moo ^w ^vim
billing date) may be assessed a late fee as allowed by law not to offers Tz3I ST
exceed $20 per month. Additionally, third party collection /attorney c�rosale°
IIh ..•.IL„ah,,il „lal „1, Jill A.A
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. ea„ ^m^r�•aarP'9^`•"`P`? e,,e.+Y° Pay electronically
Tomana9eY�1dC om. Youcan ayc4} a¢W, much. much ^aN�
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity I amount has been
ACTIVITY. since 'our A ccouNTACTrv'T o0000
4. Equipment re lacernent costs will be charged for bottles lost, y ��;.�,yname nh^ 1231r1a s ""c`ys paid in full to
p g last invoice
stolen, damaged or not returned. a2 S avoid late fees
Payment -Thank YOU 5
5. In accordance with NWNA's Terms and Conditions "T &C your oe, .wle9e s sGa4 ^9W =1ef
Equipment Lease and /or Service Agreement account may be 1 Monthly Oil
subject to minimum monthly purchases and /or early cancellation "o$u"" Surcharg Fuel
o9n2 I,a�xaee Pem sew
fees. (A complete version of the current T &C maybe viewed on the o 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. ""siw`
1.0 Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 5
D Deliver Fee as described in our T &C. Only one of these fees Pay ment stub ACCOUNT SUMMARY 99
elivery y our o.x^- -e c.,ou.ca uou... PAY 111 AMOUNT
ACCOUNT NUMBER PAY By 57a0
will apple to each account. The fee that applies to your account 2
°A 1 214 5 67890 MT. ENCLOSED
is stated on the front of the invoice. For further information please W.IcrNOM9E9 9RUr4GDATE
visit the website listed below or contact our customer service pv 1D0j00
T 2}45678
center. 18
7. As a food product, bottled water is subject to the rules and 0420046301 04282712619 000391049 2004 Amount due
regulations promulgated by the Federal Food and Drug W,,D«
Administration ICE MOUMAIN WAT.11011A'" ..Mae`D0000
8. Your first invoice indicates the products delivered on your first °w.,r,
Submit your
delivery, along with any applicable bottle and account deposits, roR :TONER :E 941 cc cucl9ooa payment by this
CA 9 e,anae.. .s�
i nvoices date
redemption fees, and any dispenser charges. All future invoices ar ^uo�9wre°On"` °y°
will reflect charges for water delivered and dispenser rental, bottle s"'„ °P,�,PEEAUTVP
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
S.—
Prescribed by Stale Board of Accounts City Form No. 201 (Rev. 1995)
'i 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.
v �Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4- cat
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.
Q A ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
0 7p I W l
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
t'. P1 ,�i� 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
2
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
.r
B 720806
kY
6/01109 6130109 09FO121776199
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
FRI- JUL 17 0121776199
III IIII I IIII IIII I I IIII II it III I (IIII II II II III MOrv- AUG 17
WED= SEP 16
#BWNNWYR THU- OCT 15
#0400001217761992#
CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888
SHELLY LINGELBAUGH
1 CIVIC SQ Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -2584 Deliveryl We value your business.
NEW Savings Advantagel Ice Mountain Direct now delivers:more 6avin ever. Ice Mountain ha liter cases•
r for as low as $4.9$ %ca 6e. Vest. AS.low,as $4:99- a,ease DELIVERED!,• Call 800 -472 -9888 or visit
Iceslountai^vrater -..com /service to -takp 3d�oantagQ Of 6tlr naw otver_prlcea- 1
I
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or b x ehone at: 1-800-472-9888. It's free!
Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032
90/9 60L MN ON WJoj OUI eDIJ@wV y1JON SJOMM 911 ON 10 UOISInId a `Auedwoo JeleM 6uudS uielunoW eol 90OZ G
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saaionui ajnln
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BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER"
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WAI'ER QUALII "Y 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 bIOUNTAIN 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 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 later than thirty (30) days after SM M PL E I N ®NC E
sent you the first bill on which the he error or problem appeared. You can an
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.
tion are obligated to pay the parts of your bill that are not in question. 1234sb�a90 Your Account Number
You do not have to pay the disputed amount while it is being 00/00100 00
investigated. During the investigation, we cannot report your account
123456
as delinquent or take any action to collect the amount in question. THR "OCI a
MoN OCI 29 Watch here for a
GENERAL INFORMATION Tu NOV a1
HE -oEr personalized account
I. Payments received after the billing (INVOICE) date will appear on Important
n. n.., ut., m .,mn.6.,twa,au,,.,tun.,a,.n,t,m eusmmttserv;_�,^Baoov,�uRB message
your next invoice. past due invoices (not paid within 30 days of news and T,,, nEY°g' 1 «9n^
billing date m be assessed a late fee as allowed by law not to
g y offers aL'r.saleM000Oo
exceed S20 per month. Additionally, third party collection /attorney ex u .,,dt.,,u „i.ad
unaid balance or the maxiimum allowed b y la 100% of the ^LaAYL aaY O.1�s^csm+PHro9^^t °pw r�o-,ue.m Beat
p y wa �.1me v9�� tt Pa
T�srvTna9eY W +xcOU Youun �,eE4VOUS�p1
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. 'I- ,aaa k Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity I ;^,,,,K• amount has been
ACTIVITY.
$IneeyOUr ACCOUNT 5 ow .5 a m ooW
4. Equipment replacement costs will be charged for bottles lost, last invoice cer�nAdarea w "°pe'173Ma paid in full to
stolen, damaged or not returned. ,R,l <z avoid late fees
5. In accordance with N WNA's Tenns and Conditions "T &C your oenl 4r.1R9e s ParY
]1780510444 SGallon Natwal5prin9
Ke MOUntainSGal DepRS' 396
Equipment Lease and/or Service Agreement account may be T „easla444 s KeMO ",amsca;ReLRm 1,?9 Monthly Oil
subject to minimum monthly purchases and /or early cancellation 09111 p wets ^+IRalx S
complete version of the current T &C may be viewed on the 1 10497 S,RO S urchar ge, Fuel
fees. (A con
p Y Surcharge or Delivery
websitc 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 rrt ,+amw "Y si+o, f ormation")
n 1
6. you will be charged a monthly Oil Surcharge, Fuel Surcharge or 9
P lease MMARY 9
Deliver Fee as described in T &C. On one of these fees Accour+TSU
Y y our Y P stub a PAV TNIS AMOUNT
PAY BY
will apply to each account. The fee that applies to your account �Nn s we+0� Y°"P+��a' ACCOUNT NUMBER 0000100 5 40
is stated on the from of the invoice. For further information 1za4s MT. ENaosro
p RauNC DATE
INVOICE NUN10E0.
visit the websitc listed below or contact our customer service 1s34sa7R90 oolOOlUo
CClCr. I 042,,0963(1'1 042,2712619 (100391,,49 200 LE
7. As s p a food prod bowled water is sub to the rules and Amount due
regulations promulgated by the Federal Food and Drug C pl, "Doe
Administration (FDA). ICE MOUNTAIN wATERCOM,V,?,ulM o "state5t Woo
8. Your first invoice indicates the products delivered on your first 0^^_ 1-1 N Submit your
11.- CALL I "8oU -477 -9880 not E II:
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
I Mountain Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
22.73
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. j W RRANT NO.
ALLOWED 20
E Bb6680 IN SUM OF
Louisville, KY 40285 668
Z4 9(,
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
12 05 E, 9FC) bill(s) is (are) true and correct and that the
99 390 -99 3 materials or services itemized thereon for
which charge is made were ordered and
received except
20
r
Sign atu
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
p 720806
6/01/09 6/30/09 09FO120048525
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 g 0 e
service.icemountain.com
p FRI- JUL 17 0120048525
III IIII III I IIII II II III II IIII IIIII II II II III MOD- AUG 17
WED- SEP 16
#BWNNWYR THU- OCT 15
#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.
f NEW Savings Advantage! Ice Mountain Direct now delivers more savings than ever. Ice Mountain half liter cases
for as low as $4.99 /case. Yes! As low as $4.99 a case DELIVERED! Call 800472 -9888 or visit
�nm /onn.ica_j o ad�(anta 9- f -our new.,MWP polo-
ACCOUNT ACTIVI P ay your bill online at: service.icemountain.com or by phone at: 1- 800472 -9888. Its free!
Delivery address: CITY OF CARMEL TOWN HALL ENGIN, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 47.86
6/07 170711 PAYMENT -THANK YOU -17.45
6/30 295930 PAYMENT -THANK YOU �112 13 '47 -30.41
6/17 0625215272 2 5 GAL ICE MOUNTAIN DRK W /HANDLE qr S 6.98
2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN c� .00
1. 9 07. PLAST-IC_IIP_ 5nCLSl_FFV.F �r<c�� °�A --7 _QA
90/9 hoc MN'oN w,0=1 'oul e31J9wV ylaoN saateM eliseN fo uo!s1A14 a `Auedwoo aaleM BwadS uiefunow eol 800Z OO
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soawnw 3Aia031 ,(IUO pim noA inn lad sauaAgap LI -9I ;o Ie101 e
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 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 thiny (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, lvhy you believe there is
an error.
You are obligated to pay the pans of your bill that are not in question. lz3asa7a9 Your Account Number
You do not have to pay the disputed amount while it is being oolo0,00- 00,01100
investigated. During the investigation, we cannot report your account
123456
as delinquent or take any action to collect the amount in question. TNB oc, w
MoN�o 29 Watch here for a
GENERAL INFORMATION w M
u 1eE ,e p ersonalized account
I. Payments received after the billing (INVOICE) date will appear on Important Crammer sem«.1 eao' °]2
n n m„ nt „mn,l, „u„u.f01 M°unulnPr°aua, message
vour next invoice. Past due invoices (not paid within 30 days of news and
date) m be assessed a late fee as allowed b law not to 1 113 1 1 ,pQ
billing Y Y offers 123 Main S 1
exceed S20 per month. Additionally, third party collection /attorney ctysta,e 000o' L.aLL ,IdIL... ILA ,.II,,,IL,LIt „6�I,I,t,t.,I „11 at a
unpa�d balance or the mases may be assessed
all by l e not to weed 100% of the Pay electronically
u �yWraC4W .can d,ttKYa4 nt
2. Each returned check is subject to a service charge subject to the y ,f" 1C0dix wy°` 9 ro d
maximum check return charge allowable in your State. a J Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. since our AccouNTAalvm amount has been
00,00
4. Equipment replacement costs will be charged for bottles lost, last invo ice oem ynaa -1 °h,O 123M i nzu c y s,a,e 7 paid in full to
stolen, damaged or not returned. P e ri °a�0me °s avoid late fees
PaymentTftank YOU SOW
5. In accordance with NN'NA's Terms and Conditions "T &C Your oen, 4 e s sca �anNa, °raise ^9w
ui ment Lease and/or Service Agreement account may be
Q P g Y o rn mess s Ce n mseai9emm 99 Monthly Oil
E
subject to minimum monthly purchases and/or early cancellation g
pg12 „BZfi3M„ ae" sv 4u Surchar e, Fuel
fees. (A complete version of the current T &C may be viewed on the
Surcharge or Delivery
websitc listed below) Upon service discontinuation, rent for the rornE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. ww .m "sTM
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or „w. g s Inf ormation")
Deliver Fee as described in our T &C. Only one of these fees Payment stub ACCOUNT SUMMARY 99
Y y our p„•••.or.w -x^rnr oc.°au�re TNI
PAYSAM
will apply to each account. The fee that applies to your account ."m v�wr^•”` ACCOUM NUMBER PAY BY 5 44
P 123456]890 oo1 W MT.ENCEOSEO
is stated on the front of the invoice. For further information please ,M,o,cENUMerR ewN W
TT
visit the website listed below or contact our customer service ppj 1w
12;456]
center.
P 0420096307 0426171 0003910V9 200V 1
7. As a food p roduct. bottled water is subject to the rules and Amount due
regulations promulgated by the Federal Food and Drug I°nn ooe
payment by t h is
Administration (FDA). ,cE MOUNTUN watRoMANr
H.
City's,, o0ow Submit vour
8. Your first invoice indicates the products delivered on vour first
uB SERYTETaE .ao 41
delivery, along with cu1T1MER
h any applicable bottle and account deposits, t Ili I t al a u,adl,d,•dddd „6,
redemption fees, and any dispenser charges. All future invoices swN A 0 ",,,,s;, "uPeeaw'•°°^ ""S1de P,� neevc4e5ie date
will reflect charges for water delivered and dispenser rental, bottle
deposits and credits plus charges for any additional products
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
OX b5bbbU Purchase Order No.
Terms
Louisville, KY 40285 -6680
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/04/09 09F012004852 Rent and Service -June, 2009 $13.96
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
Fee Mou ntain IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
$13.96
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 9FO120048525 ENG4239099 V3.96 materials or services itemized thereon for
A cnt 0120048525 which charge is made were ordered and
received except
120 20
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
r 720806
6/01/09 6/30/09 09FO117821082
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0
service.icemou ntain.com
MON- JUL 13 0117821082
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII T
T HU AUG 11
HU- SEP 10
FRI- OCT 09
#BWNNWYR
#0400001178210823# Customer Service: 1- 800 -472 -9888
CITY OF CARMEL STREET DEPATMEN
3400 W 131 ST ST Thank you for choosing Ice Mountain Home Office
WESTFIELD IN 46074-8267 Delivery! We value your business.
FNEW ngs Advantage! Ice Mo untain Direct'now delivers more savings than ever. Ice Mountain half litjcase�s as $4.99 /case. Yes!..As lcw.as $4.99_a rasa DE! l :�ERED! Call 800 -472 -9888 or visit
ln�.at+rr.com/ erv:ce to talz2 a� \san #are ot.ou. ne:l� rover prices
ACCOUNT ACTIVITY Pa your bill online at: service.icemountain.com or hone at: 1 -800- 472 -9888. Its free!
D
Delivery address: CITY OF CARMEL STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074
PREVIOUS BALANCE 11.60
6/30 295931 PAYMENT -THANK YOU -11.60
6/11 0624108882 4 9 OZ PLASTIC UP 50C /SLEEVE 11.96
_A. C /_l11_ .T l.`_C \1!11.1 \1 T..A.T. \1 -AOV UI_I.l1 A•IC11 -C ___._r__. ___a.n _.n
90/9 60L MN'oN Wloj 'Out L'OIJ9wV LIVON SJOIuM a11sON 10 U0191AId B 'Auedwoo JaleM 6uiJdS ulelunolN eol 8002 OO
'sauangap x111
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S3310AUI IA10031 Aluo Ipm noA IeaA lad sauangaP L 1 JO I0,101 n
joJ •s>laa,1N lnoJ to ooig1 A1313 apeul 3.1e saua.vlaU noA Aq polop.lo
slanpoid Icuoulppe Aue joJ saAinga said svpalo pue sl!sodap
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUALITY AND INFORMATION. PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means
CALL 1- 800 -472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING W,cfER 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
sent you the first bill on which the error or problem appeared. You can SAMPLE INVOICE
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 pans of bill that are not in question. 12 3456789 0 Your Account Number
You do not have to pay the disputed amount while it is being
ooleeioo ooloo/
investigated. During the investigation. we cannot report your account 123456
as delinquent or take any action to collect the amount in question. m8 on w
,,ON -OCT 29 Watch here for a
GENERAL INFORMATION TUE DEC 18 aE -EC 18 personalized account
1. Payments received after the billing (INVOICE) date will appear on Important
ILII„VIII .VIII „IIIII,I,•IIII,1,1111,„11111 „II,.ILLIII Cuaocnec seNlce. ieoo 1n 988
your next invoice. Past due invoices (not paid within 30 days of news and manP.YO I ^,4ilcy1 <eMOUn,an
P .��n message
billing date) may be assessed a late fee as allowed by law not to offers I �iiM�m SI ane aemc••
exceed S20 per month. Additionally, third party collection /attorney eny,na,e 00000
nl,.,.al..al,a,lt „I,.a,i l l I.J,
...,n
expenses may be assessed at a rate not to exceed 100% of the a y oh... Pap electronicall
unpaid balance or the maximum allowed by law. 1 AaxYW 3
2. Each returned check is subject to a service charge subject to the 4T` s ,a. n'"`s'T4Ca max
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity moo, amount has been
since 'our ACTIVITY
ACTIVITY. ACCOUNT
>onnDne 1z3Ma s ee� °`r's`a`epp ns9 paid in full to
4. Equipmem replacement costs will be charged for bottles lost, last invoic e ceWe
stolen, damaged or not returned. 4y gala avoid late fees
5. In accordance with NW NA's Terms and Conditions "T &C your 8813, 46,e98 sacaliol+ ursl soil ^eW"e` so o
111 31]8851 Maa 5 Ice MOUntainSGal DeOOSit 296
Equipment Lease and /or Service Agreement account may be 3nees, s ,a;ns�alnewc^ u?9 Monthly Oil
Surchar
subject to minimum monthly purchases and/or early cancellation g e, Fuel
89 neT638 1 Qe
fees. (A complete version of the current T &C may be viewed on the 17
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the ToTAE Fee (see #6 under
Leased Equipment is chan ged through the end of the billing cycle "General
m88ENT.RNm PaY,Bno
in which service is discontinued. Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or EMeu aw4 ^99 u,NT we,�
Deliver Fee as described in yourT &C. Only one of these fees Payment stub AccouNTSUMMARY a. 99W
PAY TED
S AMOUNT
will apph PAY BY to each account. The fee that applies to your account o�^ ACCOUNT NUMncR 0 PAY oo sr.
is stated on the front of the invoice. For further information please .z34s6re" enuNC DATE MT ENaosrD
INVOICE NUM 8E4 00100100
visit the website listed below or contact our customer service 1 :3056)890
CCIIICT. P sub 042,1712by9 00039L0V9 200V la Amount due
7. As a food p bottled water is sub to the rules and
regulations promulgated by the Federal Food and Drug Rhn—
Administration (FDA). MOUNTAIN WPTE0. 12 Ciy 3 ;nS S 00000
ICE �OM1tPANY
R. Your first invoice indicates the products delivered on your first aw1n,"
Amy+ lir
aSToMTP Se8YlceIIAEU eoo Submit your
FOR =98Be payment by this
delivery, along with any applicable bottle and account deposits, GP 4
6,.In,L,al,a.n,a,,,l,l,l1 °I MnnA D ..Nx
r Icu,puon fees. and any dispenser charges. All future invoices date o^cY.sgn uP B¢yal,ac o errs
...:11 _...,.......1... c.._ ....1:..,._,.,, .....1 .1:,...,......... .._._I ,.....1,. v6M1 OP. «cea. "T
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))
07/04/09 09FO117821082 $37.91
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
VOUCH NO. WAR NO.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$37.91
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 09FO117821082 42- 389.00 $37.91 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
n
Friday, July 17, 2009
Street Comrrais igS6r`
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
0 720806
6/01/09 6/30/09 09FO121202766
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
TUE- JUL 14 0121202766
IIIIIIII IIII III I IIIII I II I IIII I IIIII IIII II III WED AUG 12
r r, FRI- SEP 11
#BWNNWYR `�Q4 1 O OCT 12
#0400001212027662# y, 2009 i
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.
I This invoice includes a $2 Oil Surcharge. It was triggered` by the average price of oil rising above $50 /barrel in
i May. As before you are only charged once a month;no matter how many deliveries you receive and not charged if
you. don't have a dellvE y d ,-ring a billing period.-=. r=
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1- 800472 -9888. It's free!
Delivery address: CITY OF CARMEL PARKS DEPT/MONO, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032
PREVIOUS BALANCE 86.81
6/07 170712 PAYMENT -THANK YOU -57.90
6/30 295929 PAYMENT -THANK YOU -28.91
6/12 0624451522 7 5 GAL ICE MOUNTAIN DRK W /HANDLE 27.93
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
BOTTLE DEPOSIT: 7 DELIVERED, 7 RETURNED .00
6/30 0628501702 1 OIL /FUEL SURCHARGE 2.00
F7735602 RENT 4.99
TOTAL 37.91
10.•09
e• m a4
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CUR NT A TIVITY PAY THIS AMOUNT
86.81 86.81 37.91 37.91
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE 01' ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUALITY AND INFORMATION. PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means
CALL 1-900 -472-9888 OR WRrfE US Al: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE MOUNTAIN SPRING N VrER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
M216 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 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. 1 Z34s67a90 Your Account Number
You do not have to pay the disputed amount while it is being 00,00100- 0Dlootoo
investigated. During the investigation, we cannot report your account 123456
as delinquent or take any action to collect the amount in question. THR -Dana
mON -aT 29 Watch here for a
1+
GENERAL INFORMATION WED"NOV
lDE -Dec ,B personalized account
I. Payments received after the billing ate will ap on Important
Y g (INVOICE PP Customer Semc e: 1 800 <)2 -98
II,II,.,IIL,111,.IIIIII 11111 ,1111,.11lllll.11,l,lll Mtl„ma ^v.oau<t• message
your nest i nv o ice. Past due invoices (not paid within 30 days of news and ma ^Rr •tll
billi date) may be assessed a late fee as allowed by law not to 10h^o"e
ng ,na,emee.
b Y offers ,z1 N,alo st
exceed S20 per month. Additionally, third party collection /attorney o`r'z`ate moo0
expenses may be assessed at a rate t ex ceed 100% of the
unpaid balance or the maximum allowed by law r roY �c�n a ^rt aa} 4M9hu wrw t Pay electronically
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. g Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity a amount has been
since our ACCOUNTACT1wiTY
ACTIVITY. °A
.a r� z31aa ^zt,<eLorrzla oDOOO 1199 aid in full to
4. Equipment replacement costs will be charged for bottles lost, 199 P
last invoice
stolen, damaged or not returned. p, <�;oueBalarKe az.� avoid late fees
warm .mm
TNnk Y,w
5. In accordance with NWNA's Terms and Conditions ("T &C your OBl1+ ab'B� s e a lwnNawrals9h ^B
mean4+aa amsr>a1Dea°+"
Equipment Lease and /or Service Agreement account may be Monthly Oil
9 lness+4aaa s �eMw�umswlR
1 3 +7805 S I FUel5ulcha�9 e
subject to minimum monthly purchases and /or early cancellation Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the ^9' 574 Surcharge or Delivery
wcbsite listed below) Upon service discontinuation, rent for the roTAi Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued •`Y""` s In formation”
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or ."u
Delivery Fee as described in your T &C. Only one of these fees Paymen stub ACCOUNT SUMMARY fa• •E9w Mr
y PAY BY VAY THIS AMOUNT
Acc
will apply to each account. The fee that applies to your account .n� m �,mera+Rro^•^ ouNrNUMeB6 BBim 5740
U:, n�e.�tl
is stated on the from of the invoice. for further information please 131450 90 Bu MT. ENCLOSED
uNC DME
INVOICE NUMBER miW10
visit the wcbsite listed below or contact our customer service u1as67a9a
center.
7. As a food product, bottled water is subject to the rules and 0420096307 r,,82112619 0003910`19 zoDR 1
Amount due
regulations promulgated by the Federal Food and Drug 1.h D«
Administration (FDA). 123 Ma1n
ICE MOUNTAIN WATER COMPANY c,tY,State OOBOD
a „N.,,I•W Submit your
9. Your first invoice indicates the products delivered on your first ,oR CUSTOMER SERY'�E ""BO9- +7a9BeB
delivery, along with any applicable bottle and account deposits, p by this
L.. 111.1 A11 11 a1 .a,u.,1,,,l......�D ^R «.,,•5�B• °n,<5ae. date
redemption fees, and any dispenser charges. All future invoices ,NUP10nfREE ^u,0,,, "z•' "u,n•9W�
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
p 720806
0
6/01/09 6/30/09 09FO120095351
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
WED- JUL 29 0120095351
III Iilli�IIIIIII�IIIII �III��III� III THU -.AUG 27
MON- SEP 28
#BWNNWYR
TUE OCT 27
CARMEL LAY AND REC DEPT JUL l?
AUDREY KOSTRZEWA 9 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 NEW Savings Advantage! Ice Mountain Direct now delivers more savings than eve-r. Ice Mountain half liter cases
for as low as $4.99 /case. Yes! As low as $4.99 a case DELIVERED! Call 800- 472 -9888 or visit
leeMountainwater.com /service to,take.advantage of our new lower prices_ a
A A Pay your bill online at: service.icemountain.com or by phone at: 1- 800 -472 -9888. Its free!
DY r �g wjn
Delivery address: P CARMEL CLAY PARKS AND REC DE, 1427 E 116TH ST, CARMEL IN 46032
PREVIOUS BALANCE 57.87
6/07 170713 PAYMENT -THANK YOU -26.94
6/30 295928 PAYMENT -THANK YOU -30.93
6/29 0626998124 7 5 GAL ICE MOUNTAIN DRK W /HANDLE 27.93
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
BOTTLE DEPOSIT: 7 DELIVERED, 4 RETURNED 18.00
6/30 0628485013 1 OIL /FUEL SURCHARGE 2.00
F7660281 RENT 9.98
TOTAL 60.90
7 10• fl9
e cc)urty
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CUR PAY THIS AMOUNT
57.87 57.87 60.90 m 60.90
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 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 WR'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 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 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. 1134567890 Your Account Number
You do not have to pay the disputed amount while it is being 0 r 100100- 00100)00
investigated During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. raa �oa o.
12345
M0N -aT n Watch here for a
GENERAL INFORMATION TUU DE- Dec DEC 1,
1e p ersonalized account
seMa: l�aoos]z
1. Payments received after the billing (INVOICE) date will appear on Important
ILI1,,, 111„ 111„ IIIIIa,,, IIII ,I.11I1,,.1111111,.11,1111 gnome, 9888
M n R°uducU message
your next invoice. Past due invoices (not paid within 30 days of news and rn,nkyopl vnp9
1W Dce and seMces
billing date) may be assessed a late fee as allowed by law not to offers u Main
3 s L
exceed $20 per month. Additionally, third party collection /attorney a1r, stale 00000
L,al66,A,.IDDOO1. ,.I1,.,11,d,a „I,,,I,I,I,L,L.11 v
expenses may be assessed at a rate not to exceed 100% of the "U,”
unpaid S
unpaid balance or the maximum allowed by law. may°!" s. Pay electronically
2. Each returned check is subject to a service charge subject to the 3e rvu Kemon n+lite�"�y DfOd „a,„, 01.01901 mo�.E n
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. since our pccouNTpcnvlTM a amount has been
u3 Main s" 0 e1y s�ie ON) nm paid in full to
4. Equipment replacement costs will be charged for bottles lost, last i nvoice �Deu�ery Aad[ess'. 3onn DOe. 1199
stolen, damaged or not returned r<e m avoid late fees
Payment- Tnankyou 5000
5. In accordance with NWNA's Terms and Conditions "T &C your oen, e61e9e z
9111 sGannoNa[9,alsrp�newa.n soon
31]9BSl gaga Ice MOUn[dln seal Depo*` 1.9fi
Equipment Lease and/or Service Agreement account may be ,1, 3vpes,a4w s keMn�numsGalReWm ne9 Monthly Oil
subject to minimum monthly purchases and/or early cancellation ov11 3nepsa+a+ we l w.eFa,9e
09 „1 31111E"B 11 Qen Surchar Fuel
fees. (A complete version ofthe current T &C may be viewed on the °9 'x 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 pp mm
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or ,p aa +1 s Information
Delivery Fee as described in your T &C. Only one SUMMARY one of these fees Payment stub pAV 1N6 AMOUNT
will apply to each account. The fee that applies to your account I
-Mm„�a.w-^' ACCWNrNUMBS 'Aypy
0000 00
is stated on the front of the invoice. For further information please 12'4667890 BILLING DATE Mr ENCLOSED
INVOICE NUMBER
visit the website listed below or contact our customer service 1 134167890
center.
7. As a food product, bottled water is subject to the rules and 0920016307 092 82712619 D003 20 °4 1 Amount due
regulations promulgated by the Federal Food and Drug Iw1n
Administration (FDA). ICE MOUNTAINWATERCOMPANY 113 Main S[
d T M c;y ,sale 04000 Submit your
R. Your first invoice indicates the products delivered on your fire
Epp CUSTOMEp SERVICE CALL 1-800-473 -9
delivery, along with any applicable bottle and account deposits, payment by this
1.,, nl, l,,, 1.. „lal „I,,,I,I,la,a °0 „e swe „n..•y�w�o•p....usid
redemption fees, and any dispenser charges. All future Invoices zwn0pa•9,�.do•Re.. date
will reflect charges for water delivered and dispenser rental, bottle y1
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 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 Date Due
Louisville, KY 40285 -6680
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/4/09 09FO121202766 Water cooler rental Monon Center Jun'09 37.91
7/4/09 09FO120095351 Water cooler rental Maintenance Dept. Jun'09 60.90
Total 98.81
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
98.81
i
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 09FO121202766 4353099 37.91 1 hereby certify that the attached invoice(s), or
1125 09FO120095351 4353099 60.90 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
16 -Jul 2009
Signature
98.81 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund