HomeMy WebLinkAbout169944 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
0 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $273.51
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 169944
LOUISVILLE KY 40285 -6680
CHECK DATE: 3118/2009
DEPARTMENT ACCOUNT PO NU IN NUMBER AMOUNT DESCRIPTION
2201 4238900 09BO11782108 X104.16 OTHER MAINT SUPPLIES
2200 4239099 09BO12004852 /45.37 OTHER MISCELLANOUS
1125 4353099 09BO12009535 23.03 OTHER RENTAL LEASES
1047 4353099 09BO12120276 ✓67.87 OTHER RENTAL LEASES
1205 4239099 09BO12177619 /16.54 OTHER MISCELLANOUS
1701 4239099 09B722032704 _/16.54 OTHER MISCELLANOUS
r.
0 720106
Hgom
2/01/09 2/28/09 09B7220327048
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service. icemountain.com
THU- MAR 19 7220327048
IIII III ICI I iii III III �I III III III "I'� I APR 17
MO N- MAY 18
#BWNNWYR WED- JUN 17
#0400072203270488#
CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 472 -9888
ANN DAVIS
1 CIVIC SO 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.
STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL, 1
Liter, Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases
per deliVM._Call_80 -9888 pr_go online T ODAY!��
ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SO, CARMEL IN 46032
PREVIOUS BALANCE 25.70
2/08 510420 PAYMENT -THANK YOU -12.99
2/19 0607154804 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
3 5 GAL ICE MOUNTAIN DRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
2/28 0609852702 1 OIL /FUEL SURCHARGE 2.08
87106559 RENT 3.99
TOTAL 29.25
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU ENTACTIVITY PAY THIS AMOUNT
�biect to terms on reverse side. 25.70 12.99 16.54 29.25
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 \VATER 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 -172 -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 IlWY.. 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 it separate slicer 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. 123456799 Your Account Number
You do not have to pay the disputed amount while it is being 0 0100100- 00
investigated. During the investigation, we cannot report your account 123456789
as delinquent or take any action to collect the amount in question. THR OCT o4 7
MON 29 Watch here for a
GENERAL INFORMATION D. ND 2
ruE -DEC 18 personalized account
I. Payments received after the billing (INVOICE) date will appear on Important
n n,,, tu, au, auu l mtaam ,,,,ttttl „u „u.1.tu c4„ ",ner5e,v message
your next invoice. Past due invoices (not paid within 30 days of news and
billin date) may be assessed a late fee as allowed by law not to �°a"oce
t` Y offers ,n Mal "s
1 1Y.Sw 0000°
exceed S20 per month. Additionally, third party collection /attorney o
t lilt t,at t e xceed 100% of the
expenses may be assessed at a rate unpaid balance or the maximum allowed by law Pay electronically
Ta,wcem woucw,. vww ^c^K nm«r
2. Each returned check is subject to a service charge subject to the
;rs," aom w. aae+a^nY m w oa4aa a
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
„e amount has been
ACTIVITY. since your Aa0 NTACnvm J e;rys.a1e0D000
4. Equipment replacement costs will be charged for bottles lost. Der,renpamea+ w^ °o ,'z3Ma 5 paid in full to
last invoice
stolen. damaged or not returned ^4aalaMe 4: avoid late fees
vav me "T^' "xm4 5000
5. In accordance with NWNA's Terms and Conditions "TRC"), your oenl 461e9a sGano ^Nam,al zo ^9Wa,e. .Sono
IN 3178851 N.A4 5 ke MOUnuin 5Gal Deposit 2.96
Equipment Lease and/or Service Agreement account ntay be 8,788SI4444 S wIRel ,1. Monthly Oil
091,1 '0.114344 8 'Ned SU,cNege
subject to minimum monthly purchases and/or early cancellation w1❑ "IDOM Surcharge, Fuel
fees. (A complete version of the current TRC may be viewed on the O9nz 'bd'°497 n+o
Surcharge or Delivery
website listed below) Upon service discontinuation. rent for the rood Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
a Information
in which service is discontinued. °A,.RIa
6. YOU will be charged monthly Oil Surcharge, Fuel Surcharge or 9� 4aN*+
Dellvery Fee as described in vour T&C. Only one of these fees Payment stub ACCOUNT SUMMARY Ea•'cEY PAY THIS AMOUNT
PAY BY will apply to each account. The fee that applies to your account w,,,.e -a..uM�.. r°"°"^'" o /W-
ACCOUNTNUMSM .EN
is stated on the front of the invoice. I-or further information please 1234567890 RO.ING DATE T. ENCEOSED
INVOICE NUMBER 00100100
visit the website listed below or contact our customer service w1,08
center. 2pp9630"1 04282712619 000393049 2004 1E
7. As a food prod bottled water is sub ect to the rules and Amount due
regulations promulgated by the Federal Food and Drug p^ Dee
AdI inistration(FDA). ICE MOUNTAINWATENR GOMM�,A x 113YMta3e5t OOOOn
D kw•m Submit your
S. Your first invoice indicates the produce delivered on your first EDRCDSrOMERSEnv1<E eoo+n =Ise
delivery, along with any applicable bottle and account deposits, e„.sa. pay ment by this
redemption fees, and any dispenser charges. All future invoices 1,,, tti' i,, ,i „ni,,,,, „•a,di ^i,n.,t.,aa,M �a� ^TT6a�9.,o ^R•• date
will reflect charges for water delivered and dispenser rental, bottle rs Re•.
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
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
Sr
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
I LL Purchase Order No.
v (a(0 b V Terms
<q Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
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
materials or services itemized thereon for
which charge is made were ordered and
received except
r 20
Signatu
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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))
03/04/09 09BO120048525 Rent and Service, February 2009 $45.37
ccnt 012004852 3
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 Mauntain IN SUM OF
P.O. Box 856680
Louisville, KY 40285 -6680
$45.37
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 01130120048525 ENG 4239099 5.37 materials or services itemized thereon for
Ac nt 0120048525 which charge is made were ordered and
received except
3 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
JJ ~1A A 720106
FT 2/01/09 2/28/09 09BO120048525
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 r
service.icemountain.com
THU- MAR 19 0120048525
III IIII III I IIII II II III II IIII III III II I I IIIII FRO- APR 17
MON- MAY 18
#BWNNWYR WED- JUN 17
#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.
j STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL,1
Liter, Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases
per delivery. Call 800- 472 9888 -or go_online TQOAY!
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 TOWN HALL ENGIN, 1 CIVIC SO, CARMEL IN 46032
PREVIOUS BALANCE 45.37
2/08 510416 PAYMENT -THANK YOU -21.44
2/19 0607154630 5 5 GAL ICE MOUNTAIN DRK W /HANDLE 17.45
5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
2/28 B7080138 RENT rol 89 7017 3.99
TOTAL N 45.37
j RECERIFP
M MAR 2009
M GAVEL a
CITY ENGINI EEh oee
"I,'G
ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
biect to terms on reverse side. 45.37 21.44 21.44 45.37
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 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.
9216 If you prefer, you can pay your bill online at sen'ice.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 he later than thirty (30) days after SAMPLE INVOIC
sent you the first bill on which the error or problem appeared. YOU c an 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.
You are obligated to pay the parts of your bill that are not in question. 12 3 g s6Je90
You do not have to pay the disputed amount while it is being 234567 00100100- 00100100$ Your Account Number
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. THR of104
m0N0CT =9 Watch here for a
GENERAL INFORMATION WEa pY
r.E- 0Ef 19 personalized account
1. Pavments received after the billing (INVOICE) date will appear on Important
11 .11���1.��1111 ,1,1111,,,,11111 „11 „11,1,111 message
Cu+mm e+Servrn+e:l ao 0r]z -988
your next invoice. Past due invoices (not paid within 30 days of news and 111 manE
Y offers
billing g date may be assessed a late fee as allowed h law not to
Ion^ oce
exceed $20 per month. Additionally. third party collection /attorney d1 e s
L.dll.l..l„III II II II III.A IIII 1
expenses may be assessed at a rate not to exceed 100% of the
unpaid 2. Each returned check islsubjectmto all erviicel Pay electronically
charge subject to the a oun m
maximum check return charge allowable in your State. r Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. since your ACCOUMACr1y1TY amount has been
4. Equipment replacement costs will be charged for bottles lost. Ue,i ryAdde 1 ^rynOOe•1JM'� "s frs 1e000oo paid in full to
last invoice
stolen, damaged or not returned. o" :mince =<s avoid late fees
p„ymen+llonk YOU 50.08
5. In accordance with NWNA's Terms and Conditions "T &C your 0 p av+99e 5G8 NZ +4al scg' "914"e` s0m
9lli ]]895 5 uin SGal peps" 'M
Equipment Lease and/or Service Agreement account may be 1 1 e 5u4u s mnmSC mm 1 1 .99 Monthly Oil
0911+ 31)0951 hf4a 11 UiCn -IV
subject m minimum monthly purchases and /or early cancellation 0v,= 1,8263x911 Ren+ Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the wo 51 40 Surcharge or Delivery
mvebsite listed below) Upon service discontinuation, rent for the ]olAE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle
"General
in which service is discontinued. cux "u,,
u +M information
6. You will he charged a monthly Oil Surcharge. Fuel Surcharge or
Delivery y our Fee as described in T &C. Only one of these fees Payment stub AccouE+T suMMARY E? "u
y pPY THIS AMOUNT
will apply to each account. The fce that applies to vour account .n:nr p• ACCOUNT NUMBER 9AY BY 5740
o0 00 00
is stated on the front of the invoice. For further information please 1234567890 BIUINC OATS MT. ENCLOSED
�NVOIfE NUMBER
visit the websitc listed below, 001W100
or contact our customer service 123456]8
center.
7. As a food product, bottled water is subject to the rules and 0120096307 04282712619 000391019 2004 1d Amount due
regulations promulgated by the Federal Food and Drug 1
Admini stration (FDA). ICE MOUNTAIN WATEN oM=L C, .51a1e5t 00000
S. Your first invoice indicates the products delivered on your first •�^w^ Submit your
iOR CUSTOME0.5ERVICECKEI- BW-+ "9888
delivery, along earth any applicable bottle and account deposits, ILA,�.LLIA,.L.11 e,us,,,
ti p ayment by this
•,p panurocn,n9.gun 9a.
1... IIIa� I, 5m.
redemp fees. and any dispenser charges. All future Invoices „5," "upR•9W�� °n date
will reflect charges for water delivered and dispenser rental. bottle S,r,4up+oR+9EEaurop.,
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
Sr
Af 720106
2/01/09 2/28/09 09BO117821082
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 'g
service. icemou nta! n.com
THLI- MAR 26 0117821082
III IIII IIII III III I III III III III II I III III FRI- APR 24
TUE- MAY 26
WED- JUN 24
#BWNNWYR
#0400001178210823# Customer Service: 1 800 472 9888
CITY OF CARMEL STREET DEPATMEN
3400 W 131ST ST YOUR ACCOUNT IS SERIOUSLY DELINQUENT and is
WESTFIELD IN 46074 -8267 subject to additional late fees. You must make
immediate payment to avoid collection action. For
your convenience, you can pay by phone. Please
call today!
STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL,1
Liter Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases
per delivery. Call 8 00- 4 72 -9888 or go o nline T ODAY
i
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 STREET DEPARTME, 3400 W 131TH ST, WESTFIELD IN 46074
PREVIOUS BALANCE 120.14
2/08 510421 PAYMENT -THANK YOU -34.97
2/28 0609324629 1 LATE FEE 15.00
87067809 RENT 3.99
TOTAL 104.16
AC COUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
�hiAnt M tarms nn rpver silo 120. 34.97 18.99 104.16
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU 116TER
IN CASs: 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 REPORC 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- 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 %VNfER 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
hear from you in writing error than thirty g (30j days after an SAMPLE IN VOICE
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:
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. II34 Your Account Number
You do not have to pay the disputed amount while it is being 00100/00 0000100
investigated. During the investigation. we cannot report your account 1.23456789
as delinquent or take any action to collect the amount in question. TBR -07 a
I ON a.T 19 Watch here for a
GENERAL INFORMATION WED N I
nE -DEC ,R p ersonalized account
I. Payments received after the billing (INVOICE) date will appear on Im messa e
i nvo i ces pa id II. 11.,, IIL�III,, IIIII�IIII,1.1111,��.11111 „11 „11,1,111 gnome. x,wee:lsW <n 9884
your next invoice. P ast due invoices (not paid within 30 days of news and Pr
m, ^xr ^�t "`M°"n`al ^ay g
belling date) may be assessed a late fee as allowed by law not to offers I �i3 Man st
ana ,erect..
exceed S20 per month. Additionally, thud party collection /attorney car stale .1o"'
expenses may be unpaid balance or the enax t
um allowed 100% of the
law ,?tr^soOYtR.re• ^iPmP'Y nce,�wP"'n"°”' 9 Pay electronically
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. Make Surf this
3. All bottle and equipment deposits are shown as CURRENT Activity`°
ACTIVITY. +mN••�°^"°'�'"°°' ACC amount has been
since our
last OUNT ACTInTM ?rr'=
4. Equipment replacement costs will be charged for bottles lost. invoice Y cell �enAdd,e ran ^o^e.1 MS ^stmecatYSta,e00000 ,,9 paid in full to
stolen, damaged or not returned. avoid late fees
PaYmenl- TtwnkVOU SOW
In accordance with NWNA's Terms and Conditions "T &C your 00 41189R s scauo ^Nat ^,X1501 ^9Watee
1 3 veenaaa+ me MP. ^ta; ^s�aeDeo^+�t i� Monthl Oil
Equipment Lease and/or Service Agreement account may be 3n s lee wlRemm s9 Y
s ect to minimum monthly 0sn, 3 ,=".a+ fi Y P urchases and/or early cancellation 0v,z n.10 -n Re 9 s w Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the Wnz '6640X9] Surcharge or Delivery
websitc listed below) Upon service discontinuation, rent for the TDTAE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued T n„
6. Informa
will be charged a monthly Oil Surcharge. Fuel Surcharge or ,.,AN< g..,. n ormatio
N
Delivery Fee as desc ribed F d in y our T &C. Only one of these fees Pay ment stub ACCOUNT SUMMARY 9e
Y ,er THIS nv vn ER PAY BY 5]40
R unt tin n ,A,.a num.m 00100 W
is stated on the front of the invoice. For further information please I lz3 +ss]B90 B UNG DATE MT.ENCLOSED
l4V
visit the websitc listed below or contact our customer service 1z34s 67 fi]8 90 90 WlWloo
center.
7. As a food product, bottled water is subject to the rules and 0420096301 042,2]12619 000391049 z0o4 1
Amount due
regulations promulgated by the Federal Food and Drug
Administration (FDA). I<E MOUNTAIN WATER COMPANYN Clty State St00000
Submit your
8. lour first Invoice indicates the products delivered on your first rob n oMER SERY U'+' 600^jj nee8
delivery, along with any applicable bottle and account deposits. a'ment by this
1.. o^n p. e'u sm P ^t Am cm,ne:D date
redemption fees. and any dispenser charges. All Curare invoices N TOP s Y ^vPRe4W�
will reflect charges for water delivered and dispenser rental, bottle w.vP loR tRa
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. )on 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
Se
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))
03/04/09 0980117821082 $104.16
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.
Ice Mountain ALLOWED 20
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$104.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 09BO117821082 42 389.00 $104.16 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
F i 6y, h 13, 2009
ua�� J
Street Commissi
Str eet 1 11"blul i
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
720106
two 2/01/09 2/28/09 09BO121776199
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
19J I
service. icemountain.com
THU- MAR 19 0121776199
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
MO 18 APR
MON- MAY 18
#BWNNWYR WED-JUN 17
#0400001217761992#
CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888
SHELLY LINGELBAUGH
1 CIVIC SO 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/sery ice. If payment has been
made, we thank you.
j STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint,.700mL, 1
Liter, Aqua Pod, Perder 1/2 Liter plastic aced San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases
per_ �IPlivPry._Cali.6nn- a72- 9686.nr go.onlEne TODAY!.A..._
t
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free!
e e r
Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032
PREVIOUS 70.12
2/08 -I 510419 I PAYMENT-THANK BALA I 53.43
90 /9 60L MN oN wJO=1 'oul so!aawV yiJON sJ81eM allsaN 10 uoisiA!Q e 'Auedwoo jateM 6u!adS ule;unon aol 8003 OO
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saaionw aNaaal Sluo piety 110,1 .uaS gad sauangeP LI J11 1¢101 r
oJ syaae moJ o aanp S�ana apr.w aye sauaeila4 110S Sq paaapio
stanpo.id luuontppu Sue .IoJ sofur a snld sppo n purr sysodop
BILLING RIGHTS SUMMARY YOUR INVOICE 4 NVAYS TO HELP US SERVE YOU BETTER
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service.
A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2 Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means
CALL 1- 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 NVXfER 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 SAM INVOIC
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 parts ofvour bill that are not in question. 1234567890 Your Account Number
You do not have to pay the disputed amount while it is being f 0010010 001011,
investigated. During the investigation. we cannot report your account 123456
as delinquent or take any action to collect the amount in question. TNR -oa oa
MON -00 29 Watch here for a
GENERAL INFORMATION WE D -NOV 71
ToE.DK personalized account
I. payments received after the billing (INVOICE) date will appear on Important message
11,11,x, 111„ III „IIIII,I,,,pp,Lp11 HIL 111.11.MU cm,a^� sB '^g.0° P�u�e g
your next invoice. Past due i nvo ic es (not paid within �0 days of news and
billing (late) may be assessed a late fee as allowed by law not to offers li z3M.'n5
wow e4-
exceed S20 per month. Additionally, third party collection /attorney o,ys,are
expenses may be assessed at a rate not to exceed 100 of the wf eMy .eeLle at
unpaid balance or the maximum allowed by law. r ;,,Ka.,Y Y w a ^9 Pay electronically
T men?(7e YOV �M1COm -Y edR'�U�,a9d V(h nwct, mtvt
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 de deposits are shown as CURRENT Activit
p amount has been
ACTIVITY. since Vour Accout4rArnvnY
4. Equipment replacement costs will be charged for bottles lost. D r YAdme. paid In full to
last invoice
stolen, damaged or not returned. a: es avoid late fees
VaY^'en1 "Thant YOU 5000
5. In accordance with NWNA'sTerms and Conditions "T &C your IT �1 s scauo ^Na,walsc,� ^9'Na,e,
ll1 31Ig05 S Ice MOUntainSGal Dep^*'t
Equipment Lease and/or Service Agreement account may be 1 lrreasa'+a IeeM ^sealRem�^ 1,99 Monthly Oil
09111 31I005 S fuel Surc�rge
subject to minimum monthly purchases and /or early cancellation o9nz 1,g:63ggn ae Surcharge, Fuel
fees. (A complete version of the current T&C may be viewed on the 09r 2 x+ 9' s790
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.
6. You will be charred
ed a onth Information
ly Oil Surcharge, Fuel Surcharge or
Delivery Fee as described in voul "T &C, Onh One of these fees Pa meet stub ACCOUNT SUMMARY eo +w. w
Payment PAY THIS AMOUNT A Y by
will apply 57A0 to each account. 'fhe fee that applies to your account ��a,,,�� oDlog o0
ACCOUNT NUM000.
is Milled oil the front of the invoice. For further information please 1234567890 BILLING DATE Mr. NCLOSED
INVOICE NUMBER I
visit the websitc listed below or contact our customer service 1234567890 00100100
LCs I 19 00.391099 211111 16
7. Asa a food Troducl, bottled w subject is .ub'J /1120096307 012.21126
ect to the rules and Amount due
regulations promulgated by the Federal Food and Drug In1
Administration (FDA). ICE MOUNTAIN _o, OM ANY IyMtateS1o00oo Submit your
vrvirbn W Nn,kwnen
I lour first invoice indicates the products delnered on your first u 1.g9o-nz 9848
voa cusTOMeR S eRVlcc cn S ee.
delivery, along with any applicable bottle and account deposes, a }meet by this
J o„ =.e „P date
I.,. la,l,„ 1,. III...., 11.... 11.,11.111 „I�,.1,1�1,1��1 „11 r,
redempuen fees. and any dispenser charges. All future invoices sq^ eaw,�enRe ".es
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
I MOunta Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09BUl 21116199 x7\ a er Coolef Rent.a.
Total
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
03/16/09
ALLOWED 20
I';e Mo u n tain
IN SUM OF
P.O. Box 856680
Louisville, 0285 -6680
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 Administration
Board Members
PO# or
DEPT. NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 INVOICE
960121776 ,,,materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
720106
r 2/01/09 2/28/09 09BO121202766
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 B oom=
service.icemou ntai n.com
MON- MAR 23 0121202766
III Ilil I IIII I!I I VIII I I" IIII III III I I VIII TUE- APR 21
WED- MAY 20
#BVVNNVVYR FRI- JUN 19
#0400001212027662#
CITY OF CARMEL PARKS DEPARTMEN Customer Service: 1- 800 472 -9888
MANDY SPADY
1411 E 116TH ST Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -3455 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.
STOCK UP: SAVE.on a variety of Ice Mountain Direct productst. Take an additional $3 off on Half Pint, 700mL; 1, v
Liter, Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases
r
pe,delive Cal! 800- 472 -9MO or go online�TOCA`f! s
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 PARKS DEPT /MONO, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032
PREVIOUS BALANCE 77.82
2/08 510417 PAYMENT -THANK YOU -42.91
2/23 0607830742 9 5 GAL ICE MOUNTAIN DRK W /HANDLE 35.91
3 9 OZ PLASTIC UP 5OC /SLEEVE 8.97
BOTTLE DEPOSIT: 9 DELIVERED, 7 RETURNED 18.00
2/28 0609872403 1 OIL /FUEL SURCHARGE .00
87165073 RENT 4.99
TOTAL �J p> 102.78
o ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CUFytE VITY PAY THIS AMOUNT
ihinnt to tarmc nn ravnrca circa 77.82 42.91 67.87 102.78
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU 1iETTt
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 WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
P216 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 its 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 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. Tz3ase7s Your Account Number
You do not have to pay the disputed amount while it is being o010"D- oowol0o
investigated. During the investigation, we cannot report your account 4
as delinquent or take any action to collect the amount in question. TMR _oCT o, 1z34s67se
M N -a 29 Watch here for a
GENERAL INFORMATION WED N
m z,
1R personalized account
I. Payments received after the billing (INVOICE) date will appear on Important 7z eeeR
n. n,.. al „nl „nw.L.dwa,uu, „aml,dl,alaau c�nomelsernMOU ^U00P, ^a message
your next invoice. Past due Invoices (not paid within 30 days of news and
n^ ooe
g date) may be assessed a late fee as allowed b law not to ao
billing Y offers hz1 Mai^ sL
°ty,s`a °0000
exceed S20 per month. Additionally, third party collection /attorney
L,III,I,.I III 1111..,11 Iii 1 I111,1.• 7.
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. Pay electronically
Tomarce9ssan tn.min t c cnxkym'a` ^c6.m�cn+."ael
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. r Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. amount has been
since your ACCOUNT ACT” V P
4. Equipment replacement costs will be charged for bottles lost, Woeme Adales ^n 123Mams 1,�,,olyslamo0o00 paid in full to
last invoice j 99
stolen, damaged or not returned. P1e�in 42 45 avoid late fees
Payment -TM1ank YOU 5
5. In accordance with NWNA's Terms and Conditions "T &C" your 0em X1 s span ^Na' ^a' o
9111 317RR51a444 Ice Mountain S dal OePOSit
Equipment Lease and/or Service Agreement account 317W ay be t s,71Re4a s CeM ^RnlamscaiRel^f^ ,1.9q Monthly Oil
09111 'o-14W4 Fue15u1cM1arge
subject to minimum monthly purchases and /or early cancellation 0q „z 31RaASRS,I R 1 nw Surcharge, Fuel
fees. (A complete version of the eurrent may be viewed on the 9112 '�aO1' e Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TorAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued.
N �R Information
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or 9
a
Delivery Fee a our
s described in T &C. Onh one of these fees Pa stub ACCOUNTSUMMPRV is NIS AMOUNT
E.^
y y PAV T
PAY BY
will apply to each account. The fee that applies to your account .•�w^�P^1'"`" M ACCOUNT NUM"”' 'N
is stated on the front of the invoice. For further information please 123456799D Rluwc OATe MT. ENaosEo
INVOICE NUMRnt 00100100
visit the website listed below or contact our customer service 1z3456R
center. P sub OV2B2"112619 000391049 2004 1E
7. As a food p bottled water is subject to the rules and Amount due
regulations promulgated by the Federal Food and Drug ^nn o«
Administration (FDA). 123 M4i ^s1
ICE MOUNTAIN WATER COMPANY cty State °0000 Submit your
ICE nANenl' waters NaM1 1rc
S. Your first invoice IndlC p roducts delivered On y our first. 1,,,1111 •II•il..I II ,L.LLI L.I .II wR CL,u, SERVICE CPLL coo- >Z -aese
P y payment by this
delivery. along with an applicable bottle and account d 1
redemption fees, and any dispenser charges. All future invoices ,4 „6,q ^u,R�, ^1,�aD ^R• °e`” P 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 tour weeks, for
a total of 16 -17 deliveries per year. You "ill 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
t wo 720106 2/01/09 2/28/09 0980120095351
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258
service.icemountain.com
MON- MAR 23 0120095351
III I'll Ill I'll ll ll I'll' Illl II 111 Ill ll Ill ll ll E- APR 21
VV
WED- MAY 20
#BWNNWYR FRI- JUN 19
#0400001200953515#
CARMEL CLAY PARKS AND REC DEPT Customer Service: 1- 800 472 -9888
AUDREY KOSTRZEWA
1411 E 116TH ST Did you forget about us? Kindly pay upon receipt.
CARMEL IN 46032 -3455 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.
STOCK UP SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL,1
i Liter, Aqua Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages.; Limit 6 discounted cases
pe deliv ery. Call 800 472 -9888 orgo online TO
s
i
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. Its free!
Delivery address: P CARMEL CLAY PARKS AND REC DE, 1427 E 116TH ST, CARMEL IN 46032
PREVIOUS BALANCE 68.60
2/08 510418 PAYMENT -THANK YOU -31.45
2/23 5533183403 2 5 GAL ICE MOUNTAIN DIRK W /HANDLE 7.98
1 9 OZ PLASTIC UP 50C /SLEEVE 2.99
BOTTLE DEPOSIT: 2 DELIVERED, 2 RETURNED .00
2/28 0609855093 1 OIL /FUEL SURCHARGE 2.08
B7095236 RENT 9.98
TOTAL C 60.18
)WA 9
lay ?OOg
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU NT TIVITY PAY THIS AMOUNT
�bject to terms on reverse side. 68.60 m 31.45 23.03 60.18
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 WAl'ER 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 NI. your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE 11OUNTAIN SPRING WATER 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 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 its on a separate sheet of paper. We
hear from you in writing later than thirty (30) days after we
sent SAMPLE INVOICE
sent you the first bill on which the he 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 parts of your bill that are not in question. tz3as6i99 Your Account Number
You do not have to pay the disputed amount while it is being 001 olpp -o01a0100
investigated. During the investigation. we cannot report your account Iz345
as delinquent or take any action to collect the amount in question. TNR -W 04
MDNaT 19 Watch here for a
GENERAL INFORMATION WED NOV 31
T 11 DEE I0. personalized account
I. Pavnlents received after the billing (INVOICE) date will appear on Important n, 1111 nt,. am, „.,nm „ttl,tt,l,lti CusmlOee Selv;ce: t- 800'1]3 -990.8
your next invoice. Past due invoices (not paid within 3(1 days of news and
leg ke Mau ^uln peoapau message
billing date) may be assessed a late fee as allowed by law not to offers �ck St a ,ervka.
olr. sla1P oo°oO
exceed $20 per month. Additionally. third party collection /attorney t a, ,,,u.,,u,•i•a.-t'
expenses may be assessed at a rate not to exceed 100 of the
unpaid balance or the maximum allowed by law. t YY kanaec.yw uiawwMe� "P` ,0.y Pay electronically
2. Each returned check is subject to a service charge subject to the w
maximum check return charge allowable In your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
ACTIVITY. amount has been
since your ACCOUNT ACTIVITY r 0"S1a 00000
4. Equipment replacement costs will be charged for bottles lost. last invoice Del veryAddl ss. IUII^Doe 33Ma; paid in full to
stolen, damaged or not returned. p,ee ;uvsgalaelce <s avoid late fees
paYmenl ilunEYOU 5000
5. In accordance with NWNA's Terms and Conditions "T &C your w, x61998 scan NaluealsWl ^9'�1P' -sono
9111 313895 5 Ice Mountain 50x1 Dep^sil Z 96
Equipment Lease and/or Service Agreement account may be 3 v99naw IceM^v ^seal9ewm 1199 Monthly Oil
subject to minimum monthly purchases and/or early cancellation O'"' 31 s ne' s Surcharg Fuel
09111 3103638911 pent
fees. (A complete version of the current T&C may be viewed on the 0911: '�j Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TDTAE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discominuctl. 1 57<a
6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or w a Informaho
n
Delivery Fee as described In your r &C. Only one of these fees Payment stub ACCOUNT SUMMARY p4 C99 po___ THIS AMOUNT
will apply to each account. The fee that applies to your account „„n,."II�,A.o>.^ ACCOUMNUMBER pAYBY s <9
oolOOloo
is stated on the front of the invoice. For further information please 313<561990 BILLING DATE MT. ENCLOSED
INVOICE NUMBER pp1p0100
visit the website listed below or contact our customer service 1234567890
center.
P J 0120°96301 01262712619 00°3910'19 2001 18
7. Asa food p bottled water is sub�ect to the rules and Amount due
regulations promulgated by the Federal Food and Drug ^hn Doe
Adm inist ration (FDA). ICEMOUN3NNWATERCO RANY 113m -00000 Submit your
8. Your first invoice indicates the products delivered on your first r don
ppp CUSTOMEe SEpvl<E CALL I'600'Vl "9888 a ment b this
delivery, along with any applicable bottle and account deposits, e amEH1,�,a,,�..�xs�ce- y
redemption fees• and any dispenser charges. All fldti;re invoices 6 t u. 6,. t., tu,, „dadd. '.v9. date
will reflect charges for water delivered and dispenser rental. bottle
o ,�N 1p E ^p 1 pEE a�, ^p.Yl 5gn "p p•9U,.�
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 hill only receive invoices
12 times per year, so approximately 5 of those invoices will reflect
two deliveries.
NQ yy 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW cos 5108
I
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
3/4/09 0980121202766 Water cooler rental Monon Center Feb'09 67
3/4/09 09BO120095351 Water cooler rental Maintenance Dept. Feb'09 23.03
Total 90.90
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.
051125 Ice Mountain Allowed 20
P O Box 856680
Louisville, KY 40285 -6680
In Sum of
90.90
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 0980121202766 4353099 67.87 1 hereby certify that the attached invoice(s), or
1125 0980120095351 4353099 23.93 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
12 -Mar 2009
V
Signature
90.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i