170901 04/16/2009 \,f CITY OF CARMEL, INDIANA VENDOR: 357977 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN CHECK AMOUNT: $32.20
CARMEL, INDIANA 46032 P O BOX 856680
LOUISVILLE KY 40285 -6680 CHECK NUMBER: 170901
CHECK DATE: 4116/2009
DEPARTMENT A PO NUMBER INV OICE N UMBER AMOUNT DESCRIP
1205 4239099 090012177619 9.76 OTHER MISCELLANOUS
1701 4239099 090722032704 22.44 OTHER MISCELLANOUS
eo
'0v
0 720106
3/01/09 3/31 /09 0900121776199
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 0
service. icemountain.com
FRI- APR 17 0121776199
III IfliIH IN�IHIIWNII1 MIN HIIMH MOD MAY 1
WED- JUN 17
#BWNNWYR FRI- JUL 17
#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 Delivery! We value your business.
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
i per deliv Call 800 -472 -9888 or go online TODAY!
e
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. Its free!
Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032
PREVIOUS BALANCE 33.51
3/08 668968 PAYMENT -THANK YOU -16.69
4/01 806130 PAYMENT -THANK YOU -16.54
3/19 0611709478 1 5 GAL ICE MOUNTAIN DRK W /HANDLE 3.49
BOTTLE DEPOSIT: 1 DELIVERED, 1 RETURNED .00
3/31 0614426831 1 OIL /FUEL SURCHARGE 2.00
C7214951 RENT 3 9
SALES TAX
TOTAL 10.04
1
BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER
IN CASE Or 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 INFORMAr1ON, 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 USAr: your first invoice will include a pro -rated fee for the current month, plus the next month's rental.
ICE NIOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash.
1216 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 ifyou need more information about
a transaction on your bill, write its on a separate sheet of paper. We
must hear from you in writing error than thirty (30) days after we SAMPLE INVOICE
sent you the first bill on which the he error or problem appeared. You can
telephone us, but doing so will not preserve your rights. In your letter,
give its the following information:
Your name, address. telephone and account numbers. Date range of this invoice t
The dollar amount of the suspected error.
Describe the error and explain if you can. why you believe there is
an error. Mao
You are obligated to pay the parts of your hill that are not in question. 1234 567190 Your Account Number
You do not have to pay the disputed amount while it is being 00/00/0000100100
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. Tnn 12 3 456 99
Watch here for a
WED -NOV 21
GENERAL INFORMATION DEc'B personalized account
I. Payments received after the billing (INVOICE) date will appear on Important ILll,.dll „III•.IIIII•L., 1111,1,1116 „IIIII,al,.11.l,lll c °a9,11e1 s =mpeLI aN.47 message
your nest invoice. Past clue invoices (not paid within 30 days of news and m. °Er °9ieeM
billing dine) ittit' he assessed a late fee as allowed h lave not to Iin"I a °e,.mee,
b Y offers nA +4 °s'
exceed $20 per month. Additionally, third party collection /auorney ons+ale 00000
6.1ILL..L.IR.....11.•.. 11.•,11 „I,II,J,,,1,1,1,1,.1,.11
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the
a r g^a °^I Pay electronically
maxmuun allowed by law. aro,am 1�4leww°'
Ta mm+a9°Y°” °m, Y°V d>�4S U1. much mwN
2. Each returned check Is subject to a service charge subject to the x� �ft� O „;a wunro•w�p
maximum check return charge allowable In your State. I u 4... Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
amount has been
ACTIVITY.
since your AccouNUrnw st' clr s ale oOBOO
4. Equipment replaccmcnl costs will be charged for bottles lost. I,l ,yArrr °u` '°anOOe ,z3 Ma paid in full t0
last invoice 4:45 avoid late fees
stolen. clamaecd or not rcnuncd. 50.00
5. In accordance with NWNA's Terms and Conditions T &C). our
31 Pa ^k
Y sera Na, °gat s °9wa e. so_m
I, ]08614444 5 nta�n SGa...... t 3.96
Equipment Lease and /or Service Agreement account may be Tees, 4 e w ie, 99 Monthly Oil
p9111 31]085 S IIFUeI5u1cM9e
subject to minimum monthly purchases and /or early cancellation 09112 31B263BBn rte Surcharge, Fuel
fees. (A complete version of current T&.0 may be viewed on the osr12 16wo49' Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the TOTAL Fee (see 46 under
Leased Equipment is charged through the end of the bilging cycle "General
in which service is discontinued. u cT ,,,m P•�TM" s
G. You will be charged a monthly Oil Surcharge. Fuel Surcharge
Y c or
Delivery Fee as described in our T &C. Only one of these fees Pay ment stub ACCOUNT SUMMARY .4,gg 99
PAY BY PAY TNIS AMOUNT
will apply to each account. Tile ACC
e fee that applies to your account „m,*�,WyP�"""` OUKr NUMBER 0oloo sz4o
a °TWA °'•1w•.N •n
is stated on the front ofthe invoice. For further information please INV0ICENU 1234567890 BEN BILLING DATE T. ENCLOSED
visit the website listed below or contact our customer service pojo
12 CE NUN
center. P J p42Dp9630T 04262"112619 000391049 2004 1B
7. As a food roduct. bottled water is Sub to the rules and Amount due
regulations promulgated by the Federal Food and Drug I_DOe
23
Administration (FDA). iCE MOurrrnw wAreB CO6 +PANY 0
w
N•.m.�... �M. acy. slate 0000
8. Your first invoice indicates the products delivered on your first roB CUSroMEB SEBVICrcuLlaoo <n -96ee
Submit your
delivery. along with any applicable bottle and account deposits, ayment by this
1.., ma,,, l.. nl,,.. dl .•.dl.•al,a,n „I „a,l,l•I••I•11 •,.6b= P., ",Am�°a"9� "9e.4 „esa=
redemption fees, and any dispenser charges. All future Invoices date :GN T +wiOn uoae9u1re°
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
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
PrescriDKd by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Ice Mountain Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
nwm/nd 09C01:21776 Wafer Geeler Rental
Total _T,
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accorda
with IC 5- 11- 10 -1.6.
1 20
Clerk- Treasurer
A
VOUCHER N00 ft3l &ARRANT NO.
ALLOWED 20
ce ountain
P.O. Box 856680 IN SUM OF
I n' lir-ville, KY 4E)H5-6680
$9.76
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
PO# or
DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
IZUb 900121776199 390 -99 $9 6 materials or services itemized thereon for
which charge is made were ordered and
received except
r
Si
Cost distribution ledger classification if
claim paid motor vehicle highway fund
c 720106
co o
3/01/09 3/31/09 09C7220327048
#215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 O 0
service.icemountain.com
FRI- APR 17 7220327048
IIII Ili III I III III III II III II 119IIli II II III II MOD- MAY 18
WED- JUN 17
#BWNNVVYR FRI- JUL 17
#0400072203270488#
CITY OF CARMEL OFFICE OF THE C Customer Service: 1- 800 472 -9888
ANN DAVIS
1 CIVIC SO Thank you for choosing Ice Mountain Home Office
CARMEL IN 46032 -2584 Delivery! We value your business.
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. all 800 -4 -9 888 or o online TODAY!
rY' g
i o
ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. Its free!
Delivery address: CITY OF CARMEL OFFICE OF CLERK, 1 CIVIC SQ, CARMEL IN 46032
PREVIOUS BALANCE 29.25
3/08 668969 PAYMENT -THANK YOU -12.71
4/01 806134 PAYMENT -THANK YOU -16.54
3/19 0611709528 2 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 9 OZ PLASTIC UP 50C /SLEEVE 5.98
3/31 0614561710 1 OIL /FUEL SURCHARGE 2.00
C7250724 RENT 3.99__
TOTAL !2 4
4 ACCOUNT S UMMARY CURR PAY THM
FtZcV10Uj 6MLHNV•EI Pi,YMEi�TiADSTMEi�iT C::�:�� T rlli l i/
r,�� ihiart to terms an reverse side. 29.25 0 29.25 22 44 22.44
r
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 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 40255 4. Never hesitate to call us with comments, questions, or concerns.
If you think your bill is wrong, or if you need more information about
a transaction on your bill. write us on a separate sheet of paper. We
sent[ hear from you in writing he n
error than thing (30) days after we SAMPLE INVOICE
sent you the first bill on which the error or problem appeared. You ca
telephone us, but doing so will not preserve your rights. In your letter.
give us the following 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. 1234567990 Your Account Number
You do not have to pay the disputed amount while it is being 00100/00 0 0 1 00100
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. Trte ocT 0a tza4seze9
,0'T 29 Watch here for a
weo n
GENERAL INFORMATION UE OE Nov C ,B personalized account
I. Payments received after the billing (INVOICE) date will appear on Important ILII,.. 111„ III, �IIIII, I,. �III1 ,1,1111����11111,.11,.11.1.111 as "se""` =�'A0o -a�z 9esa message
your next invoice. Past due invoices (nor paid within 30 days of news and ma "Eroo g
oce
bdhng (late) may be assessed a late fee as allowed by tae not to offers 1 n" z1M SE ..d,.--1
oar. state 00000
exceed S20 per month. Addmonally, third party collecti �II�„II,�I
on /attorney
1...IIII..I.IIL III. !,1,1,6A,.1
cxpcnses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. T,m9 Pay electronically
2. Fach returned check Is subject to it service charge subject to the
maximum check return charge allowable In your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
AC "fIVIr),. since amount has been
'our n couNTACrIwTY
y
4 Equipment replacement costs Yvill be charged for bottles lost. O 3OhnDpe' s o'rsla1e 0o000 ,.v p aid in full to
last invoice «a5
stolen, damaged or not returned. P,e+ame avoid late fees
e ma "EVOO so
5. In accordance with NWNA'sTerms and Conditions ("T _C`), your 4a,B9e saw oN4w,a,sPa�9wa�e� s o0
l,ieBS,4^^a 5 ",a� "se4i oevmB 19e
Equipment Lease and /or Service Agreement account may be 3 s e4, Be 99 Monthly Oil
3 ]B 0.14 S Surcharge, FU¢I
Benl Su�cMrge
subject to minimum monthly purchases and/or early cancellation osnz l+BZelaen
fees. (A complete version of the current T &C may be viewed on the o9,a ,x.91 5 7 Surcharge or Delivery
websitc 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.
r
s Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or wA 9
Deliver\, Fee as described in your T &C. Onh one of these fees Pavment stub ACCOUNT SUMMARY o c L E YOU
PAY BY AY TS,S AMOUNT
will apply to each account. The fee that applies to your account 140
ACCOUM NUMBER
n.o.wn,M „sue. �n�im 0000100 M
is stated on the front of the invoice. For further information please 133456)890
w ,NV 2345 7890 to DAT T ENCLOSED
E
visit the ebsitc listed below or contact our
customer service
2;456)8
center.
7. As a food product. bottled water is subject to the rules and a42UU96307 04282712619 0003910V9 200 1
Amount due
regulations promulgated by the Federal Food and Drug Ion "Doe
Administration (FDA). ,CE MO �NTA,N WATE CD P er+�n� oy M,ate S �0oo 00
8. Your first invoice indicates the products delivered on your first •0^^ E Submit your
w oB TOMEB EBY,< <A ,.e"o z.9EBe this
delivery, along with any applicable bottle and account deposits, p ayment b ,ca.�9•�o�a<.n.. m e
redemption fees. and any dispenser charges. All future Invoices L" 111'1...1 "111...,ILIL „11111 1 1111 l ea o�B...�u 510 date y
will reflect charges for water delivered and dispenser rental, bottle
s
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
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))
l� rt ]Z
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
CY�L'li �Z 1 IDI
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
fa f 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund