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172876 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $187.34 PO BOX 856680 CHECK NUMBER: 172876 LOUISVILLE KY 40285 -6680 CHECK DATE: 5/27/2009 DEPART ACCOU PO NUM BER IN NU MBER AMOUNT DESC 2200 4239099 09DO12004852 17.45 OTHER MISCELLANOUS 1125 4353099 09DO12009535 26.94 OTHER RENTAL LEASES 902 4239099 09DO12022391 5.97 OTHER MISCELLANOUS 1047 4353099 09DO12120276 57.90 OTHER RENTAL LEASES 1205 4239099 09DO12177619 13.25 OTHER MISCELLANOUS 902 4239099 09DO12197559 39.90 OTHER MISCELLANOUS 2201 4238900 09EO11925282 25.93 OTHER MAINT SUPPLIES 720806 4/01/09 4/30/09 09DO120223912 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 e e service.icemou ntai n.com MON- MAY 18 0120223912 III IIII III I III II III III Ili II III II III �I II WED- JUN 17 FRI- JUL 17 #BV1/NNWYR MON- AUG 17 #0400001202239129# CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 472 -9888 SHERRY MIELKE 111 W MAIN ST STE 140 Did you forget about us? Kindly pay upon receipt. CARMEL IN 46032 -1905 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 i per delivery. Call 800 or go online TODAY!: o ACCOUNT AC TIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. It free! UV mej Delivery address: CARMEL REDEVELOPMENT COMMISION, 111 W MAIN ST STE 140, CARMEL IN 46032 PREVIOUS BALANCE 27.96 4/17 0616127452 2 9 OZ PLASTIC UP 5OC /SLEEVE 5.98 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -6.00 4/30 0619334329 1 OIL /FUEL SURCHARGE 2.00 D7421412 RENT 3.99 TOTAL 33.93 Q A CCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURR�N�_ACTIVITY PAY THIS AMOUNT ihiact to tarms nn rcvcrs civic 27.96 .00 5.97 J 33.93 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER d 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. 4216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE UNIY., 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 hill that are not in question. ty34s61R9 Your Account Number You do not have to pay the disputed amount while it is being 1 00100100 00 investigated. During the investigation. we cannot report your account A 456]89 oe as delinquent or rake any action to collect the amount in question. TPR -o0- ,M I IO r 19 Watch here for a GENERAL INFORMATION N o ,9 personalized account 21 oE I. Payments received after the billing (INVOICE) date will appear on Important n,n,,,In, „nuta,.,nu,tlitit t,ut aumerze mOYnB nPr°a °0-8 message your next invoice. Past due invoices (no[ paid within 30 days of n¢w5 and Tnankr°°I billing date) may be assessed a late fee as allowed by law not to offers j113m- n 00000 Ana aervmea exceed S20 per month. Additionally, third party eollecuon /attorney ary,5,a,e 1,,.111 1 III 11 ,.�IL.,11"1 expenses may be assessed at a rate not exceed 100% of the Pay electronically unpaid balance or the maximum allowed by law. r 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 Y amount has been ACTIVITY. our ACCOUNT ACTIVITY y •celirervAaarea lnnno °e.1z3Ma-nsveel.orr slale°o0o0 1199 paid in full t0 4. Equipment replacement costs will be charged for bottles lost, last invoice 99 stolen, damaged or not returned. rani °,9alancr.Y e 43 avoid late fees Parme manO� s0o° 5. In accordance with NWNA'sTerms and Conditions "T &C your 08131 46,999 5 sta ll °nHa 5000 Ill 31M51- Ice MOUnuin SGal DeP°a�l 196 Equipment Lease and /or Service Agreement account may be 1„ ;I39es,ea44 5 IceMn °n1am5GalPetum 11.99 Monthly Oil s a9 .subject [o minimum monthly purchases and /or early cancellation ov„ ;nsw4a 5 wels urcha.9e Surcharge, Fuel a 113 3183891 261 Pent fees. (A complete version of the current T &C may be viewed on the 9n3 6�049J 5140 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 "G eneral in which service is discontinued. ,Ar,PI+ 5 I f M T R.. 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 99 n ormaUo Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARr 99 n PAY THIS AMOUNT will apply to each account. The fee that applies to your account w^-^` s"OuwrHUMS" PAY By s'" nxe arov s^' r ooloolo° is stated on the front of the invoice. For further information please pc6 N13 1234561890 RUING DATE MT ENCLOSED NUMBER visit the website listed below or contact our custom INVOICE 00100100 er service 1234567 center. 200, 18 7. As a food product, bottled water is subject to the rules and 0,20096301 14282112619 0003910,9 Amount due regulations promulgated by the Federal Food and Drug i w "ooe Administration (FDA). I CE moUNTAIN`WATERCOM NY ,y$td1e5to0010 S. Your first invoice indicates the products delivered on your firs' Submit your Se RVICEC delivery, along with any applicable bottle and account deposits, roR USroMe P j$00- 129888 payment by this e.. n a n a ,,,6t,td P ^1A "v�6a ^9•• redemption fees, and any dispenser charges. All future invoices date �51GNV r a.mwAYlsg ^0P Pro0-e�0n P 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. 0 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. Nw 709 5108 1 720806 e� M 10 Ka 4/01/09 4/30/09 09DO121975593 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com ice MON- MAY 18 0121975593 III 1111111 IN I11I111101111111111911111I 1111111 WED- JUN 17 FRI- JUL 17 #BWNNWYR MON- AUG 17 #0400001219755935# CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 472 -9888 SHERRY MIELKE 111 W MAIN ST STE 140 Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -1905 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 'reverages. Limit 6 discounted -cases r w, ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free! Delivery address: CARMEL REDEVELOPMENT COMMISION, 30 W MAIN ST STE 220, CARMEL IN 46032 PREVIOUS BALANCE .00 4/17 0616832903 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 11.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC UP 5OC /SLEEVE .00 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99 1 PLEATED CUP DISPENSER .00 4/30 0619224439 1 OIL /FUEL SURCHARGE 2.00 7472703 1 RENT(04 /17/09 04/30/09) 3.03 RENT(05 /01/09 05/31/09) 6.99 SALES TAX .91 TOTAL 39.90 THIS RENT IS FOR A PARTIAL MONTH ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT .00 .00 39.90 m 39.90 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR 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- 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. If you #216 prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate ��B�IG sheet of paper. We must hear from you in writing no later than thirty (30) days after we sent you the first bill on which the error or problem appeared. You can telephone us, but doing Date range of this invoice so will not preserve your rights. In your letter, give us the following information: Your name, address, telephone and account numbers, u34sb]690 The dollar amount of the suspected error. oo /oaloo- 0 o�o 0 l 00 Describe the error and explain if you can, why you believe there is t 4567990 an error. You are obligated to pay the parts of your bill that are not in question. gip. ov Your Account Number Tuc orc ,e You do not have to pay the disputed amount while it is being ,LIn omtt XPna'. ,'eo°A]z 96 ee IIIILI,,,np,l,lni,,,,nllt „11..11 c °n mves[tgated. During the investigation, we cannot report your account n,16 „111 „III Y °°ro y Mw ^w ^w°a °R* Watch here for a as delinquent or take any action to collect the amount in question. 123 M°` personalized account c vs ,e co- GENERAL INFORMATION Important 1111 ,1„ I n message I. Payments received after the billing (INVOICE) date will appear on pews and your next invoice. Past due invoices (not paid within 30 days of offers ab oh Y o billing date) may be assessed a late fee as allowed by law not to exceed $20 per month, Additionally, third party collection/attomey u m 116 n w.M H Pay electronically expenses may be assessed at a rate not to exceed 100% of the prnvm' unpaid balance or the maximum allowed by law. ACCOUNT oe e,yAacre 5` ,ZyMal "n•e cros ppp Make sure this 2. Each returned check is subject to a service charge subject to the B,i.Me sow amount has been maximum check return char a allowable in our State. Activity 696 111. wMe g Y BP,3, nN „u•asP•' paid in full to since our 3`,;PB s M °^m ^6�,aP°,e 3. All bottle and equipment deposits are shown as CURRENT Y „66,4 p e,iPmm 99 avoid late fees ACTIVITY. last invoice «e•9• 09113 3,836389,1 4. Equipment replacement costs will be charged for bottles lost, o9n= stolen, damaged or not returned. oTAE Monthly Oil 5. In accordance with NWNA's Terms and Conditions "T &C your Surcharge, Fuel Equipment Lease and/or Service Agreement account may be a subject to minimum monthly purchases and/or early cancellation Your new 99� P�P°A Delivery s e Surcharge or n' fees. (A complete version of the current T &C may be viewed on the delivery ACCOUNT SUMMARY Fee (see #6 under website listed below) Upon service discontinuation, rent for the Calendar. "General AcmuM Leased Equipment is charged through the end of the billing cycle My Deliveries 'M D' indicates Information” in which service is discontinued. ;,01; 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge of a scheduled „'0 Soup„ m mom" Delivery Fee as described in yourT &C. Only one of these fees d¢IIV¢ry will apply to each account. The fee that applies to your account is stated on the front of the invoice. For further information please M„o;l;,;. =o,;;;n n m ter° visit the website listed below or contact our customer service ei5 ;�'nu;; m u center. Payment stub n rz PAY PAY THIS AMOUM T As a food product, bottled water is subject to the rules and a P AccouNrNUMen eolom BY w Amount due regulations promulgated by the Federal Food and Drug 123456)890 B�WNG DATE A Naoseu INVOICENUMBER 00100100 Administration (FDA). 1z3s0e 8. Your first invoice indicates the products delivered on your first delivery, along with any applicable bottle and account deposits, 0420096307 04262712619 000391049 200401016 Submit your redemption fees, and any dispenser charges. All future invoices will wz ^o« payment by <E reflect charges for water delivered and dispenser rental, bottle i MOU NTw "W ATEBCOMPANY ,°".m.,<mlw, °,N „9,.:,•.«.� a,ros— oa000 this date deposits and credits plus charges for any additional products WPC :3 oMEPSEPV�c 6 BOQ 3-98B8 ordered by you. Deliveries are made every three or four weeks, for 1 m1 6, 111. ...,n,.:.u, „n,a.n,a,.d.61.na.,n P.:” =Amy ",a:a` 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 708 1 1i08 service. icemountain.com Pre9cribed by State Board of Accounts City Form No. 201 (Rev. 1995) f 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)) 5 j 0 9DI o 211 311 Z G4 _s� Le Sf S s q C G 0 i r Total L g 3- 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 VOJJCHER NO. WARRANT NO. ALLOWED 20 I LCe M0% AV.10L In D,,eC IN SUM OF P•0- Bo,c $Sb68o Lo,i5yille, kI ijoygS 6 4 -10 ON ACCOUNT OF APPROPRIATION FOR 9U7-/ 1 7�3905q Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 9d Z Q` 0) Z�LZ3y�L �a 3 9 3 bill(s) is (are) true and correct and that the 02 09DO)ZN '5sti3 p materials or services itemized thereon for which charge is made were ordered and received except 0 0�' SigrVature Director of O era s Cost distribution ledger classification if Title claim paid motor vehicle highway fund 720806 0 e� 04/13/09 5/12/09 09E0119252823 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 o service. icemountain.com MON- MAY 18 0119252823 III IIIIIIIIIIII III IIIIIIIIIIIIIIIIIIIIIIIIII WED- JUN 17 FRI- JUL 17 #BWNNWYR MON- AUG 17 #0400001192528234# CITY OF CARMEL STREET DEPARTME Customer Service: 1- 800 -472 -9888 BONNIE CALLAHAN 3400 W 131 ST ST Thank you for choosing Ice Mountain Home Office WESTFIELD IN 46074 -8267 Delivery! We value your business. STOCK UP SAVE; on a variety of lce 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 .l=rt; t U 8 discounted cases per delive Call 800 -472 -9 or qo online TODAY 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 STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 22.94 5/11 022122 PAYMENT -THANK YOU -22.94 4/17 0616127361 4 5 GAL ICE MOUNTAIN DRK W /HANDLE 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 24.00 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 5/12 0621213123 1 OIL /FUEL SURCHARGE 2.00 E7530237 RENT 3.99 TOTAL 25.93 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT+ CURRENT ACTIVITY PAY THIS AMOUNT �Ziect to terms on reverse side. 22.94 22.94 11 25.93 25.9 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS 1'O 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 INFORMA'T'ION, 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 11OUNT,UN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #716 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE, IPXY.. 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 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. 1 2 345e7890 Your Account Number You do not have to pay the disputed amount while it is being 00100100- 00100100 investigated. During the investigation, we cannot report your account 3456 as delinquent or take any action to collect the amount in question. mB OcT o0- 2 MoN -«T 29 Watch here for a GENERAL INFORMATION ments received after the billing DNDV TUE DEC ,B crsonalized account 1. Payments a I P Y INVOICE 1 dale will a p p ear on Important 1j, tl„ au ,AU „tdn CmmmttServke'.1- BW- a]2�9888 message your next invoice. Past due invoices (not paid within 30 days of news and Tn anFY uuluru,{ ^91aeMOU "mmpr°a g billing (late) nlav be assessed a late fee as allowed by law not to offers l ID'1.1^sl exceed S20 per month. Additionally, third party collection /attorney 116 ate 110000 "..d,. III,. ,nt6nA1,n1I „I,11,�11,666,6A1 6 expenses may he assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. ,;e yw °^""A Pay electronically 2 To,rena9<Ya ,Yd, Wnchec%Ya'iaa°uM mull, mucB morN Each returned check is subject to a service charge subject to the aawre e maximum check return charge allowable in your State, •.a. a” Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. w amount has been AC since your ACCOUNT ACTIVITY CY,Sww opopo 4. Equipment replacement costs will be charged for bottles lost. Deherrpeare. 2;M° s paid in full t0 last invoice stolen, damaged or not returned. P,",I° °,Bala ^a <z4s avoid late fees pavme ma ^ova, waO 5. In accordance with NWNA's Terms and Conditions "T &C your °eel n6Ie96 500 Na1�,alsp I ^e'""er .m.w 9111 31]68810-40-4 S nlainSGal Depcs�t ;96 Equipment Lease and /or Service Agreement account may be 1 n]ees,a444 s 199 Monthly Oil 09/11 11]088 Il U e1 3 8urcNr9e subject to minimum monthly purchases and/or early cancellation 69n] 3182636611 6°01 5940 Surcharge, Fuel fees. (A complete version of the current T &C may be viewed on the o9nz 1 b 97 Surcharge or Deliver] 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 P..Y THE: in which service is discontinued. c a ,„1Arn�TD' 946 aawH. °t Information") 6. YOU will be charged a monthly Oil Surcharge, Fuel Surcharge or Delivery Fee as described in y our T &C. Only one of these fees Payment stub ACCOUNT SUMMARY Y w „a era w- xoror --_o.c eo,,,rF u PAY BY PAY THIS AMOUNT ACCOUNT NUMBE0. will apply to each account. The fee that applies to your account S yo _u�,- aa,,,,,,;,,„��a,.wn^•^' ODloolo0 is stated on the front of the invoice. For further information please 123456]690 BIWNC DATE MT. ENCLOSED Iwo10E NUMBE0. O G DA visit the websitc lisle(] below or contact Our customer service 12341 7B9O center. 7. As a food product, bottled water is subject t0 the rules and 0420096307 ❑4282712619 000391099 2000. 1 Amount due regulations promulgated by the Federal Food and Drug nwtO0« Administration (EDA). n ouanaN lvTl co"111Y ays�a� Submit your Icct w...,, 8. Your first invoice indicates the products delivered on your first B CUS1oMEe :eB�lcE ULL I- 800O3 -9B delivery, along frith any applicable bottle and account deposits. TO payment by this 1... w0-„ A6,6n,A,,,n,tA'n "t "0 „;�,a ^YC6a•9n� "use redemption fees, and any dispenser charges. All future invoices date el oPAY,s,,,,vPea9,wa4o� "w4" will reflect charges for water delivered and dispenser rental, bottle O deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of I6 -17 deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect Iwo deliveries. qq 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 5/08 o Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL r 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)) 05/14/09 09EO119252823 $25.93 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. W A RR ANT N ALLOWED 20 Ice Mountain IN SUM OF s P. O. Box 856680 Louisville, KY 40285 -6680 $25.93 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 09E0119252823 42- 389.00 $25.93 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 Thursday, I' 1 21, 2 rr is I 9 J d Street ComrrtisiQper`' �r �ar Title Cost distribution ledger classification if claim paid motor vehicle highway fund 0 720806 i 0 4/01/09 4/30/09 09DO120048525 #215 6661 DIXIE HWY, SUITE 4'. LOUISVILLE KY 40258 service. icemountain.coIn MON- MAY 18 0120048525 111 11111111 IN 11111111111111111111111 RE 11 WED- JUN 17 FRI- JUL 17 #BWNNWYR MON- AUG 17 #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. 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 TODAY! 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 SQ, CARMEL IN 46032 PREVIOUS BALANCE -3.49 4/17 0616127437 4 5 GAL ICE MOUNTAIN DIRK W /HANDLE 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99 4/30 D7364413 RENT 3.99 TOTAL 17.45 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUST MENT GURRENI ACC iVi T Y PAY T HiS AW.G 1NV I bject to terms on reverse side. I -3.49 .00 20.94 17.45 I 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 Z. 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 DIOUNTMN 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.eom. 6661 DIXIh 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 its on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAM sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your tights. 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. r 12345678 Your Account Number You do not have to pay the disputed amount while It is being 00/00/ 00 100100 investigated. During the Investigation. we cannot report your account 1 2345678 as delinquent or take any action to collect the amount In question. TNR OC' 0a MON o -a 29 Watch here for a WED NO, 1, GENERAL INFORMATION NEGIa personalized account 1. Pavments received after the billing (INVOICE) date will appear on Important Customer messag c Service. ,.soo-4T�-9sa YO or next Invoice. Past due Invoices (not p' y IIAI,III. III„ IIIII, 1„ IIII,I.IIII,,.IIIIIAI „II,IAII T 1, a nt Y OU tar 4Yn9 ice MOUnUm prod4nt paid within 311 da of news and billing date) may be assessed it late fee as allowed by law not to offers 1c,"St st and erw<e.. exceed 520 per month. Additionally, third party collection /attorney c;' 111.1— 111.1. ,I,.III II i6.,11 ,I.ILA, 1111 I 1 expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. Y .a aht, r4uwn re.. Pay electronically n <nectw 9 2. Each returned check is subject to a service charge subject to the x"""''` Y adwroF wo daa,.e^d mvd+m4m mar” maximum check return charge allowable in your State. y w Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since y our ACCOUNT ACTIVITY a ty O 4. Equipment replacement costs will be charged for bottles lost, 0e R« rygdd— 123 paid e pp l "?s paid in full to l ast invoice 199 stolen, damaged or not returned, prtvmu :aa,a s� avoid late fees Raymem TM1anxYOU Wate, 5. In accordance with NWNA's Tcrnts and Conditions "T &C your oam X 1898 S scan ^nNa,4�alsvr� ^9 s° rte m 9l„ 31]90514aa< Ice MOUntain6Gal DepvR Equipment Lease and/or Service Agreement account may be o „Tees,A44a s amsGa,Re' n 99 Monthly Oil Surcharge, Fuel subject to minimum monthly purchases and/or early cancellation p jD char9 nex63ean Be fees. (A complete version of the current T &C may be viewed on the °s 'BMOf9' n Surcharge or Delivery websi(c listed below) Upon service discontinuation, rent for the mTAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General s in which service is discontinued. E �,MC,n•<*mTM nA 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 9 Information Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY e 99 u,< Euou pqY BY PAY TNIS AMOUNT will apply to each account. The fee that applies to your account °^'°"""'°'wYM ACCOUM NUMBER 57, is stated on the front of the invoice. For further information please iz3 +s6ra9° BIL LING GATE MT. ENCtosao ,NVOIC visit the websitc listed below or contact our customer service 1z3s6T890 WIM100 center. 7. As e food product, bottled water Is Subject to the rules and 0420096307 04262112619 000391049 2009 16 Amount due regulations promulgated by the Federal Food and Drug 1^h^Cce Administration (FDA). ,CEMOUMAINYJATERCOMRANY C. Sia�e "BeOOO Submit your 8, Your first invoice indicates the products delivered on your first a0"""°" oR n oMER :ER ICEcA<L `aaa ment by this delivery, alone with any applicable bottle and account deposits, h�, IILL�. Ld16•, 11•IL.,II „1,11,d,,,hl.l...l.. p redemption fees, and any dispenser charges. All future invoices [isv+wroRVRiiArmap ^y,vy "°,Rea e�R m. 0 en ^rAmc 4 "Re.en.s,ae 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 four weeks, for a total of 16 -17 deliveries per year. You will only receive invoices 12 times per year. so approximately 5 of those invoices will reflect two deliveries. 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 5/08 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) t 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)) 05/05/09 09DO120048525 Rent and Service April, 2009 $17.45 ccn Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Il ee Mounta IN SUM OF P.O. Box 856680 Louisville, KY 40285 -6680 $17.45 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the n/a 9D0120048525 I-NG4239099 17.45 materials or services itemized thereon for A cnt 0120048525 which charge is made were ordered and received except S` 1 20 Signature �ng-Ut/ Cost distribution ledger classification if 5 Title claim paid motor vehicle highway fund I wo 720806 4/01 /09 4/30/09 09DO121202766 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com e WED- MAY 13 0121202766 III IIII I IIIB III I IIIII I II I IIII� II III II I IIII II FRI- JUN 12 TUE- JUL 14 #BWNNWYR WED-AUG 12 #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. Fi SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL, 1 Pod, Perrier 1/2 Liter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases y. Call 0!)Q- 472 -9&8 8 or. gQ online TODAY! ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1 -800- 472 -9888. It's free! ARM, 1 Delivery address: CITY OF CARMEL PARKS DEPT /MONO, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032 PREVIOUS BALANCE 57.88 4/14 0615551033 8 5 GAL ICE MOUNTAIN DRK W /HANDLE 31.92 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 BOTTLE DEPOSIT: 8 DELIVERED, 5 RETURNED 18.00 4/30 0619313679 1 OIL /FUEL SURCHARGE .00 D7451181 RENT �5 4.99 TOTAL D �9 II 115.78 M 0 A Y 1 1 2009 ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRE TN AG IVITY PAY THIS AMOUNT 1 to terms on reverse side. I 57.88 .00 57.90 115.78 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION. PLEASE 2 Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL I -800- 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE INIOUINTAIN 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 LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAMPLE I NVOIC E sent you the first bill on which the error or problem appeared. You can telephone us. but doing so will not preserve your rights. In your letter. give us the following information: Your mane, 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. 134567990 Your Account Number You do not have to pay the disputed amount while it is being 00100100 00100100 investigated. During the investigation. we cannot report your account 2345678 as delinquent or take any action to collect the amount in question. TN0 -aT WED 79 Watch here for a GENERAL INFORMATION WED ,e personalized account I. Payments received after the billing (INVOICE) date will appear on Important n, n,.. nt„ m „um.L,dnla,uu.,,,uul,dl,.n,1,m Cusmme/ S<rvi<ea- 800 -4]2 -980 your next Invoice. fast due invoices (not paid within 30 days of news and Tn, ^ky^^, uu^9I¢Mw ^ta ^P•°du messa billing date) may be assessed a late fee as allowed by law not to offers �123M.i 5t exceed $20 per month. Additionally. third party collection /attorney olrs� LIII.I I III II.AI.,,II expenses may be a >sessed at a rate not to exceed 100% of the unpaid balance or the maxunum allowed by law. g „",a m y 1D`°'9 Pay electronically 2. Each returned check is subject to a service charge subject to the °m.vw. °1eC ap°a a `nom. maximum check return charge allowable in your State. L Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity s ACTIVITY. amount has been since your ACCOUNT ACTNI7Y P Cn 5 00000 4. Equipment replacement costs will be charged for bottles lost. D,,� yA ad, 3 00e. i1 3 Ma "s paid in full to last invoice 199 stolen, damaged or not returned. A� avoid late fees 5. In accordance with N WNA's Terns and Conditions y our 50.00 y 3�]BBS T &C" ,61098 Paym< TMa ^firo° wa/e/ SGallon 1.5 5P in9 5 iceMw «air SGal De°0*it 7.96 Equipment Lease and/or Service Agreement account may be )neev4w^ MO «a ^stal Rey °m n.99 Monthly Oil subject to minimum monthly purchases and /or early cancellation o9 F °e i s "6a`ee S urchar g e, Fuel fees. (A complete version of the current T &C may be viewed on the w 7 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the ToTAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 10 Information 6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or .aE. -wo .aa 99 Dclivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY u L coo xu PAY BY PAY TSIaAMOUN •....a+••ox,ao. 7. 0 will apply to eac account. The fee that applies to your account ro,�„I, «a�ww P•,^�^� ACCOUNT NUMBER 00 ao 00 is stated on the front of the invoice. For further information please lzls6 NU BER euuNC GATE MT. ENaosfo INJ visit the website listed below or contact our customer service 1234 567890 00 /m center. 7. As a food product. bottled water Is Subject to the rules and 0420,307 04212132619 000391045 200 1 4 Amount due regulations promulgated by the Federal Food and Drug I On "DO� Administration (FDA). Ice MOUNTaN wATEa eOMM A K c�ryMms,aooao 8. low first invoice indicates the products delivered on your first Submit your fOR CUSTOMER SEMICf ULE L800- 37D9888 p ayment by this delivery. along with any applicable bottle and account deposits. L, du, l., a. dn.,.., n. ,.,11,,,11..La,a,.,Maa „1 ,.e.,•w� redemption fees. and any dispenser charges. All future invoices P P A ,w„e ^u: date will reflect charges for water delivered and dispenser rental. bottle Sia. deposits and credits plus charges for any additional products ordered by vou. Deliveries are made every three or four weeks, for a 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 Nestle Waters North America Inc. Form No. NW 709 5 /08 ,1� 0 720806 4/01/09 4/30/09 09DO120095351 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service. icemountain.com FRI- MAY 29 0120095351 III IIII III I III II II I IIII IIII III II III II II III �I MON- JUN 29 WED- JUL 29 #BWNNWYR THU- AUG 27 #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. FLite SAVE on a variety of Ice Mountain Direct products! Take an additional $3 off on Half Pint, 700mL, 1 Pod, Perrier 1/2 Li ter plastic and San Pellegrino Sparkling Fruit beverages. Limit 6 discounted cases y. Call 800- 472 -9888 or go online TODAY! ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1 -800- 472 -9888. It's free! Delivery address: P CARMEL CLAY PARKS AND REC DE, 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 16.95 1I�" 4/29 0617934849 3 5 GAL ICE MOUNTAIN DRK W /HANDLE 11.97 1 9 OZ PLASTIC UP 5OC /SLEEVE 2.99 BOTTLE DEPOSIT: 3 DELIVERED, 3 RETURNED .00 4/30 0619296429 1 OIL /FUEL SURCHARGE 2.00 D7379284 RENT 9.98 D� TOTAL 43.89 MAY I 1 2009 BT. ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CU NT AC IVITY PAY THIS AMOUNT �bject to terms on reverse side. 16.95 m .00 26.94 m 43.89 b a y 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 1 800- 472 -9888 OR WRITE: US Ac 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 40253 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill. write us on a separate sheet of paper. we must hear from you in writing no later than thirty (30) days after we SAM I NVOICE sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter. give 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. 1234567 Your Account Number You do not have to pay the disputed amount while it is being 00100100 00100,00^ investigated. During the investigation, we cannot report your account i 12;45 as delinquent or take any action to collect the amount in question. TNR -ocr o4 MoN OCT 29 Watch here for a WEO N01 7I GENERAL INFORMATION TUE DEC I9 p ersonalized account Y I. Payments received afterthe billinb (INVOICE) date will a PP car on Important u, n,,, p6. nl„ lllli b.,ImJJ�111J1111 "0 "��'I'lll c °,eom•,S`M_14NA72 -9811 your next invoice. fast due invoices (not paid within 30 days of news and Tm "Lr "`M°° messag billing date) may be assessed it late fee as allowed by law not to offers �iz3M=^SE exceed S20 per month. Additionally, third party collection /attorney ctrstate L1aa.1..,i„IIL•.„ III,, ,Ii, „II „Ia1,l,,,�,l,�,1,.1,.11 expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. -r ma�9e,a«>w0 r x,e.mr�� m "g Pay electronically 2. Each returned check is subject to a service charge subject to the maximum check return charge allowable in our State. b Y t Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ".,,,W "�•0- amount has been ACTIVITY. since your AccoUNT °ITS' ni�� 000 4. Equipment replacement costs will be charged for bottles lost, cer nAaa' "DOe'123Ma1 "S� LCY'Swt` p8id in full to l ast invoice stolen, damaged or not returned. sooro avoid late fees Parme "L rna kvOY wager 5. In accordance with NN'NA's Tents and Conditions ("T &C your 0013, 461s91 sGaBO "Na.Rralspri "9 x000 ui Agreement account may be n, 1,711n^°^° S 1eM a i "sGalDeoO q P g 01,1 117ae51^°a4 5 IceM°unuinSG.,Re .99 Monthly Oil Equipment Lease and/or Service A wm Surchar subject to minimum monthly purchases and/or early cancellation o9n, 31J�510a°° s P°eis�rmar9e g 31 0 3 610 0 1, e, Fuel fees. (A complete version ofthe currentT &C may be viewed on the 0911,. 166.0497 5J a0 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 charged a monthly Oil Surcharge, Fuel Surcharge or WA Information Deliver Fee as described in vourT &C. Oniv one of these fees Payment stub ACCOUNT SUMM y w "o> R r pAY THIS AMOUNT PAY BT will apply to each account. The fee that applies to your account aP•r^•^' ACCOUNT NUMB" 5740 is stated on the front of the invoice. For further information please 1 214 5 67 890 B11LiNG DATE MT ENCLOSED INVOICE NUMBER visit the website listed below, W1001W or contact our customer service 1 2}4567190 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 000391049 z0o4 I' Amount due regulations promulgated by the Federal Food and Drug IRO Administration (FDA). IGEMOUNTAJNw"RE 0.PANY aie S. Your first invoice indicates the products delivered on your first Submit your FOR CUSTOMER SLmICECAU,.100�°73.98� payment by this delivery along with any applicable bottle and account deposits. 6. ul, b. A6eAl,.l...61.66,1„n 51de P„ A rCti �,u„R• redemption fees, and any dispenser charges. All future invoices v "Rne,. date will reflect charges for water delivered and dispenser rental, bottle 514 PI 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. )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 Nestle Waters North America Inc. Form No. NW 709 5 /08 p 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 Louisville, KY 40285 -6680 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5/5/09 09DO120095351 Water cooler lease 26.94 5/5/09 09DO121202766 Water cooler lease 57.90 Total 84.84 l 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 1 20 Clerk Treasurer Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. box 856680 Louisville, KY 40285 -6680 In Sum of 84.84 ON ACCOUNT OF APPROPRIATION FOR 101 General 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1 125 09D0120095351 4353099 26.94 1 hereby certify that the attached invoice(s), or 1047 09DO121202766 4353099 57.90 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 21 -May 2009 Signature 84.84 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund V4 720806 a 4/01/09 4/30!09 09D0121776199 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountain.com 0 MON- MAY 18 0121776199 III IIII I IN IN I I IN 1111111111 8I III II I IIII II WED- JUN 17 FRI- JUL 17 #BWNNWYR MON- AUG 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 varlet of.lce Mountain Direct p rotlucts! Take an additional $3 off on Half Pint, 700m y L;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 TODAY!' 1 ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1- 800 472 -9888. It's free! D. Delivery address: CITY OF CARMEL HUMAN RESOURCES, 1 CIVIC SQUARE, CARMEL IN 46032 PREVIOUS BALANCE 10.04 4/24 934109 PAYMENT -THANK YOU -9.76 4117 0616127593 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 6.98 BOTTLE DEPOSIT: 2 DELIVERED, 2 RETURNED .00 4/30 0619163058 1 OIL /FUEL SURCHARGE 2.00 D7357145 RENT 3.99 SALES TAX TOTAL 1 53 ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY a PAY THIS AMOUNT �biect to terms on reverse side. 10.04 m 9.76 13.25 m 13.53 L� 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" datCnoted 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 he later than thirty (30) days after SAMPLE INVOICE sent you the first bill on which the 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. �T You are obligated to pay the parts of your bill that are not in question. ,734567890 Your Account Number You do not have to pay the disputed amount while it is being i 00100100 00100100 a investigated. During the investigation. we cannot report your account 1234567 as delinquent or take any action to collect the amount in question. rHR -oct on MDN -DR 29 Watch here for a GENERAL INFORMATION WED N N EC TI DE. 1- personalized account 1. Payments received after the billing (INVOICE) date will appear on Important i I p c °me, seM <e. oo <7z 9 -aa your next invoice. Past due invoices (not paid within 30 days of news and rna "Ry ui «uun91<eM °u ^�41 PfO�„c, message billing date) may be assessed a late fee as allowed by law not to offers i3mm s am.ee+ exceed $20 per month. Additionally, third party collection /attorney °`y'Si"e 0000it it unpaid i Ibalance or the maximum allowed t by law. ectl 100% of the Pay electronically 2. Each returned check Is subject to a service charge subject to they maximum check return charge allowable in your State. n n� Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity PMaR...� amount has been ACTIVITY. since your AccoUNTAC IVnr ,23 Ma1n s,.eeL 0 pp aid in full to 4. Equipment replacement costs will be charged for bottles lost. De r e y Aaa�ss 1 "n 0o' p last invoice stolen, damaged or not returned. 4245 avoid late fees Payment -thank YOU Wale 5000 5. In accordance with NWNA's Terms and Conditions "T &C your oe131 m, -9- s G a P ^Na1^.als ^9 31788514444 5 ainS Gal Dep^I�• i96 Equipment Lease and /or Service Agreement account may be o 3v- -54444 s �Q13ountamsGalRe,aen 1,.99 Monthly Oil 3,183514444 Renl SUrc "ar9e subject to minimum monthly purchases and /or curly cancellation z 18 63 Surcharge, Fuel fees. (A complete version of the current T &C may be viewed on the Danz 16640°97 5 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the 10— Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General "u.w.*. P.Y,R1s.vM in which service is discontinued. 5T0 Information 57 4D 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 9 99 Delivery Fee as described in our T &C. Only one of these Pees Pay Stub ACCOUNT SUMMARY ��a.W Y Y PAY THIS AMOUNT will appl Y ACCOUNT NUMBER to each account. The fee that applies 10 VOUr account _W ry }A1 PAY i 57.40 a a uv14"' �ew.n wile 00100 00 IS staled on the front Of the invoice. For further information please 1234561-90 wa c DATE MT- ENCLOSED INVOICE NUMBER 00100100 visit the website listed below or contact our customer service 1 234 5 67 890 center. 420096307 ❑V2E2712619 000391049 200. 18 7. As a food product bottled water is sub ect to the rules and Amount due regulations promulgated by the Federal Food and Drug 1 ^hnD^e Administration (FDA). WATER COMPANY 123 Main St ocv,s Submit your 8. Your first invoice indicates the products delivered on your first DR DSTDMER5 -"E Ai PR.41 .E ayment by this delivery. along with any applicable bottle and account depos n,.,.0 „at „i,n,d u i,,. iu, 3,ae P,;n,An,� "a^ n redemption fees, and any dispenser charges. All future invoices date R R y will reflect charges for water delivered and dispenser rental, bottle 5�G "oPlo i EA 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 e /09 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)) Total $13.53 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO.05 RRANT NO. J oun ain ALLOWED 20 P.O. Box 856680 IN SUM OF Louisville, KY 4028 ;P q --6- 07 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1205 Administration Board Members Po O INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify hat the attached invoice(s), or DEPT. y y bill(s) is (are) true and correct and that the 2177619 390 -99 3 materials or services itemized thereon for i which charge is made were ordered and received except 20 Sy5,a re Title Cost distribution ledger classification if claim paid motor vehicle highway fund