206069 02/08/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $3.99
CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 206069
LOUISVILLE KY 40285 -6680
CHECK DATE: 2/8/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
920 4239099 01KO12220610 3.99 01KO122206105
service.lcemountainwater.com O r r) t
f 215 6661 DIXIE HWY, SUITE 4 11/01/11 11/30/11 01KO122206105
M LOUISVILLE KY 40258
My,
ADDRESS SERVICE REQUESTED
T- DEC 0122206105
1 T JAN 05 05
MON- FEB 06
WED- MAR 07
CITY OF CARMEL ENGINEERINGIISTAVE Customer Service: 1- 800 -472 -9888
KATIE NEVILLE Thank you for choosing Ice Mountain Home Office
1 CIVIC SQ Delivery! We value your business,
CARMEL IN 46032 -2584
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ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at :1.800 472.9888. it's freel
E AfERENCE QTYr DESCRIPTION r
Delivery address: CITY OF CARMEL ENGINEERING, 1301ST AVE SW, CARMEL IN 46032
PREVIOUS BALANCE 7.98
11113 798664 PAYMENT -THANK YOU -3.99
11130 K1743805 RENT 3.99
TOTAL 7.98
7C
ACCOUNT SUMMARY PREVIOUSBALANCE PAYMENT I ADJUSTMENT CURRE TIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 7.98 3.99 1 3.99 7.98
Delach Ihis slub and retum with your payment
ACCOUNT NUMBER PAY BY PAY THIS AMOUNT
P.O. Box 856680 0122206105 12/22111 7.911
Louisville, KY 40285 -6680
INVOICE NUMBER BILLING DATE AMT, ENCLOSED
01 KO122206105 12/02/11
407201222011056 0000399 00007988 5
ICE MOUNTAIN Direct M
a Division of NestI6 Waters North America Inc. CITY OF CARMEL ENGINEERING 11ST AVE
P.O. Box 856680 KATIE NEVILLE
Louisville, KY 40285 -6680 1 Civic SQ
CARMEL IN 46032 2584
DIIIII11 IIIili► uIII111111111111111111111111111111 1111111111 ll
FOR CUSTOMER SERVICE CALL 1- 800472 -9888
SIGN UP FOR FREE AUTOPAY! Sign Up Required On Reverse Side. El Print Any Changes On Reverse Side.
720103 040 -0 1 -D -E•C -00019706 Page 1 of 1
VOUCHER NO. WARRANT NO.
Ice Mountain Direct ALLOWED 20
PO Box 856680 IN THE SUM OF
Louisville, KY 40258 -6680
3.99
ON ACCOUNT OF APPROPRIATION FOR
Ice Mountain Direct
PO# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
DEPT.#
NA 01 KO122206105 4239099 $3.99
NA I hereby certify that the attched 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
19 -Dec 20 11
A r"`aa� i S
Total y3.99 Signature
Cost distribution ledger classification if City En gineer
claim paid motor vehicle highway fund Title