169463 03/04/2009 CITY OF CARMF.L, INDIANA VENDOR: 131130 Page 1 of 1
0 er ONE CIVIC SQUARE HINCKLEY SPRINGS
CARMEL, INDIANA 46032
PO sOX 660576 CHECK AMOUNT: $538.83
DALLAS TX 75266 -0579 CHECK NUMBER: 169463
CHECK DATE: 314/2009
DEPARTMENT ACCOUNT' P&NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 02091720946 505.02 OTHER EXPENSES
1301 4239099 172200426778 33.81 OTHER MISCELLANOUS
Hinckley Springs For Customer Service and Account Inquiries,
a brand of Call 1- 800 -444 -PURE (7873) or visit
prangs DS Waters of America, Inc.
PO;Box 660579 www.hinckleysprings.com
Dallas, TX 75266 -0579
Customer Account 17220042677859
KIM ROTT Your Next Deliveries: Invoice Date: 02 -21 -09
CARMEL CITY COURT 03 -19 -09 Invoice 0209 1722004 2677859
1 CIVIC SQ 04 -16 -09
CARMEL, IN 46032 Purchase Order
Date Details Qty. Each Amount
Previous Balance 106.18
02 -06 -09 Payment Check 168029 Thank You -62.71
02 -20 -09 Payment Check 168511 Thank You -43.47
Remaining Balance 0.00
TRANSACTION 090642494748
HOT AND COLD COOLER RENTAL 1.0 13.00 13.00
02 -06 -09 TRANSACTION T090373042066
HINCKLEY 5.OG DRINK NON -SPILL 2.0 0.00 0.00
5.0 GAL BOTTLE RETURN -2.0 6.00 -12.00
5.0 GAL BOTTLE DEPOSIT 2.0 6.00 12.00
HOT AND COLD COOLER Installed Serial #010709 1.0 0.00 0.00
HOT AND COLD COOLER Removed Serial #-1 -1.0 0.00 0.00
Rec'd By:
02 -19 -09 TRANSACTION T090503042010
HINCKLEY 5.OG DRINK NON -SPILL 2.0 9.49 18.98
5.0 GAL BOTTLE RETURN -2.0 6.00 -12.00
5.0 GAL BOTTLE DEPOSIT 2.0 6.00 12.00
Rec'd By:
02 -19 -09 TRANSACTION 38584919
ENERGY SURCHARGE 1.0 1.83 1.83
Total New Charges 33.81
30356 -P -0023
Previous Balance Payment Total New Charges Pay This Amount
$106.18 $106.18 $33.81 0 $33.81
V Write- the.complete.account.number_on -your check .Detach.remittance.and.mail with. payment .in.the.enclosed.envelope._To pay online go.to_www hicnkleysprings.com o
J
How to Read Your Statement Visit Our Website•
Register online for access to your
account. You can view and pay your bill,
check delivery schedule and order
Customer Account Number: K..,,,,., o W products all online.
For prompt service, please use this
number when referring to your account. �q.
Ytik, Bottle Deposits:
Summar
Y Highlights bottle deposits and returns.
Balance from previous bill
(previous balance minus payments).
Easy to Pay:
You can pay through the mail, online, or call us
Easy to Read: d r to expedite your remittance with automatic credit
All charges and credits are easy card payments.
to understand.
Total New Charges: .••_.M. ,mA
.h
This information provides totals for Mail Remittance With Payment To:
various products and transactions. "aw Please detach remittance and mail
s® using business envelope provided.
Important Monthly Message
rue:a IDaL13 Se 22 i6d 3LbL t93 OL 1id0 p C00:]O L J
Billing Rights Summary Electronic Funds Transfer Notice
In case of Errors or Questions About Your Bill: If you pay by check, it will be converted into an "Electronic Funds Transfer"
If you think your bill is incorrect, or if you need more information about a (EFT), a process in which your financial institution is electronically instructed to
transaction on your bill, write us as soon as possible on a separate sheet, at transfer funds from your account to ours in lieu of processing the check. By
P.O. Box 660579, Dallas,TX 75266 -0579. We must hear from you no later sending your completed check to us, you authorize us to use the account
than 60 days after we sent you the first bill on which the error or problem information therein to create an EFT for the amount indicated on the check. If
appeared. Your bill shall be deemed correct unless disputed within 60 days the EFT cannot be processed for technical or other reasons, you authorize us
from receipt. You can telephone us, but doing so will not preserve your rights. to process an image replacement document, draft, or copy of your check.
In your letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion
program, please write to us on a separate sheet at:
Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579.
The dollar amount of the suspected error.
o Describe the error and explain why you believe there is an error. If you need Insufficient Funds Notice
more information, describe the item you are unsure about.
If your check is returned for insufficient or uncollected funds (NSF), your signature
on your check gives us permission to debit your checking account electronically
You do not have to pay any amount in question while we are investigating, but for the uncollected amount. Payment by check constitutes your acceptance of
you are still obligated to pay the amount of your bill that is not in question. While these terms.
we investigate your questions, we cannot report you as delinquent or take any
action to collect the amount you question.
We appreciate your business.
As a food product, bottled water is subject to rules and regulations promulgated by the federal Food and Drug Administration (FDA).
For further information, please write DS Waters of America, Inc. at P.O. Box 660579, Dallas, TX 75266 -0579.
PO Box 660579
Da'Jas, TX 75266 -0579 H j n q
CARMEL CITY COURT Springs
KIM ROTT
1 CIVIC SQ
CARMEL IN 46032 -2584
Dear CARMEL CITY COURT
At Hinckley Springs we are committed to providing you with top quality products and service.
As part of that dedication to customer service and to assist you with your delivery dates, we have provided you
with your 2009 delivery schedule at the bottom of this notification. Please detach and post in a location
to help remind you when our courteous Route Sales Representative will be making your next delivery.
As part of our effort to give you quick and easy access to your account information, we would like to invite you to
help us provide a cleaner'paperless' environment by registering for elnvoice through our self service website.
This service will not only help us decrease our paper footprint by eliminating unwanted invoice mailing, but allows
you to conveniently review and pay your bill online while saving you the cost of a stamp. Additionally, other
features of our self -serve website will enable you to:
Check your delivery calendar
View your account activity
View your current bill
Make a payment
Find answers to other frequently asked questions
It's easy! Start by navigating to water.com. Select'Log into my account' and enter your zip code. Then just click
on the 'Register Now' button and follow the simple instructions. Once you have registered, you can immediately
start using the site and learn more about the benefits of online service. If you have any questions on registering,
please contact Customer Service at 1- 800 -4- WATERS.
Now, for a limited time, when you refer your friends and family to our delivery service, we'll give you $25 credit on
your account. What's more, your friend or family will also receive a $25 on their account AND a special
introductory offer! Visit www.Water.com /Referral or call us at 1- 800 -4- WATERS today!
Thank you for your business. We look forward to serving all your bottle water needs.
Sincerely,
Hinckley Springs
"Account credit offer valid only for existing customers with accounts in good standing who refer a new customer(s) with approved credit. 12 -month rental
agreement with dispenser rental and water service and minimum purchase of either on 3 or 5- gallon bottle or one case of .5 litre bottles (24 case) per billing period
or 12 -month Value Plan agreement required in order for existing customer to receive $25 account credit per new customer. A variable energy surcharge will apply
each billing period. Refundable bottle deposits and early cancellation fees may apply. Offer available for a limited time. Offer not available in all areas.
Expires 12/31/09
JANUARY FEBRUARY MARCH APRIL MAY JUNE
Thursday 22 Thursday 19 Thursday 19 Thursday 16 Thursday 14 Thursday 11
2009 delivery CALENDAR
*Dates appearing in BOLD are delivery day changes to accommodate holidays.
JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
Thursday 9 Thursday 6 Thursday 3 Thursday 1 Friday 20 Thursday 24
Thursday 29
ROUTE sales representative: DAVID L PHILLIPS Customer Service: 1- 800 -4- WATERS
Your account number. 1722004
Serviced %ocr can coon! on. Quality ycnr can trust.
I 1 1
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.
�0 d Terms
OWL, 7- 5 RI'66 05 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
g Ddoglzub 1729 li�
.3 .06
�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
op IN SUM OF
0 G G 6 .r7
33,81
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
o 3 0.9 3 3 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
20
a
Tit le
Cost distribution ledger classification if
claim paid motor vehicle highway fund
r Hn c 0 oSp For Customer Service and Account Inquiries,
S DS Waters of America, Inc. Call 1- 800 -444 -PURE (7873) or visit
prmgS,. a brand PO'Box 660579 www.hinckleysprings.com
Dallas, TX 75266 -0579
Customer Account 17209463083945
ACCOUNTS PAYABLE Your Next Deliveries: Invoice Date: 02 -14 -09
CITY OF CARMEL•UTILITIES 02 -26 -09 Invoice 0209 1720946 3083945
9609 HAZEL DELL PKWY 03 -12 -09
INDIANAPOLIS, IN 46280 Purchase Order
Date Details Qty. Each Amount
Previous Balance 1,115.64
01 -26 -09 Payment Check 167629 Thank You 561.72
Remaining Balance 553.92
TRANSACTION 090571797710
ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50
ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50
ROOM TEMP AND COLD COOLER RENTAL 1.0 10.50 10.50
01 -29 -09 TRANSACTION T090293042002
HINCKLEY 5.OG DRINK NON -SPILL 6.0 9.49 56.94
HINCKLEY 5.OG DISTILLED NON SPILL 18.0 9.99 179.82
5.0 GAL BOTTLE DEPOSIT 18.0 6.00 108.00
5.0 GAL BOTTLE DEPOSIT 6.0 6.00 36.00
5.0 GAL BOTTLE RETURN -24.0 6.00 144.00
Recd By:
i
02 -12 -09 TRANSACTION T090433042016
HINCKLEY 5.OG DRINK NON -SPILL 6.0 9.49 56.94
HINCKLEY 5.OG DISTILLED NON SPILL 18.0 9.99 179.82
5.0 GAL BOTTLE DEPOSIT 6.0 6.00 36.00
5.0 GAL BOTTLE DEPOSIT 18.0 6.00 108.00
5.0 GAL BOTTLE RETURN -24.0 6.00 144.00
Rec'd By:
Total New Charges 505.02
30356 -P -0023
Payment Total New Charges o Pay This Amount
_-____._$_1,k58.94
How to Read Your Statement Visit Our Website•
t.• .er oenem.r s.mlu. e.xe m m, ".w..
Register online for access to your
I�wo„.s M.swe_ CMICwbm.r S•MCn er
�weV w•^•I° account. You can view and pay your bill,
check delivery schedule and order
Customer Account Number: w...,,,,.. w products all online.
For prompt service, please use this
number when referring to your account.
ti.
Summary: m cur Bottle Deposits:
Y: Highlights bottle deposits and returns.
Balance from previous bill C
(previous balance minus payments).
Easy to Pay:
You can pay through the mail, online, or call us
Easy to Read: to expedite your remittance with automatic credit
All charges and credits are easy :fit card payments.
to understand. „a
Total New Charges: y
This information provides totals for dn Mail Remittance With Payment To:
various products and transactions. mw Please detach remittance and mail
0 o„ a] a using business envelope provided.
6. 11... IL.... IL .LILL..L.L..ILIIII..LL.ILI IILIL•JIA,.L.LJ..IL. .IL.L...ILLLLL.I
Important Monthly Message wry nn
eus:a zoo u3 s "znezn«us3 nc r.rn a cowo
Billing Rights Summary Electronic Funds Transfer Notice
In case of Errors or Questions About Your Bill: If you pay by check, it will be converted into an "Electronic Funds Transfer"
If you think your bill is incorrect, or if you need more information about a (EFT), a process in which your financial institution is electronically instructed to
transaction on your bill, write us as soon as possible on a separate sheet, at transfer funds from your account to ours in lieu of processing the check. By
P.O. Box 660579, Dallas,TX 75266 -0579. We must hear from you no later sending your completed check to us, you authorize us to use the account
than 60 days after we sent you the first bill on which the error or problem information therein to create an EFT for the amount indicated on the check. If
appeared. Your bill shall be deemed correct unless disputed within 60 days the EFT cannot be processed for technical or other reasons, you authorize us
from receipt. You can telephone us, but doing so will not preserve your rights. to process an image replacement document, draft, or copy of your check.
In your letter, give us the following information: OPT OUT NOTICE: If you do not wish to participate in this check conversion
program, please write to us on a separate sheet at:
Your name and complete account number. P.O. Box 660579, Dallas, TX 75266 -0579.
The dollar amount of the suspected error.
Describe the error and explain why you believe there is an error. If you need Insufficient Funds Notice
more information, describe the item you are unsure about.
If your check is returned for insufficient or uncollected funds (NSF), your signature
on your check gives us permission to debit your checking account electronically
You do not have to pay any amount in question while we are investigating, but for the uncollected amount. Payment by check constitutes your acceptance of
you are still obligated to pay the amount of your bill that is not in question. While these terms.
we investigate your questions, we cannot report you as delinquent or take any
action to collect the amount you question.
We appreciate your business.
As a food product, bottled water is subject to rules and regulations promulgated by the federal Food and Drug Administration (FDA).
For further information lease write DS
PO Box 660579 Ni
Dallas, TX 75266 -0579 H.-_n, L
CITY OF CARMEL UTILITIES Spnngs
760 3RD AVE SW STE 110
CARMEL IN 46032 -7612
Dear CITY OF CARMEL UTILITIES
At Hinckley Springs we are committed to providing you with top quality products and service.
As part of that dedication to customer service and to assist you with your delivery dates, we have provided you
with your 2009 delivery schedule at the bottom of this notification. Please detach and post in a location
to help remind you when our courteous Route Sales Representative will be making your next delivery.
As part of our effort to give you quick and easy access to your account information, we would like to invite you to
help us provide a cleaner'paperless' environment by registering for einvoice through our self service website.
This service will not only help us decrease our paper footprint by eliminating unwanted invoice mailing, but allows
you to conveniently review and pay your bill online while saving you the cost of a stamp. Additionally, other
features of our self -serve website will enable you to:
Check your delivery calendar
View your account activity
View your current bill
Make a payment
Find answers to other frequently asked questions
It's easy! Start by navigating to water.com. Select 'Log into my account' and enter your zip code. Then just click
on the 'Register Now' button and follow the simple instructions. Once you have registered, you can immediately
start using the site and learn more about the benefits of online service. If you have any questions on registering,
please contact Customer Service at 1- 800 -4- WATERS.
Now, for a limited time, when you refer your friends and family to our delivery service, we'll give you $25 credit on
your account. What's more, your friend or family will also receive a $25 on their account AND a special
introductory offer! Visit www.Water.com /Referral or call us at 1- 800 -4- WATERS today!
Thank you for your business. We look forward to serving all your bottle water needs.
Sincerely,
Hinckley Springs
`Account credit offer valid only for existing customers with accounts in good standing who refer a new customer(s) with approved credit. 12 -month rental
agreement with dispenser rental and water service and minimum purchase of either on 3 or 5- gallon bottle or one case of .5 litre bottles (24 case) per billing period
or 12 -month Value Plan agreement required in order for existing customer to receive $25 account credit per new customer. A variable energy surcharge will apply
each billing period. Refundable bottle deposits and early cancellation fees may apply. Offer available for a limited time. Offer not available in all areas.
Expires 12/31/09
JANUARY FEBRUARY MARCH APRIL MAY JUNE
Monday 5 Thursday 12 Thursday 12 Thursday 9 Thursday 7 Thursday 4
Thursday 15 Thursday 26 Thursday 26 Thursday 23 Thursday 21 Thursday 18
Thursday 29
2009 delivery CALENDAR
`Dates appearing in BOLD are delivery day changes to accommodate holidays.
JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
Thursday 2 Thursday 13 Thursday 10 Thursday 8 Thursday 5 Thursday 3
Thursday 16 Thursday 27 Thursday 24 Thursday 22 Thursday 19 Thursday 17
Thursday 30 Thursday 31
ROUTE sales l DAVID L PHILLIPS Customer Service: 1- 800 -4- WATERS
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
131130
HINCKLEY SPRINGS Purchase Order No.
PO BOX 660579 Terms
DALLAS, TX 75266 -0579 Due Date 2/2312009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/2009 0209172094( $505.02
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 095104 WARRANT ALLOWED
131130 IN SUM OF
HINCKLEY SPRINGS
PO BOX 660579
DALLAS, TX 75266 -0579
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
02091720946 01- 7202 -05 $505.02
Voucher Total $505.02
Cost distribution ledger classification if
claim paid under vehicle highway fund