208517 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $89.28
o
PO BOX 856680 CHECK NUMBER: 208517
LOUISVILLE KY 402851680
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 020011782108 54.89 02CO117821082
2201 4238900 02DO11925282 34.39 02DO119252823
service.icemountainwater.com 0 Q
AFONW 215 6661 DIXIE HWY, SUITE 4 03/13/12 04/12/12 02D0119252823
I-OUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
MON MAY 07 0119252823
WED
I WED- JUN 06
FRI- JUL 06
MON- AUG 06
CITY OF CARMEL STREET DEPARTMENT Customer Service: 1- 800 472 -9888
BONNIE CALLAHAN Pay your bill online at: service.icemountainwater.com or
3400 W 131ST ST by phone at: 1- 800 -472 -9888. It's free!
CARMEL IN 46074 -8267
IIIII' llllllll' llllllll' illll' IIIIIIIIIIII��IIIIIIIJ�llllllllll�
something. NE1Nb! New flavors of our San i?eltegrino SparklingFruit Beverages are here. Now choose from
Orange, Lemon; Grapefruit, and�Blooc! Orange. Made with real fruit juice, they're an Italian tradition since
X1932. Call1- 800. -472 -9888:
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472.9888 or visit service.icemountainwater.com.
9
Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W. 131 ST ST, CARMEL IN 46032
PREVIOUS BALANCE 20.79
4/03 542600 PAYMENT -THANK YOU -20.79
4/05 0769882705 6 5 GAL ICE MOUNTAIN DRK W /HANDLE 20.94
6 5 GALLON ICE MOUNTAIN, BOTTLE DEPOSIT 36.00
6 5 GALLON ICE MOUNTAIN DEPOSIT.,RETURN', -36.00
2 9 OZ PLASTIC C,UP. 50C /SLV 6.58
4/12 0772328159 1 OIL /FUEL SURCHARGE 2.88
D2534193 RENT 3.99
TOTAL 34.39
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 20.79 20.79 34.39 34.39
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 m 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.icemountainwater.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 no later than thirty (30) days after we SA MPLE
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. l z3ase7B90 Your Account Number
You do not have to pay the disputed amount while it is being t 00l0 c100 0 0 1 00100
investigated. During the investigation, we cannot report your account r
234567
as delinquent or take any action to collect the amount in question. TNR.a a
MOD -No rR Watch here for a
GENERAL INFORMATION WED NDV
T t,E� DEC 19 personalized account
1. Payments received after the billing (INVOICE) date will appear on Important
n, matt. nb�ttna� <,a
t i,r18t "111�„naau CmumerSeM MOUnuonPl° •R message
your next invoice. Past due invoices (not paid within 30 days of news and Th- &Y^°'"
billing date) may be assessed a late fee as allowed by law not to offers X123 i st a ^a .erv'�•=
exceed $20 per month. Additionally, third party collection /attorney o`Y.s`ate 00000
Lana. a a�a n .n.,.0 an t, 1611 J-
expenses may be assessed at a rate not to exceed 100% of the
a
unpaid balance or the maximum allowed by law. z �ilaY ^'s�7`� Pay electronically
Yt^ wxmar «d f a It
2. Each returned check is subject to a service charge subject to the ,seer �a ��"����''~•.��,,..ii
maximum check return charge allowable in your State. Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity "<,.n.w 5bK_
AR1V1T amount has been
ACTIVITY. since your ACCOUNT
4. Equipment replacement costs will be charged for bottles lost, last invoice Del verypaa,e paid in full to
stolen, damaged or not returned. o�sBala a�4s avoid Tate fees
Pavmen1 ma hvm Soon
W a6
5. In accordance with NNA's Terms and Conditions "T &C your 09131 M s span Nat^. z'W
9111 31,9961C4M Ice Mountain 5 r+al DzPOSit
Equipment Lease and/or Service Agreement account maybe 3 „9gsu4a s memo ^ta; ^sy xlRetum nss Monthly Oil
subject to minimum monthly purchases and/or early cancellation Surcharge, Fuel
0911, 1182639811
fees. (A complete version of the current T &C may be viewed on the o9nr p 97 R 9749 Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the I.M Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. 9g
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge oz M m Information
Deliver Fee as described in our T &C. Only ne of these fees Pa stub ACC ouNrsuMMAaYoU -s
Delivery y our J PAY THIS AMOUNT
will apply to each account. The fee that applies to your account N,a^'• NUMBEB PAY By 17..
pCCOUNr o0 /00100
is stated on the front of the invoice. For further information please lz3 +567e90 g DT
ENnoseD
INVOICE NUMBER pp100100
visit the website listed below or contact our customer service ,110M
center.
7. As a food product, bottled water is subject to the rules and 0,2009630"1 04282712619 000391049 2004 1B 1 Amount due
regulations promulgated by the Federal Food and Drug i h ^D9e
Administration (FDA). o° M n""Y,,,<. Ys; St00000
8. Your first invoice indicates the products delivered on your first Submit your
U40MEg 3ERVKE CPLL1900<739809 b this
delivery, along with any applicable bottle and account deposits, n,;t,p „t. „t.ttca..a fOR` A „s9 p ayment y
redemption fees, and any dispenser charges. All future invoices date
will reflect charges for water delivered and dispenser rental, bottle
sw” uP vo9 REE n ln0 "Y u g<aa
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 cos 11/08
service.icemountainwater.com
service.icemountainwater.com
o 215 6661 DIXIE HWY SUITE 4 03/01/12 03/31/12 0200117821082
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED e
IIIIIIIIIIIN III�II �II �lO TUE- APR 17 0117821082
WED- MAY 16
FRI- JUN 15
TUE- JUL 17
Customer Service: 1 800 472 9888
CITY OF CARMEL STREET DEPATMENT Pay your bill online at: service.icemountainwater.com or
3400 W 131ST ST by phone at: 1- 800 -472 -9888. It's free!
CARMEL IN 46074 -8267
�I�
Bring InSpr =ing Now-is the time to tt�rsomet4�ing`new! Fora limited time, enjoyup to $2 offon a Variety of°
products including Sweet deaf leas; San Pellegrino, and SP. Sparkling Fruit Beverages. Ca11,1 -8U0 -472- 9888.:
�O�fferexptres,4 /30 %12.�
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountainwater.com.
NEW i
Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074
PREVIOUS BALANCE 86.15
3/25 504380 PAYMENT -THANK YOU -86.15
3/16 0767043177 4 9 OZ PLASTIC CUP 50C /SLV 13.16
10 5 GAL ICE MOUNTAIN DIRK W /HANDLE 34.90
10 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 60.00
10 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -60.00
3/31 0770428688 1 OIL /FUEL SURCHARGE" 2.84
C2342784 RENT 3.99
TOTAL 54.89
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY,THIS AMOUNT
Subject to terms on reverse side. 86.15 86.15 54.89
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.icemountainwater.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 no later than thirty (30) days after we SAMPLE 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, why you believe there is
an error.
You are obligated to pay the parts of your bill that are not in question. c 12 34567890 Your Account Number
You do not have to pay the disputed amount while it is being I wwoo- 00100)0, t r
investigated. During the investigation, we cannot report your account 7
as delinquent or take any action to collect the amount in question. rNR0cr w
123456
MoN 39 Watch here for a
GENERAL INFORMATION
nE -oEE personalized account
1. Payments received after the billing INVOICE date will appear on p
Y g PP Imortant ILtl: tidal; dlllFa »,t1tl1.184.�dbld„ll »ttadW c' :EOm1�;^"� message
your next invoice. Past due invoices (not paid within 30 days of news and ma�Er��
billing date) may be assessed a late fee as allowed by law not to offers 123 11 S, I--
exceed $20 per month. Additionally, third party collection/attomey o Y '51- OW00
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law ww i' Pay electronically
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. r :r Make sure this
3. All bottle and equipment deposits are shown as CURRENT Activity amount a'°"• "ppO "a,a�„
„,N.••.��°•'^-""'°" E amount has been
ACTIVITY. since your ACCOUNT ACnv ry paid in full to
W990
4. Equipment replacement costs will be charged for bottles lost, last invoice •oep,.ery 123 Main 5c�eel City S,me nadress' bsnooe.
stolen, damaged or not returned. P e aMe avoid late fees
Payment ThanEY W 1P( SOW
5. In accordance with NWNA's Terms and Conditions "T &C your oM31 .'m s
sOalw�Na,u�'sP a9 00
n. 3 Mouma
Equipment Lease and/or Service Agreement account may be Month) 3nePS,4w+ S IceMnanuloSGalRe Y Oil
Wn, 3,7Pes,u+^ s
wel mana g
subject to minimum monthly purchases and/or early cancellation W 31026397„ nem a s7w Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the W 16600 Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the rouE Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. y C�BPTNr. °A "1 5°5;,0 I
n f
ormation
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or plc eo a%' o
Delivery ee as described in our T &C. Only one of these fees P a y ment Stub ACCOUNT SUMMARY 99
rY Y Y Y PAT BY PAY TNIS AMOUNT
will apply to each account. The fee that applies to your account ".M, Pte^•" ACCOUNTNUMBER 57+
nn• ��w,w6+�rt�m W WIW MT.ENCEOSEO
is stated on the front of the invoice. For further information please ,z34s67999
INVOICE NUMBER w m
visit the websi[e listed below or contact our customer service ,234567899
center.
7. As a food product, bottled water is subject to the rules and D42ao963o7 04282712639 000391oV9 200" 16 i Amount due
regulations promulgated by the Federal Food and Drug ionno«
Administration (FDA). ICE MOUNTAIN WATER COMPANY Ma,n 5,
,oaN•. oir s,a,e 00000 Submit your
8. Your first invoice indicates the products delivered on your first w0 c0sTOM9P SEPYKE UU,eoa4n 9777
delivery, along with any applicable bottle and account deposits, a6 6st,cGa:9 payment by this
uaaa.atlsw ^,N«o ..o x�e, date
redemption fees, and any dispenser charges. All future invoices PfoeEeEEAOroPA ^N9 ^oPwa• „�eo• "p51de
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 11/08
service. icemountainwater.com
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))
04/04/12 02CO117821082 $54.89
04/14/12 02DO119252823 $34.39
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.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$89.28
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 0200117821082 42- 389.00 $54.89 1 hereby certify that the attached invoice(s), or
2201 02DO119252823 42- 389.00 $34.39 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
Ty ursda, April 19, 2012
r
Street QommissioAr
Stree nmrn onar
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund