208334 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $140.79
s CARMEL, INDIANA 46032 PROCESSING CENTER
PO BOX 856680 CHECK NUMBER: 208334
LOUISVILLE KY 40285 -6680
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4239099 02CO12004852 24.53 02CO120048525
1125 4350900 020012009535 34.66 0200120095351
1091 4350900 02CO12120276 60.71 OTHER CONT SERVICES
1205 4353099 02CO12177619 3.99 02CO121776199
1701 4239099 120722032704 16.90 12C7220327048
I service.icemountainwater.com J[6Jp==M0=Ik 901
A� A 215 6661 DIXIE HWY SUITE 4 03/01/12 03/31/12 02CO121776199
LOUISVILLE KY 40258
e
ADDRESS SERVICE REQUESTED B
MON MAY 07 0121776199
WED- JUN 06
FRI- JUL 06
MON- AUG 06
CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888
JIM SPELLBRING Pay your bill online at: service.icemountainwater.com or
1 civic
CARMEL a 46032 2584 by phone at: 1- 800 -472 -9888. It's free!
I 'll'l "I "1'111'1 "I'l
fi
B "ring In "Spring! Now 1s the =time to tg new For -a limittlm boy up to $2 off on anvarlety of
a ducts
pro including Sweet Le af Teas, SanrPellegrino,;and S P: Sparlclmg Fruit ^Beverages Ga111 800 472 9888.:
Offerre
expl r
s 41.30/12
F
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service.icemountainwater.com.
B' B PT 10 N
MO UNT=
Delivery address: CITY OF CARMEL, 1 CIVIC SO, HUMAN RESOURCE DEPT, CARMEL IN 46032
PREVIOUS BALANCE 10.32
3/25 504377 PAYMENT -THANK YOU -10.32
3/07 0765517966 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE .00
BOTTLE DEPOSIT: 2 CHARGED, -2 CREDITED .00
3/31 C2347785 RENT 3.99
TOTAL 3.99
p Q
APR 3 2012
By
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
y Subject to terms on reverse side. 10.32 10.32 3.99 3.99
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- 800472 -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 later than thirty (30) days after we SAMPLE I NVOIC E
sent you the first bill on which the he 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.
You are obligated to pay the parts of your bill that are not in question. 1234s6 Your Account Number
You do not have to pay the disputed amount while it is being Dotootoa Doloolao
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. iW MR cr 04 23456789
MONOCL 19 Watch here for a
GENERAL INFORMATION D
YE D N 7
TDE. rc ,e personalized account
I. Payments received after the billing (INVOICE) date will appear on Im messa e
Ilaln, dl :dL'd1dW.AiI.I,id4 „,IDq „d „tlaad cu:,o�s°'""Mw"w w"a g
your next invoice. Past due invoices (not paid within 30 days of news and Tn "AErW' °i
billing date) may be assessed a late fee as allowed by law not to offers �izs 1 °,oNa•
exceed $20 per month. Additionally, third party collectiontattorney ca,s18
6,mt..a dw au lu uel.a t uaa.a.0
expenses may he assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. r? Ny Pay electronically
T rtMa9eY Yd"t®ntlxekY }v",trch.a C" ell
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 w M.� .•.gym
ACTIVITY. a „4, amount has been
since your ACCOUNTACTIVITr o« 23Mal nnreeLCns 0°°°° n.99 paid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice pe °d1 wN
stolen, damaged or not returned. PredO Tha e avoid late fees
5. In accordance with NWNA's Terms and Conditions Y our
00/3
"T &C
sGallon NaWmisMl^9
n o "31 317006 5 aMOUnuinSGal DepOU a96
Equipment Lease and/or Service Agreement account may be nre"s14u+ i 'keMwnuinSGalRewm .99 Monthly Oil
89n, wd w,4re9•
subject to minimum monthly purchases and/or early cancellation 31
31810 fle Surcharge, Fuel
fees. (A complete version of the current T &C may be viewed on the o9n2 1661D 5jn0
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the roTAL Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued. M A�„MT+ "T 5
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 9s 57. Information')
Delivery ee as described in our T &C. Only ne of these fees Pay ment stub ACCOUNT SUM MARY c 99
rY y our Y PN,S AMOUNT
will apply to each account. The fee that applies to your account ,«��Pm^•^` AcCOU N °MBER
PAY AY T 57,a
ow.tli a+e wy.�rzwm po o01
is stated on the front of the invoice. For further information please 12}4567090 MT. ENCLOSED
1NyO10E NUMBER BILLING DATE
visit the website listed below or contact our customer service 1234567R w/ppj00
center. 0096307 OV202712619 003910" 003910” 2a0q 16
7. As a food product, bottled water is sub ect to the rules and Amount due
regulations promulgated by the Federal Food and Drug 0 0D
Administration (FDA). IcE MOUr+uN wntEN�
123 s„� 00000
S. Your first invoice indicates the products delivered on your first Submit your
FGLL I-g00,4R 9808 a
delivery, along with any applicable bottle and account deposits, 1 at..,n.t,u.4•u.6ua.a °P` USTOMER lr-Y p ayment by this
redemp fees, and an di char All future invoices 1'��a,d6Wa,•. na° ex date
P Y P rK �sr.uPT ^wl�9w
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 706 11/08
S 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 02CO121776199 $3.99
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 N
ALLOWED 20
Ice Mountain
IN SUM OF
PO Box 856680
Louisville, KY 40258
$3.99
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1205 0200121776199 43- 530.99 $3.99 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
Monday, April 23, 2012
f
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
A 171TA "�A service.icemountainwater.com
215 6661 DIXIE HWY, SUITE 4 03/01/12 03/31/12 12C7220327048
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED g
I, �II WON- MAY 07 7220327048
WED- JUN 06
FRI- JUL 06
MON- AUG 06
CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1- 800 472 -9888
ANN DAVIS Pay your bill online at: service.icemountainwater.com or
1 CIVIC
CARMEL Q 46032 -2584 by phone at: 1- 800 -472 -9888. It's free!
IIIIIII IIIIII' lllill' IIII I II I "I "IIIIIII
�s� spa �5.�+a: ,r Pte: €�,re° `.�.n?,s, :a� �"�,.�i4:,-< 3�ra.� aa�"a as .v�a�, e
Bring InaSpring! Now is the time to try something new! For a limited time, enjoyup to $2 off on a �ariety�of'
rotucts Inchidtng�Sweet I.eafTeas,San Pellegrino, and S.P. Sparkling Fruit�Beuerages: Call 1- 8,00 -472 -9888.
Offer expires 4'13U112.
q
a
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472.9888 or visit service.icemountainwater.com.
Delivery address: CITY OF CARMEL, 1 CIVIC S CLERK TREASURER OFFfCE, CARMEL IN 4M
PREVIOUS BALANCE 10.32
3/25 504378 PAYMENT -THANK YOU -10.32
3/07 0765518097 2 9 OZ PLASTIC CUP 50C /SLV 6.58
1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49
1 5 GALLON ICE MOUNTAIN'BOTTLE "DEPOSIT .00
2 5 GALLON ICE MOUNTAIWDEPOSIT RETURN .00
3/31 0770551042 1 OIL/FUEL SURCHARGE
2.84
C2386093 RENT 3.99
TOTAL 16.90
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURR IVITY PAY THIS AMOUNT
Subject to terms on reverse side. 10.32 10.32 16.90 16.90
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.
#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 INVOICE
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. iz3aseraso Your Account Number
You do not have to pay the disputed amount while it is being 0010- loo ooloolo
investigated. During the investigation, we cannot report your account
as delinquent or take any action to collect the amount in question. mR -00 a u3assia
,.10N
Watch here for a
WE6NW
GENERAL INFORMATION nE -EC iB personalized account
L Pay received after the billing INVOICE date will a ppear on Important WU. ID.94dUlid«tltbbia6 «,jl)p.NwtlJdtl e,- ,«�e<smk =I- BOO.,n"yBas
Ym is PP Mwmm�p -d.- message
your next invoice" Past due invoices (no[ paid within 30 days of news and m E ,I «�+Rn
billing date) may be assessed a late fee as allowed by law not to offers 1121 n and
exceed $20 per month. Additionally, third party collection attorney ci,'s 0---
6aa.6.d 644bd.0
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. a� e �°'e� Pay electronically
2. Each returned check is subject to a service charge subject to the
maximum check return charge allowable in your State. -t Make Sure this
3. All bottle and equipment deposits are shown as CURRENT Activity
a •�q amount has been
ACTIVITY.
since your A ccou+rACr m wmooeNwmS1 "00°°° s� paid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice Add, 123 123 St
stolen, damaged or not returned. Prevbu,BaU«e +s! avoid late fees
ro
5. In accordance with NWNA's Terms and Conditions "T &C your w,ePe s °a,«,N,i�oisp�mW a -som
I„ 317805 aMwn�;�SG O Pte' Monthly Oil
Equipment Lease and/or Service Agreement account may be 1 3 ❑BB Z s «M «�wm• W� sc,.
ov Wn 3,rBBS,aS++ s
subject to minimum monthly purchases and/or early cancellation 31 .51 11 P «R1, Surcharge, Fuel
fees. A complete version of the current m be viewed on the o 112 16 9 ar 9 w
P Y Surcharge or Delivery
3
website listed below) Upon service discontinuation, rent for the *ouE 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 PE AO w AN�E 57 Information"
Delivery ee as described in our T &C. Only one of these fees Payment stub ACCOUNT SUMMARY 't
ry y y y PAY TN1, AMOUN
a y •••rew -xo�o� PAY BY
will apply to each account. The fee that applies to your account m...N,�P� ACCOUNT NUMBE0. 11,40
0o ao 00
is stated on the front of the invoice. For further information please 1n- s61B90 61WNG DATE Mr. wcrosEo
IM/OIcE NUMBER
visit the website listed below or contact our customer service ,23456]89- ..,j
center.
7. As a food product, bottled water is subject to the rules and 8420096397 042B2732619 000391 2004 'B Amount due
regulations promulgated by the Federal Food and Drug �wmox
Administration (FDA)- ;a oUNT- NwAnR10"P,,AN' i s e s `000
Submit your
8. Your first invoice indicates the products delivered on your first "`°"W 29�
deliver c Sr -MERsE E b this
ry along with any applicable bottle and account deposits, a6 db db „a. b.MU�I E
redemption fees, and any dispenser charges. All future invoices p ayment y
t'ddb' sw.
E A movnnsg.wn�rt em,BM, a 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 11/08
21, service.icemountainwater.com
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 r Vy��� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
lUw IN SUM OF
PD&x ��5L-b�D
V-q 4(,785 Ug
L
ON ACCOUNT OF APPROPRIATION FOR
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
7t;40 materials or services itemized thereon for
which charge is made were ordered and
received except
a� 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
service. icemountainwater.com
171MA ".A 215 6661 DIXIE HWY, SUITE 4 03/01/12 03/31/12 02CO120048525
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
II I II I I �I I I I II II I I I I I I I I I III I III MOD- MAY 07 0120048525
WED- JUN 06
FRI- JUL 06
MON- AUG 06
CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1- 800 472 -9888
LISA SCOTT OR JUDY STOHLER Pay your bill online at: service.icemountainwater.com or
1 CIVIC SQ by phone at: 1- 800 -472 -9888. It's free!
CARMEL IN 46032 -2584
I�IIIII�I�I���II' II" IIIIIIIII�����II��III������I���I�IIIIIII���I
'Bri4lln Spring!t owns the`tlme.tt try something new! _Fora "limited time, enjoy�up to $2 o�ff:on`�a variety of
products ncluding 'Sweeti_Leaf Teas, San. :Pei le grino, and S P �Spa�kling Fruit Beverages Call 1-800-472-9
3
Offer 430/12
a
3 w
p
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemou ntainwater.com.
o
Delivery address: CITY OF CARMEL, 1 CIVIC SQ, CITY ENGINEERING DEPT, CARMEL IN 46032
PREVIOUS BALANCE 13.46
3/25 504379 PAYMENT -THANK YOU -13.46
3/07 0765517917 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
2 9 OZ PLASTIC CUP 50C /SLV 6.58
3/31 C2356035 RENT 6� 9
8 107 1 3.99
TOTAL 4� 3� 24.53
Cn
c� RECEN 6�
o GARME�
8' c G1T`/ ENGINEER ���tO
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 13.46 13.46 24.53 24.53
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.
#216 If you prefer, you can pay your bill online at service.icemountainwater.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 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 S AMPLE INVOICE
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. Iz3+seraeo Your Account Number
You do not have to pay the disputed amount while it is being ootooloo- 00100100
investigated. During the investigation, we cannot report your account r rz3456rar
as delinquent or take any action to collect the amount in question.
MoNocr z9 Watch here for a
GENERAL INFORMATION personalized account
1. Pa �ro-NO
ents received after the billing INVOICE date will appear on Important
cy Imp IIlLLU1L.dlltl.p „t�tN s""”" j$00'"z -rasa
Payments g( PPe m MaunWnP -d— message
your next invoice. Past due invoices (not paid within 30 days of news and Tt,mEY°1Iw.A�9 K`
billing date) may be assessed a late fee as allowed by law not to offers
exceed $20 r month. Additionally, third a collection/attome C",Sl +e o�
Pe l) i
Y p arty Y
expenses may be assessed at a rate not to exceed 100% of the.asa+A++'
unpaid balance or the maximum allowed by law. ,�rt��ra^"�u rr^'w`°"'"" I Pa y electronicall y
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 1 amount has been
ACTIVITY. since your AccouMAa'v'Tr z;w s aid in full t0
4. Equipment replacement costs will be charged for bottles lost, last invoice p
stolen, damaged or not returned. „n.;o,,.e,l•�• .zys F avoid late fees
5. In accordance with NWNA's Terms and Conditions "T &C your oen+ w umw i g w,u. om i
r "M51 w
s ra MO mu nsr„ IaP°S zrs
Equipment Lease and/or Service Agreement account maybe r,reas+u.A s keMwsratxuu. ,,.rs Monthly Oil
1 Y P Y mn, nraes r„�w +e�xf' 14 {r i Surcharge, Fuel
sub to minimum month) pu rchases and/or earl cancellation �5 c
orn nemre%n Ae 1
fees. (A complete version of the current T &C may be viewed on the +'z -�i'' smo Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle i in in which service is discontinued. A<I+Y+rt 9,- i
ATM° a Information")
Delivery 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or �Ys.A'� """`"`,+.vr ,.�e•^^°'_e i
Fee as described in ourT &C. On one of these fees Payment stub A ccour+rsuMMAm' p1 PAY rY Y b• y PAY THIS A,AWNr
to each account The fee that a pplies to our account PAY Sr
wills
PPIY PP Y eemeN eu rv�vM ACCpUM NUMBER w1w oo w
is stated on the front of the invoice. For further information please u 3+ssrevo 01WNG DATE .ENUos D
W.,cE NUM WrWt00
I AEA
visit the website listed below or contact our customer service 123 561ero
center.
7. As a food product, bottled water is subject to the rules and 1120096307 0426271261 9 ooa391oV9 aaay LB t Amount due
regulations promulgated by the Federal Food and Drug b A U O e
Administration (FDA). ,UMOU nrN WCO AMCOMP c r,s �`L e s `�000
8. Your first invoice indicates the products delivered on your firs[ Submit your
,aB�uzroMUSUSZE�"' „0O"z �1
delivery, along with any applicable bottle and account deposits, date p ayment b y this
a m „aL.aL.a1.La..L .LLLLd a
redemption fees, and any dispenser charges. All future invoices 1 .u ,,,,,P�.•��^"`°"j S i O e
will reflect charges for water delivered and dispenser rental, bottle s�r„wwPrE
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.'
ra
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 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
Purchase Order No.
F al I Terms
Loo e p� I r 1 �2 5��( Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
aziz DZ
Total �3
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
n IN SUM OF
PD Z� B0(
4e 2-n &h
ON ACCOUNT OF APPROPRIATION FOR
X200
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Dom. q 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
I ZZ -2D 20a
i n re
Cost distribution ledger classification if itle
claim paid motor vehicle highway fund
service. icemountainwater.com
(A W. "AA 215 6661 DIXIE HWY, SUITE 4 03/01/12 03/31/12 02CO120095351
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED e
MON- APR 23 0120095351
TUE- MAY 22
THU- JU 21
MON- JUL 23 APR 0 9 2012
CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1- 800 -472 -9888
AUDREY KOSTRZEWA Pay your bill online at: service.icemountainwater.com or
1411 E 116TH STt by phone at: 1- 800 -472 -9888. It's free!
CARMEL IN 46032 -3455
II��IIIIIIII' lIIIIII "'l "'11
r a:a .e E•.w°� a "WARM
Bringln. Spring! Now is the time toetry something new! For a limited time, enjoy up fo$2 off on a lrariety of
r§ products including Sweet Leaf Teas, San Pellegrino, and S P. Sparkling;Fruit Beverages. Call 1- 800 -472- 9888:.
Offie eX ires41�011�2
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountainwater.com.
B B
Delivery address: P CARMEL CLAY PARKS AND REC DEPT., 1427 E 116TH ST, CARMEL I 46032
PREVIOUS BALANCE 38.65
3/25 504376 PAYMENT -THANK YOU -38.65
3/22 0768082802 3 5 GAL ICE MOUNTAIN DIRK W/HANDLE 11.97
3 9 OZ PLASTIC CUP 50C /SLV 9.87
BOTTLE DEPOSIT: 3 CHARGED '3 CREDITED. 00
3/26 0769293317 1 5 GAL ICE MOUNTAIN,DRK NDLE> t aae _LAZ- i-I�L' W 00
BOTTLE DEPOSIT 1 CHARGED 1 CREDITED .00
a
3/31 0770434611 1 OIL /FUEL SURCHARGE PA) P or F 2
C2371852 RENT i y �j 9.98
2472560
RENT .L #fi FREE
a� t
TOTAL w:S�r_l1_� 34.66
i �;rnl,�,rser_ Date
Date
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 38.65 38.65 34.66 34.66
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.
#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 I
sent you the first bill on which the error or problem appeared. You can SAMPLE
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. 1z3+s6ra 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.ma
Watch here for a
yyrp NP/ 31
GENERAL INFORMATION ror Mr personalized account
1. Payments received after the billing (INVOICE) date will appear on Important ld »t1WGi06..Rllt "UatWdG c sawn
your next invoice. Past due invoices (not paid within 30 days of news and tbU 9 "`M°'°" message
billing date) may be assessed a late fee as allowed by law not to offers
exceed $20 r month. Additionally, third a collection /attor a cns�" aap
Pe Y p arty Y iao .eat „aS,.J�an:�
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. Pay electronically
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 M ,„�,«,.�R- amount has been
ACTIVITY. since your ACCOUMAawriv 6 u "nom a1x mceOOOao aid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice U Add—
p
stolen, damaged or not returned. nN;a a,wK• <ii avoid late fees
Par n"u`rw som
5. In accordance with NWNA's Terms and Conditions "T &C your Oenl 5 swiw.Nm�USCd^9�s 5000 E:
ui men[ Lease andor Service A g ree ment account may be i _MOw:uw,sc.�o.w*� y
q P gree y �,,,,,HI,sc,�r� Monthl Oil
E
subject to minimum monthly purchases and/or early cancellation 04 I Surcharg Fuel
fees. (A complete version of the current T &C may be viewed on the wn r' nm 5'
Surcharge or Delivery
website listed below) Upon service discontinuation, rent for the roTA Fee (see #6 under
Leased Equipment is charged through the end of the billing cycle "General
in which service is discontinued.
Information")
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or .,•wa dA�` w 00r00N0
Deliver Fee as described in our T &C. Only one of these fees Payment stub ACCOUNT SUMMARY
Y Y Y y PAY WIS AM UKT
will apply to each account. The fee that applies to your account ,r,
�,�,�,,�„a. Wm A CCOU UMeea
is stated on the front of the invoice. For further information please �.ry 12H5679 17, E 90 s6ra90 s T. T. r aosw
6 MBFA
visit the website listed below or contact our customer service 1u4
center.
7. As a food product, bottled water is subject to the rules and 042009630'1 0428271261 000393049 2004 )8 a Amount due
regulations promulgated by the Federal Food and Drug
Administration (FDA). `"A "'A cry.��u00°°° Submit your
8. Your first invoice indicates the products delivered on your first soo-+n -9sm
rY g Y PP deposits, ,i{,,,a.6W.t w N STOMrxSr"Y' a b this
delive with an applicable bottle and account
p ayment y
redemption fees, and any dispenser charges. All future invoices 1 ..t&� 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 11/08
service. icemountainwater.com
A IT service.icemountainwater.com 0 D e V
215 6661 DIXIE HWY SUITE 4 03/01/12 03/31/12 02CO121202766
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED 9 e
MON- APR 23 0121202766
�I� D L�J IYl THU- M
UN 21
MON- JUL 23
APR 0
CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1- 800 472 -9888
MANDY SPADY Pay your bill online at: service. icemountainwater.com or
1411 E 116TH ST BY...
by phone at: 1- 800 -472 -9888. It's free!
CARMEL IN 46032 -3455
.gyp 4 W �•a
In n rin i �.r
g� p g. Now Is�th ttm�to try someth g new �Folr a.limited tirne,,erijoy up.to $2 off -on a-uarlety :6. 5y
products ncluding Sweet LeafTeas, San Pellegrino, and S P. Sparkling Frult Beverages Cal(1 800 -472
Offer expires 4%30%1A2.
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service.icemountainwater.com.
Delivery address: CITY OF CARMEL PARKS DEPT /MONON CENTER, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032
PREVIOUS BALANCE 5.20
3/25 504375 PAYMENT -THANK YOU -5.20
3/22 0768082851 2 5 L NATURAL SPRING WATER ICE MTN 11.98
10 5 GAL ICE MOUNTAIN DIRK W /HANDLE 39.90
BOTTLE DEPOSIT: 10 CHARGED, 10 CREsPJT =DSe WGJ .00
3/31 0770559318 1 OIL /FUEL SURCHARGE Description 11_)CL 'i 2
C2446815 RENT P.O. P or F 5.99
TOTAL G.L. 09 1 L 60.71
Budget
mine Descr ��iJL
Purchaser_ Date
Approval Date
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reVe I 5.20 5.20 60.71 60.71
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.
#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 later 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 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. la3 +s6]6 your Account Number
You do not have to pay the disputed amount while it is being I 0otooloo- 00100100
investigated. During the investigation, we cannot report your account
=;456]89
as delinquent or take any action to collect the amount in question. THR oa w
MON-OCT 29 Watch here for a
GENERAL INFORMATION M TUE DE
C 18 personalized account
I. Payments received after the billing (INVOICE) date will appear on Important
Itinn�ldaB6dt1Ild�Illl .6166 +1FIli.�N.,[Iddtl w +tam•'s< M�'^ ow se message
your next invoice. Past due invoices (not paid within 30 days of news and n, ^I9.9a
billing ate m be assessed a late fee as allowed b law not to X113
g Y Y offers u3 Sl s
exceed $20 per month. Additionally, third party collectionlattorney °iy's`a” 00000
I d6d.d aL, Ii .IL.AI 40 L 6L11 d 6
expenses may be assessed at a rate not to exceed 100% of the
unpaid balance or the maximum allowed by law. r "Re 6'} Pay electronically
1 Each returned check is subject to a service charge subject to the Y bPma t >aREYO w^� Am
maximum check return charge allowable in your State. Make Sure this
3. All bottle and equipment deposits are shown as CURRENT Activity a
ACTIVITY. since our AccouE Arnvm MII�'^•• amount has been
rt aoow
4. Equipment replacement costs will be charged for bottles lost, Y Derl =,YAdafeSZ ,06 "OOe.'23Ma s L e rt99 paid in full to
last invoice
stolen, damaged or not returned. R,evi9uaBala 2A� avoid late fees
5. In accordance with NWNA's Terms and Conditions `T &C our
y p6O1 5 SCyllo^NawtaISWIM y(ate, -50,00
I11 3,IBBSIA•M Ice Mountains Wl Dep^sn 2.96
Equipment Lease and/or Service Agreement account may be 1 3nees,a°++ s ;eeM ^ta; ^swlnet N?9 Monthly Oil
09111 5 q I SUrcPa9°
subject to minimum monthly purchases and/or early cancellation 31]8851a4M „2 3182638811 e Surcharge, Fuel
5,w
fees. (A complete version of the current T &C may be viewed on the 2 1 0 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 AN ;99 P°. Information'')
Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUM SUMMARY
PAY BY PAY THIS AMOUNr
will apply to each account. The fee that applies to your account "'�;,;b,n m,��,.,� ACCOUNT NUMBER W 5740
is stated on the front of the invoice. For further information please /334561890 BIB DATE MT. ENCLOSED
INVOICE NUMBE0. 00100100
visit the website listed below or contact our customer service u 3 a1089 0
center.
16
7. As a food product, bottled water is subject to the rules and p420016301 04262712619 6003910” 6003910” 2o0v Amount due
regulations promulgated by the Federal Food and Drug i9n ^DO
Administration (FDA)' ICE MOUNTAIN wATE M,,,°rc,K i s SL 00006
al.,w✓••�•^ Submit your
S. Your first invoice indicates the products delivered on your first •D aBe
FOR CLLSTOMFP SEINKE CALL I- 000 -•R-9 a by this
delivery, along with any applicable bottle and account deposits, dl "LU „L "6LLLd.6 es° a swe P Y ment
redemption fees, and any dispenser charges. All future invoices P date
SP.N UP,oP,REE 6irtow.nswM�Pwo�,.6mP�
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
S service. icemountainwater.com
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
4/4/12 2CO120095351 Drinking water cooler- Maint 34.66
4/4112 2CO121202766 Drinking water cooler- MCC 60.71
Total 95.37
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.
051125 Ice Mountain Allowed 20
P.O. Box 856680
Louisville, KY 40285 -6680
In Sum of
95.37
ON ACCOUNT OF APPROPRIATION FOR
101 General 109 Monon Center
t
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 2C0120095351 4350900 34.66 1 hereby certify that the attached invoice(s), or
1091 2CO121202766 4350900 60.71 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 -Apr 2012
Signature
95.37 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund