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209193 05/22/2012 a CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $199.28 PO BOX 856680 CHECK NUMBER: 209193 LOUISVILLE KY 40285 -6680 CHECK DATE: 5/22/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 02DO11782108 29.34 02DO117821082 1125 4350900 02DO12009535 42.68 02DO120095351 1091 4350900 02DO12120276 50.67 02DO121202766 1205 4239099 02DO21776199 10.36 02DO121776199 2201 4238900 02EO11925282 66.23 02EO119252823 service.icemountainwater.com low Igmal lima glaILVAI liewdy' 215 6661 DIXIE HWY, SUITE 4 04/01/12 04/30/12 02D0120095351 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED TUE- IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII THU- JUN 21 0120095351 MON- JUL 23 5 1311 TUE- AUG 21 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1- 800 472 -9888 AUDREY KOSTRZEWA Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember, past due accounts are subject to a late fee. CARMEL IN 46032 -3455 Your prompt payment is appreciated. For your IIIIIIIII' IIIII"" IIIIIIIIIII 'I'��Ill�illlili�llll'llll "IIII convenience, pay online: service. icemountainwater.com. If payment has been made, we thank you. �r -n. t Refreshing Drinks 'Refreshtn.g Savings Fora limited time, enjoy $1 select -cases of.TRADEWINDS 8� SWEET LEAF$evecages Wlfh'pr ci es this: ool bring on�theheatlLog onto servicelcemounfainwate� corn call 1 800= 472- 9888to add toyour�nez order! Offer ex`�Ires7. /.3 1112 ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service.icemountainwater.com. =B. B 8 Delivery address: P CARMEL CLAY PARKS AND REC DEPT., 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 34.66 4/23 0772554408 5 5 GAL ICE MOUNTAIN DIRK W /HANDLE 19.95 3 9 OZ PLASTIC CUP 50C /SLV 9.87 BOTTLE DEPOSIT: 5 CHARGED, 5 CREDITED .00 4/30 0774676613 1 OIL /FUEL SURCHARGE 2.88 D2522513 RENT 9.98 TOTAL RECEIV 77.34 Purchase f I p Descriptiofl� ►U3� L�U IXC� MA1 A 2812 P.O.# PorF� r G.L. I IBS 1 3 4 35 =0 Budget p�, Line Descr U v t C 7 12 j_p Purchaser Date Approval Data ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 34.66 0.00 42.68 77.34 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 later than thirty (30) days after an 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. a' You are obligated to pay the parts of your bill that are not in question. ti t234s6]e90 Your Account Number You do not have to pay the disputed amount while it is being I 001001 ppjppj00 investigated. During the investigation, we cannot report your account 123456]89 as delinquent or take any action to collect the amount in question. mn MONOCr z9 Watch here for a x, GENERAL INFORMATION 'a personalized account 1. Payments received after the billing (INVOICE) date will appear on Important eoo+n9sae ILII.d11.96.INN atWLIt11.:1110.14.Udltl /Horn/ se.�+�e message C your next invoice. Past due invoices (not paid within 30 days of news and r y wrw.+Ank` piod billing date) may be assessed a late fee as allowed by law not to offers 123M ^u exceed S20 per month. Additionally, third party collection/anomey C.Y.S 0WW ,A..ab,,J.•t"4J expenses may be-assessed at a rate not to exceed 100% of the .,.i,..w......«x unpaid balance or the maximum allowed by law. Pay electronically 2. Each returned check is subject to a service charge subject to the' .y�e�u =sc de�aedeb rranem maximum check return charge allowable in your State. v a,?;° Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity W v a•"°` 'n amount has been ACTIVITY. since your ACCOUNTACTVTr 21MxI SUee Gry.SOU000M paid in full to 4. Equipment replacement costs will be charged for bottles lost, Oer tl ddrna .,,s9 stolen, damaged or not returned. 185t invoice rO��uMe ±s avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C your oen w,e9e s sew sv^9`°"" °m n 3 k Equipment Lease and/or Service Agreement account maybe r ,u,."4 s s �,Nk<W^ s9 Monthly Oil 09 /11 3,]Bflst4`4` 5 keMwm"^ subject to minimum monthly purchases and/or early cancellation r1z 31 v� Surcharge, Fuel fees. (A complete version of the current T &C may be viewed on the "b"O" 5j0 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the ,OtAL Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. Ae ,A„+ S b Information") 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or ,000•` �.M ,,,e Delivery ee as described in our T &C. Only one of these f e e s Pa yment stub ACCOUNT S U M M A R Y PA THIS AMOUNT will a to each account. The fee that applies to your account a 1 apply pp a n w ACCWMNUMBr0. 40 is stated on the front of the invoice. For further information please u3456] 00 00 u4aosro INVO,CE NUMBER BIWNG OATS visit the website listed below or contact our customer service 0 ,]3456]8 center. 7. As a food product, bottled water is subject to the rules and 0420096301 04262712619 000391049 2004 1° Amount due regulations promulgated by the Federal Food and Drug Administration (FDA). K ccf.S." 00000 Submit your S. Your first invoice indicates the products delivered on your first oA SF010E CASI ,.,Ow]z -9946 delivery, along with any applicable bottle and account deposits, usr ay.t.aa••6LU.a.a payment by this redemption fees, and any dispenser charges. All future invoices ,,,,,,�0•w`'^"°` 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 11108 Se service. icemountainwater.com service. icemountainwater.corn Q 215 6661 DIXIE HWY, SUITE 4 04/01/12 04/30/12 02DO121202766 a LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED TUE- MAY 22 JUN 21 0121202766 THU- MON- JUL 23 TUE- AUG 21 541 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1- 800 472 -9888 MANDY SPADY Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember, past due accounts are subject to a late fee. CARMEL IN 46032 -3455 Your prompt payment is appreciated. For your I'�'I�' I�I�'�II'��IIII�' ICI' II' �III�IIII "�I�'lllllllll�l "'III�I convenience, pay online: service. icemountai nwater.com. If payment has been made, we thank you. [Re u. n eshing'Drinks 'Refreshing Sayings For a IiFnited time, enjoy $1 off select cases of- TRADEWINDS EET LEAF BeveageWjth prices tai cool, bringn the heatrLogonto syicelcemountainwater comor 1 80.0. 472 9.888 to add to your next order) Offer expires 7131112. j^ 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 60.71 4/23 0772554457 2 .5 L NATURAL SPRING WATER ICE MTN 11.98 3 9 OZ PLASTIC CUP 50C /SLV 9.87 5 5 GAL ICE MOUNTAIN DIRK W /HANDLE 19.95 BOTTLE DEPOSIT: 5 CHARGED, 5 CREDITED .00 4/30 0774692958 1 OIL /FUEL SURCHARGE 2.88 D2600185 RENT 5.99 Purchase TOTAL R CEAVED 111.38 l) ;scdption r` P.O. P or F UM/4 2011 G.L. I oql D, DU r Line uescr Purcheser Date A^ ^r Oval Date ACCOUNT SUMMARY PREVIOUS BALANCE ]PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 60.71 0.00 50.67 111.38 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. 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 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. 1234567 Your Account Number You do not have to pay the disputed amount while it is being 00100/00- 00100100 investigated. During the investigation, we cannot report your account A 23456]8 as delinquent or take any action to collect the amount in question. TIR .ocT a MON -OCT 29 Watch here for a GENERAL INFORMATION NE- DEC 18 personalized account 1. Payments received after the billing (INVOICE) date will appear on Important IbthdFl„ tlb, llt ll, i,.,tltl,l,ItIL ",It1N„41 „ilddtl a :mmas�e�+^u°0.'O�ues message your next invoice. Past due invoices (not paid within 30 days of news and T ,,,,,E y W1m�i 1 n9 billing date Y be assessed a late fee as allowed b m 9m DOe oa ,em« Y law not to offers J&,, exceed $20 per month. Additionally, third party collection/attorney City, S_ s ooxoo 1 „dad "d m 11...,It.11 b{I E b1,41,d.p expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. m`•e•+ya- Pay electronically TofD<^• Ytws O@cFY°w uc m, amVSbmvci!mo!<' 2. Each returned check is subject to a service charge subject to the. °„wen� maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your ACCOUNT ACTtY 4. Equipment replacement costs will be charged for bottles lost, cel eryAaerel. ms 09e.123M,m5vee,.enS'°` p000 ,,.99 paid in full to last invoic e stolen, damaged or not returned. rreao�,9,v^<e 4] ±s avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C your 5 Paym<m Tn4 ^.Yw wa a w o9i31 46+99s sGauw�N ^^9 Ill 31]9051,440 Ice MOU^uinSGal Deposl+ Equipment Lease and/or Service Agreement account may be 3v99s1444+ s eMO� oSGa�Rttum Monthly Oil X1,1 3+]ees+ wd wr.ror9<'; subject to minimum monthly purchases and/or early cancellation 3,ez6399+ R Surcharge, Fuel fees. (A complete version of the current T &C may be viewed on the osi ,664049] 5 0 Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TDTAL Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. .AYTN�54Mw�M I f t 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or n OrmB ion”) Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY L0 1 "99 W 99 1AY T 1' AMouNr will apply to each account. The fee that applies to your account ^yW'P•Y^""' ACCOUNT NUMBER PPY9Y 5],40 ',y„suo •^4 rtum 123456]8 NIT. ENCLOSED is stated on the front of the invoice. For further information please INVOICE NUMBER BILLING DATE visit the website listed below or contact our customer service aoj /00 123456]8 center. 7. As a food product, bottled water is `subject to the rules and 0,,20096307 04262712619 0a0 3910V9 z00� 1° Amount due regulations promulgated by the Federal Food and Drug lono D« Administration (FDA). i ,cEouNTAwwATERCOmPANY ?YSaa1eS1 Submit your a �,w• 8. Your first invoice indicates the products delivered on your first K EeRoME.SLR„�cEO,,,sow]2 -9a� delivery, along with any applicable bottle and account deposits, bu "b °6661•d..a p ayment b this redemption fees, and any dispenser charges. All future invoices 1"' md"' t,•nb.db.db,tl• °M qn COS* u 5 itle ate y will reflect charges for water delivered and dispenser rental, bottle s„N�P�oR,.EEA�.DPA.Sg °P 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 O 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 5/3/12 2DO120095351 Drinking water cooler- Maint 42.68 5/3;12 2D0121202766 Drinking water cooler- MCC 50.67 Total 93.35 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 93.35 ON ACCOUNT OF APPROPRIATION FOR 101 General 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 2DO120095351 4350900 42.68 1 hereby certify that the attached invoice(s), or 1091 200121202766 4350900 50.67 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 17 -May 2012 Signature 93.35 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com B 215 6661 DIXIE HWY, SUITE 4 04/01/12 04/30/12 02DO117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g WED- MA 15 0117821082 HIMN101 IIIOI ifli OI� TUE- JUL 17 WED- AUG 15 Customer Service: 1 800 472 9888 CITY OF CARMEL STREET DEPATMENT Did you forget about us? Kindly pay upon receipt. 3400 W 131ST ST Remember, past due accounts are subject to a late fee. CARMEL IN 46074 -8267 Your prompt payment is appreciated, For your II' lll�ill��ll'"' I" Il�llll��l�llllllll�llllll�ll�llllll��i��l convenience, pay online: service.icemountainwater.com. If payment has been made, we thank you. Refreshing Drinks. Refreshing 5auings. Fora limited timeenjoy$a1 off select cases of TRA ®EV►(INDS SINEET4EAF'Be�erages.lNith pricesthis cool, bring on the heatll_og onto service.icemountainwater:com or cal! 1- 800 -472 =9888 toacic! toyour next order.! Offer}explres 7r %3I /i2 e 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 STREET DEPARTMENT, 3400 W 131 T ST, CARMEL IN 46074 PREVIOUS BALANCE 54.89 4/17 0771454261 3 5 GAL ICE MOUNTAIN DIRK W/HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -6.00 4/30 0774653133 1 OIUFUEL SURCHARGE 2.88 D2493825 RENT 3.99 TOTAL 84.23 F� ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT c Subject to terms on reverse side. 54.89 0.00 2934 84.23 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR l 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. 12345678 Your Account Number You do not have to pay the disputed amount while it is being 001001oo- 00,00,00 investigated. During the investigation, we cannot report your account 123456789 as delinquent or take any action to collect the amount in question. 1NR MDNG<1 z9 Watch here for a ,,vEd Nw 21 GENERAL INFORMATION If- DEC personalized account L Payments received after the billing (INVOICE) date will appear on Important tbp.,ta�a611il1t iU11•Ig4�elflu «tl,dLtdtl c una°H Boa472 -9Bee your next invoice. Past due invoices (no[ paid within 30 days of news and m,,,Lyo "•'^9 M, °,„,P�„•u message billing ate may be assessed a late fee as allowed b law not to g Y Y offers 123 MZ1 exceed $20 per month. Additionally, third party collectionlattorney c tY st. n, «,n..A 4a •t• ^Sf 1 .taa.. tu• expenses may be assessed at a rate not to exceed 100% of the 9w •t' unpaid balance or the maximum allowed by law. md9h hp up °rt�A i Pay electronically 2. Each returned check is subject to a service charge subject to the dl( �Yer;ewderfrmn maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity a°"" amount has been ACTIVITY. since your AccouNT ACnvm i Addens,. Iohn 00e Ciry,S�te 00080 4. Equipment replacement costs will be charged for bottles lost, last invoice ce�� °`ry 123 Main 5tr paid in full t0 stolen, damaged or not returned. Prevb°3BeV°" 4245 avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C your 5 ui men, Lease and/or Service Agreement account may be 317M51 5 M „v;oswiD•w1' 2.96 q P g Y 78851 rr 99 Monthly 0i1 E p urchases and/or earl cancellation w 31011 subject to minimum month) it rop15or` j. ii y p y 6388„ Surcharge, Fuel fees. (A complete version of the current T &C maybe viewed on the wn2 p 97 R S1 w Surcharge or Delivery website listed below) Upon service discontinuation, rent for the rrnAE 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 w werE r� •mtrc 5 t 5 .e• Information") Delivery ee as described in our T &C. Onl one of these fees Pa stub ACCOUNT SUMMARY Fo•K rY Y Y PAYv PAY TNIS AMWNT will apply to each account. The fee that applies to your account ,N,a.wr� Accoo t NUMBER is stated on the front of the invoice. For further information please 1234567890 Bw00 DATE ,ENCLOSED INVOICE NUMBER visit the website listed below or contact our customer service w/wIN ,234567890 center. 7. As a food product, bottled water is subject to the rules and °,ann%30T 09262712619 00039 a Amount due regulations promulgated by the Federal Food and Drug Administration (FDA). ;CE MDUNTAIN W 1TER00M1µ_ 2 ,ry"5't'"te51Do w w.� 8. Your firs[ invoice indicates the products delivered on your first Submit your o S.oMERSEEO X00 T delivery, along with any applicable bottle and account deposits, t" aat «a «tn "�t••tb °it °ba "4 "t'6t.t.d O R 5i payment by this redemption fees, and any dispenser charges. All future invoices date s�r,,,uPloRtArr.uroP.nsg•uv 9•R 5i 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)) 05/03/12 02DO117821082 $29.34 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 $29.34 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 102D0117821082 I 42- 389.00 I $29.34 1 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, ;May 17, 2012 r I 1 i Street Commissioner Cost distribution ledger classification if claim paid motor vehicle highway fund service. icemountainwater.com 011051 D O 215 6661 DIXIE HWY SUITE 4 04/01/12 04/30/12 02DO121776199 LOUISVILLE KY 40258 B e ADDRESS SERVICE REQUESTED II I II VIII I IIIII I I I I I I II I I III MOD- 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 I CIVIC CARMEL I 46032-2584 by phone at: 1- 800 -472 -9888. It's free! Refreshing ?Winks.,Refreshing Savings For a lirr%ited lime, enjoy $t select cases of7RADEWINDS 8� SWEET.LEAF Beverages "W_.ith prices this °cool, bring on the�heat!Log onto service icemountainWA com o ca11 1 800 -472 9888oaddto "y `urnext orderiOffer expires t 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 SO, HUMAN RESOURCE DEPT, CARMEL IN 46032 PREVIOUS BALANCE 3.99 4/05 0769882788 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED .00 4/30 0774702344 1 OIL /FUEL SURCHARGE 2.88 D2498753 RENT 3.99 TOTAL 14.35 MAY 2 12012 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 3.99 0.00 10.36 14.35 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 I NVOI C 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. 1234567890 Your Account Number You do not have to pay the disputed amount while it is being I D010 100.00100/00 investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. TMB oOo M 123456799 MON.oR 39 Watch here for a WEp NOV 21 GENERAL INFORMATION DE -DEC 19 personalized account I. Payments received after the billing (INVOICE) date will appear on Important nlLl NL «IIN "II.14149 c a x „a, 1.BOwn 9 eee Iyp:,N.9t.dNhl� Me ,,,,uM your next invoice. Past due invoices (not paid within 30 days of news and ,„a„kYWI•• "U•9ke P••Qp message billing date) may be assessed a late fee as allowed by law not to offers izi S, a aem ea. exceed $20 per month. Additionally, third party collection/attomey arysu,e OwlD I:d9A..d IIL. Ar .,AM•ll 49 1 LLLLd 9 expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. r-k w r Pay electronically 2. Each returned check is subject to a service charge subject to the x^�k oiByaw Ba .n±14�^^ .s. maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT AetivitV amount has been ACTIVITY. since your ACCOUNT ACT1VnV BOOBO aid in 123 Main Sweet Ciry,SUle 4. Equipment replacement costs will be charged for bottles lost, last invoice ceB e y Aaerea +:nDOe• p full to stolen, damaged or not returned. Pree,O ke 245 avoid late fees Payment- ThankYOU Waco 5. In accordance with NWNA's Terms and Conditions "T &C your w al 6 BGaibowlPmwb9 -sow Ilt 31788S1Haa ke MOV„[aIBSWIOepaaB 2.96 Equipment Lease and/or Service Agreement account may be nleesu.a. s GalRewm ns9 Monthly Oil Wl,t S 0. M 6urcla�9e'� subject to minimum monthly purchases and/or early cancellation w.,,- B9n2 ne263sen Surcharge, Fuel fees. (A complete version of the current T &C may be viewed on the o9n2 97 57M 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. „,,,�,M,+ Y s,a 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or a, w.• 9v`�` Information') Delivery Fee as described in yourT &C. Only one of these fees Payment stub ACCOUNT SUMMARY p1L_aa•, W PAY BY PAV Tls'S .o AMDUNi will apply to each account. The fee that applies to your account ACCWNtNUMBER w /wIN is stated on the front of the invoice. For further information please DICE N UMM BER 61WNG DATE MT. ENCLOSED visit the website listed below or contact our customer service INVOICE N ppj00 12345678 center. 7. As a food product, bottled water is subject to the rules and 0420046307 04282712619 000391049 2004 18 Amount due regulations promulgated by the Federal Food and Drug B n D« Administration (FDA). ICE MOUMNN WATE 1 23 M te Submit your 8. Your first invoice indicates the products delivered on your first EuR C „nOMER SERVKE U".E''°e�'J -988e delivery, along with any applicable bottle and account deposits, payment by this A „pL„,�L.dl »,t1.LB LALLA.9 a�ne« sba. redemption fees, and any dispenser charges. All future invoices Ld9l ,B;4a. date will reflect charges for water delivered and dispenser rental, bottle OP BEEA deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for M 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 Nestld Waters North America Inc. Form No. NW 709 1 1/08 S service. icemountainwater.com a Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) R NO. WARRANT NO. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER tain IN SUM OF CITY OF CARMEL 856680 An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by KY 40258 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee $10.36 Purchase Order No. COUNT OF APPROPRIATION FOR Terms dministration De artment Date Due Invoice Invoice Description Amount t. INVOICE NO. ACCT #/TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s)) I hereby certify that the attached invoice(s), or 05/03/12 02DO121776199 $10.36 02D0121776199 42- 390.99 $10.36 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, May 21, 2012 Director, Administration Title Cost distribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance claim paid motor vehicle highway fund with IC 5- 11- 10 -1.6 1 20 Clerk- Treasurer service.icemountainwater.com 1116 0 D Q 215 6661 DIXIE HWY, SUITE 4 04/13/12 05/12/12 02E0119252823 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED HILSOU9 8 D JUL 0119252823 FRI 06 MON- AUG 06 WED- SEP 05 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 ��I�I��IIIII�III�I��I�II�II��II�I��I� 'I'I�I�IIIIIII'�I��IIII�� e�: a:�:s. f'�vr d� �r �e" ^«w':�w- .'�,".,�,�5*s�.",ez �.!.��,��xw? .�`a�..�;e�%.>., -�c°..e ��iar«� win..»,. ..h �fii�er2s�,w..�. a=a�asa�a?' a��.a, "��a�, ,�;a^t".i��.. Refreshn,g Drinks Refreshing�Sa�ngs Fora limned time,enjoy $1 off select cases of TRADEWINDS:� SWEET LEAF Bo�erages. Wtth prces,this cool, bring on tfie heat.l.og onto- ser�ice.icemouatainwater coin or y call 1 800 -472 -9888 to atld to your next order! OfferVexpir =es 7131/12: q s ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountai nwater.com. B' S =0011 6 Delivery address: CITY OF CARMEL STREET DEPARTMENT 40 PREVIOUS BALANCE 34.39 5/13 761656 PAYMENT -THANK YOU -34.39 5/07 0770851251 9 5 GAL ICE MOUNTAIN DIRK W/HANDLE 31.41 9 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 54.00 6 5 GALLON ICE MOUNTAIN '.DEPOSIT RETURN -36.00 3 9 OZ PLASTIC CUP 50C /SLV 9.87 5/12 0776751356 1 OIL /FUEL SURCHARGE 2.96 E2684930 RENT 3.99 TOTAL 66.23 ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 34.39 34.39 66.23 66.23 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 SA MPLE ®I 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. lz3as6709 Your Account Number You do not have to a the disputed amount while it is being I 00100100 -00, 100 pay P g investigated. During the investigation, we cannot report your account as delinquent or take any action to collect the amount in question. THR -OC D' 1234567 MON -Da 19 Watch here for a WED -NOv 11 GENERAL INFORMATION nE -DEC 18 personalized account 1. Payments received after the billing (INVOICE) date will appear on Important BOD.an -9000 message 1>' fl: d [N;gLdg0,Im11Udrip4�dFldna�UdiU anomtt .I. proe- your next invoice. Past due invoices (not paid within 30 days of news and Tn,�ErNo-lo.�uo- billing date) may be assessed a late fee as allowed by law not to offers �123 main St ,,:<r•n�. exceed $20 per month. Additionally, third party collectionlattorttey c Y $td1e 00000 expenses may be wdaa «d 0L. d4 A4 IMLU k 64Lt a.0 unpaid balance or the assessed t maximum allowed by to l a ceed 100 of the Vi Pa y y electronicall 2. Each returned check is subject to a service charge subject to the a, maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity L ACTIVITY. amount has been since your ACCOUNT "�"Y'TM M replacement costs will be charged for bottles lost, Ne Address- b6000e.113Mamsn a °rysvaleaoDOD paid i 4. Eq uipment n full to p last invoice U" pre•;oNSO M 1A5 avoid late Fees stolen, damaged or not returned. Payment ThankY Warn 50 W 5. In accordance with NWNA's Terms and Conditions "T &C your BBr31 61098 aaeo Naaral M 9 8.86 "I 3170.851444+ Ice MOUnunS�al D¢pnan 1'96 Equipment Lease and/or Service Agreement account may be 11 e,raes14aa 5 ,�emNNOrai�SC;R. m 11.99 Monthly Oil subject to minimum monthly purchases and/or early cancellation 09 31 'ee15uf"a`9`; pJ Surcharg Fuel fees. (A complete version of the current T &C maybe viewed on the 0 1 86�+�s r Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TDUr Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued MeM Information 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or .•1A 99 RY Delivery 99 Fee as described in our T &C. Only one of these fees P Stub pC ry y y y e c PAY TH1S AMOUNT will apply to each account. The fee that applies to our account pAY BY PP Y PP Y ema N T m M ACC 567 MBER N is stated on the front of the invoice. For further information please 1234567890 BIWNG/� TE MT. ENCLOSED ,NYOICE NUMBER w /00/00 visit the website listed below or contact our customer service ,134567890 center. P sub ❑4282712619 000391049 2004 1E 7. As a food product, bottled water is subject to the rules and Amount due regulations promulgated by the Federal Food and Drug ion.U- Administration (FDA). IcEMOUN AiNWATE,Rc„°N"°�.,�,. 123 Submit your 8. Your first invoice indicates the products delivered on your first '°""°"d 4�Wa,M ORCDSTOMEA9ERYiCEULL 800477 -9M8 delivery, along with any applicable bottle and account deposits, E payment by this WJ& L .d +t16..'.11mdL.,Uo-LU.L.L4LLAra e. redemption fees, and any dispenser charges. All future invoices „,DVensg ^„p,,,4N;.�D•0�rusw date will reflect charges for water delivered and dispenser rental, bottle SwN�proRFREEA 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 Nestl6 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)) 05/15/12 02EO119252823 $66.23 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 $66.23 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 1 02EO119252823 1 42- 389.001 $66.23 1 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 FridayPay, 18, 2012 Street Commissyoger fleet tt 11 II I si Title Cost distribution ledger classification if claim paid motor vehicle highway fund