210033 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1
0 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER
CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $63.03
PO BOX 856680
CHECK NUMBER: 210033
LOUISVILLE KY 40285 -6680
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 02FO11782108 20.71 02FO117821082
2200 4239099 02FO12004852 21.44 02FO120048525
1205 4353099 02FO12177619 10.44 01FO121776199
1701 4239099 12F722032704 10.44 12F7220327048
service.icemountainwater.com 110WID0111111111110 E9
0 111A I lk OA 215 6661 DIXIE HWY, SUITE 4 05/01/12 05/31/12 02FO121776199
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED 9
IIIIIIII III IIIIIIIII I JUL 06 0121776199
MO
N- AUG 06
WED- SEP 05
THU- OCT 04
CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888
JIM SPELLBRING Did you forget about us? Kindly pay upon receipt.
1 CIVIC SQ Remember, past due accounts are subject to a late fee.
CARMEL IN 46032 -2584 Your prompt payment is appreciated. For your
convenience, pay online: service. icemou ntainwater.com.
If payment has been made, we thank you.
Rereshing Drinks: Refreshing Saviligs. For a limited time, enjoy $1 off select cases of °'TRAQ�EWINDS&
SWEETLEAF Beverages. With prices this cool, bring onthe heatlLog onto service:icemountaiinwater:c "om or
Wi ca111= 800- �17�2 =9888 to add�to your next order! Offer expires 7/31/1x2, a�'
d
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 SQ, HUMAN RESOURCE DEPT, CARMEL IN 46032
PREVIOUS BALANCE 14.35
5/13 761654 PAYMENT -THANK YOU -3.99
5/07 0774302566 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49
BOTTLE DEPOSIT: 1 CHARGED„_ _1 CREDITED .00
5/31 0779306356 1 OIL /FUEL SURCHARGE 2.96
E2649906 RENT 3.99
TOTAL 20.80
D
JUN L #2012
By
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Sub to terms on reverse side. 14.35 3.99 10.44 20.80
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 fi rst 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 S A MPLE 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. ,23456]890 Your Account Number
You do not have to pay the disputed amount while it is being t Do10010 00100,00
investigated. During the investigation, we cannot report your account
1 2345678
as delinquent or take any action to collect the amount in question. TRn -xT a
D 29 Watch here for a
wEo- NOV x,
GENERAL INFORMATION U -DEC'B personalized account
L Payments received after the billing INVOICE date will appear on Important .,.66o.n -98
Ym g( P� n. naafi «osawut nnaam :a un d ti:,naaa C',9me<SNarnw•�w message
your next invoice. Past due invoices (not paid within 30 days of news and T„ nEYou
ions ,,,a:<rvR.a.
billing date) may be assessed a late fee as allowed by law not to Offers 123 M11 ai^ S i
exceed $20 per month. Additionally, third party collection/attomey cjw scam o000o l.4n t..hMLJ.a
i ^.Ina.d^tQ...dL d4J
expenses may be assessed at a rate not to exceed 100% of the a =gam
unpaid balance or the maximum allowed by law. "ro t�°" $s Pay electronically
2. Each returned check is subject to a service charge subject to the
us
maximum check return charge allowable in your State. M a n �i Make Sure this
3. All bottle and equipment deposits are shown as CURRENT Activity aa•�@" amount has been
ACTIVITY. since your ACCOUNT
3Ma ms,resC'Y•s�'e pppp0 aid in full to
4. Equipment replacement costs will be charged for bottles lost, last invoice Ad >on °O°` „99 P
stolen, damaged or not returned. ,B u «e 4245 avoid late fees
q�,iant ThankTw 50.06
5. In accordance with NWNA's Terms and Conditions "T &C your ran w,696 s
33]645,4
mswi DeP^y'
Equipment Lease and/or Service Agreement account may be Monthly Oil
subject to minimum monthly p urchases and/or earl 3, -5
a y p y cancellation
e4„ fle Surcharge, Fuel
fees. (A complete version of the current T &C maybe viewed on the 091' "A"0"' s „o 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 Information
6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or 44.966 •41^•1 99 EN. F
Delive Fee as described in our T &C. On one of these fees Payment stub ACCOUNT SUMMARY a
PAY BY
ry Y Y r PAY TN's AMOUNT
will apply to each account. The fee that applies to your account AccouNr NumBER s !6
is stated on the front of the invoice. For further information please ,z3+s67890 BIW 0 h .ENCLOSED
,NY., CE NUMBER 06/66166
visit the website listed below or contact our customer service 234567
center.
7. As a food product, bottled water is subject to the rules and t420o96307 09282712619 000391099 zoo9 1° Amount due
regulations promulgated by the Federal Food and Drug 0
Administration (FDA). ,ouNrA3N wATERcoM, 0000
8. Your first invoice indicates the products delivered on our first Submit your
g Y PP P Y deposits, dL .,n,.en..4 9LLLLJaO w6N5T°'"E4SLTA4L,4664 2.9444 payment by this
deliver along with an applicable bottle and account
redemption fees, and any dispenser charges. All future invoices OroPAns+>^ date
❑vcN UP w4v4EEA
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 Nestl6 Waters North America Inc. Form No. NW 709 1 vos
service. icemountainwater.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF
PO Box 856680
Louisville, KY 40258
$10.44
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1205 02F0121776199 43- 530.99 $10.44 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, June 18, 2012
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/05/12 02FO121776199 $10.44
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
service.icemountainwater.com ,m M,
D 215 6661 DIXIE HWY, SUITE 4 05/01/12 05/31/12 02FO117821082
0 LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED 1101 90 1190M IN MA 0 31
FRI JUN 15 0117821082
TUE- JUL 17
NNHIE111 1 111018 II HHE NN WED- AUG 15
FRI- SEP 14
Customer Service: 1 800 472 9888
CITY OF CARMEL STREET DEPATMENT Did you forget about us? Kindly pay upon receipt.
3400 W 131 ST ST Remember, past due accounts are subject to a late fee.
CARMEL IN 46074 -8267 Your prompt payment is appreciated. For your
�I' I� I'' I I �I "I'� convenience, pay online: service.icemountainwater.com.
If payment has been made, we thank you.
R. sF'ing�Drinks Refreshing Sav ngs., For a tirrie, :$1"dW elect�cases ofTRADEWND'S"'
SlnIEET LEAF Beverages UVith prices this cool bring =on the heatlLog onto service icemountaln�water coin or
c '11 1w806= 472-9888 to addsto your'next orderl Offer ezplres
y -gam
0
o 41
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountainwater.com.
kvi
Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074
PREVIOUS BALANCE 84.23
5/13 761655 PAYMENT -THANK YOU -54.89
5/16 0775836265 1 9 OZ PLASTIC CUP 50C /SLV 3.29
3 5 GAL ICE MOUNTAIN DIRK W /HANDLE 10.47
3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00
3 5 GALLON ICE,MOUNTAIN DEPOSIT RETURN -18.00
5/31 0779255728 1 OIUFUEL SURCHARGE 2.96
E2645064 RENT 3.99
TOTAL 50.05
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT I
Subject to terms on reverse side. 84.23 54.89 20.71 50.05
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ice Mountain
IN SUM OF
P. O. Box 856680
Louisville, KY 40285 -6680
$20.71
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
2201 102FO117821082 I 42- 389.001 $20.71 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
�riday J`une 15, 2012
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/05/12 02FO117821082 $20.71
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
service. icemountainwater.com p p
215 6661 DIXIE HWY SUITE 4 05/01/12 05/31/12 121`7220327048
LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED B e
JUL 06 7220327048
MO
N- AUG 06
WED- SEP 05
THU- OCT 04
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 SQ
CARMEL IN 46032 -2584 by phone at: 1- 800 -472 -9888. It's free!
III�I�"�'I�'! III" III� �II !!��I�'
^',r»�. �v a�:4 e?.���..A`°'!.�a.„ems, c „��?.��A. ,x/A'x»:� .e s✓�?�§ —a,�4 w�. .��5. ,s,. �t..� odd
SINEE�T LEAF Beuera es. With trees this cool; brill �°on the heatELo onto service.icemo n 8�
Refre'shin Drinks. Refreshin Savin s. For a limped Time, en o $1 off�select�cases of T D.
-call 1800 -472 X9888 i fo -add to your next order! Offer exp es 7/31•/12.
ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountainwater.corn.
B 9 I3 e B
Delivery address: CITY OF CARMEL, 1 CIVIC SQ, CLERK TREASURER OFFICE, CARMEL IN 46032
PREVIOUS BALANCE 27.26
5/13 761653 PAYMENT -THANK YOU -16.90
5/27 836348 PAYMENT -THANK YOU -10.36
5/07 0774302699 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49
1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00
1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00
5/31 0779376326 1 OIL /FUEL SURCHARGE 2.96
E2687462 RENT 3.99
TOTAL 10.44
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Q Subject to terms on reverse side. 27.26 27.26 10.44 10.44
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.
p Payee
lX r t. Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
o q4
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
IN SUM OF
so
[o.44
ON ACCOUNT OF APPROPRIATION FOR
�o 0 &4 h�
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
7649 materials or services itemized thereon for
which charge is made were ordered and
received except
20
G�
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
service.icemountainwater.com
215 6661 DIXIE HWY, SUITE 4 05/01/12 05/31/12 02F0120048525
o LOUISVILLE KY 40258
ADDRESS SERVICE REQUESTED
HHHI1II �I I�I�I�I II BI I�I�I �I� MO JUL 06 0120048525
MON- AUG 06
WED- SEP 05
THU- OCT 04
CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1- 800 472 -9888
LISA SCOTT OR JUDY STOHLER Did you forget about us? Kindly pay upon receipt.
1 CIVIC SQ Remember, past due accounts are subject to a late fee.
CARMEL IN 46032 -2584 Your prompt payment is appreciated. For your
II��I�IIIII�I' �IIIII�IIII�II�IIIII 'll "'I'I "'I�'�II'I "I��'ll'I' convenience, pay online: service.icemountainwater.com.
If payment has been made, we thank you.
sx, q:;rera e .ae.e KW
RM
°r
Refreshing Drinks. Refreshing Savings. Fora limited time, en�oy$1 ofF select cases of'TRjAD`EININDS 8�
SWEET$ EAF Be�rerages. With prices this cool, bring on�the heaVJ og onto service.icemountalnwater,com ort
call 1- 800 -472 -9888 to add td�your neXt order! Offer expir._es T%31/�'12.
,w
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 SQ, CITY ENGINEERING DEPT, CARMEL IN 46032
PREVIOUS BALANCE 174.90
5/13 761652 PAYMENT -THANK YOU -24.53
5/10 EA1832369 WATER ADJUSTMENT y�� g 129.13
5/07 0774302517 5 5 GAL ICE MOUNTAIN DRK W /HANDLE a ��j 17.45
5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 00
5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN c� ED i?� .00
tr
5/31 E2657935 RENT �.i G 3.99
n
TOTAL
42.68
co
ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT
Subject to terms on reverse side. 174.90 153.66 21.44 42.68
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
Ice Mountain Purchase Order No.
POB 856680 Terms
Louisville, KY 40285 -6680 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s) Amount
615/2012 02f water 21.44
Total 21.44
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.
Ice Mountain ALLOWED 20
POB 856680 IN SUM OF
Louisville, KY 40285 -6680
21.44
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO #or INVOICE NO. ACCT /TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s), or
0 02f 2200- 4239099 21.44 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
1
6/18/2012
Signat
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund