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210897 07/17/2012
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $137.70 CARMEL, INDIANA 46032 PROCESSING CENTER o� PO BOX 856680 CHECK NUMBER: 210897 LOUISVILLE KY 40285-6680 CHECK DATE: 7/1712012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 12FO11782108 10 .24 12FO117821082 2200 4239099 12FO12004852 7 .28 12FO120048525 1125 4350900 12FO12009535 36 . 18 12FO120095351 1091 4350900 12FO12120276 39. 26 12FO121202766 1205 4239099 12FO12177619 17 . 05 12FO121776199 1701 4239099 22F722032704 27 . 69 22F7220327048 service.icemountainwater.com g ® #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 12FO117821082 LOUISVILLE KY 40258 @ ADDRESS SERVICE REQUESTED Milli 0 TUE- JUL 17 0117821082 9I��19I��IID�I IIIDIII III M1101 III [IN WED- AUG 15 FRI- SEP 14 MON- OCT 15 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at:service.icemountainwater.com or 3400 W 131 ST ST CARMEL IN 46074-8267 by phone at: 1-800-472-9888.It's free! r'v,..". .e r�„�,y✓,° ;°o z.'!, ,'••rr: 'Refrest5 n Qi'ink"s°=:Refr"esshfiJb�Savinrys For a limit`etl`time en'o" ` Toff lect:cas"esrof TRADEININDS &°a n:�"° p�s�v` .`�.. dam.,?.' 7-: • vn� � J -Y% .d.�,. . .` .t .+ �§; �,.- ,s° .�°s fi:".,�d�+` etr,�sr°'=i� s' .r....'. SUUEETLEia►F BederagesWlfhprICes thsc ool;?bngontheheat llL�OgFontorsenriceicemu lnwatercom;or cail�1i3fl0=472m�888�o_adcl to`vaur n u�artle�!�Offer�explres8%3:1/1:2 "��`� ,y �r� �`f�s:.%str+�,.. ,. �:s✓ F.s ffi do �,�� %°' ^nr rr� .,''ter ✓fir r,» r,., ,�;'m;S `_mss".:v' -.r>' .,,"�a"z"g ��a��'7"r�..3R3° t,b.� �.r.;,.' ^;�" .�;- f. ' ��✓..�d."''.w" �; ��'�Ps'.,�` ." � c;9� r����:::�,?^ :^�,,., .-„.. - ACCOU NT 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 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 50.05 6/10 909550 PAYMENT-THANK YOU -29.34 6/29 015012 PAYMENT-THANK YOU -20.71 6/15 0780314928 1 9 OZ PLASTIC CUP 50C/SLV 3.29 6/30 0783639271 1 OIL/FUEL SURCHARGE 2.96 F2798726 RENT 3.99 TOTAL 10.24 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT ^URRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 50.05 — 50.05 -�` 10.24 = 10.24 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. MEN= ,z34s67e90 Your Account Number You do not have to pay the disputed amount while it is being J 00/00/00-00100100 investigated.During the investigation,we cannot report your account " 123456789 as delinquent or take any action to collect the amount in question. MON ocr 39 Watch here for a GENERAL INFORMATION WEo-NOV=' oEC,g personalized account 1.Payments received after the billing(INVOICE)date will appear on Important 169«all«96d99a«allid,196«x119«n,d61a9 Customer Serv'MOUnUm88 message your next invoice. Past due invoices(not paid within 30 days of news and Tha«Y^° billing date)may be assessed a late fee as allowed by law not to offers X123 otvsata,«t st 11-00 exceed$20 per month.Additionally,third art collection/attome Y 1«96.a "aGn«69"6«iaa.a"a '^e,ervl<ea expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. „>sy'g gqoq" T "e o�v« °""gl';;°� e Pay electronically ". ;. r 7ema"a9aYOk",-, miFaii ?4cAW'u 2.Each returned check is subject to a service charge subject to the4 t? maximum check return charge allowable in your Slate. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. vm amount has been since your ACCOUQAR MamSnedC'tl,State00000 „99 aid in full to 4. Equipment replacement costs will be charged for bottles lost, �°el,,.e,y paaress 3Onn ope, p last invoice stolen,damaged or not returned. p,ra,,,gaia^<= «4s avoid late fees Payment-TM1anMY"u Water .SpW 5.In accordance with NWNA's Terms and Conditions("T&C"),your ogt3, 4ale9e s scan^nNawFalspn"9 r� It l 31]Bg5,M44 Ice MOUn\111^S Gal DeposR Equipment Lease and/or Service Agreement account may be +„ 3vRgs,+444 s keMUUn,a�^seaiRemm- n99 Monthly Oil pAl„ 31']ggsl4a44 Fuel SUrcM1arye� subject to minimum monthly purchases and/or early cancellation ,gic3eg„ Rent Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the : Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TOTA,. 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 -i_��FM N'7,o „ i°` Deliver Fee as described in our T&C. Only ne of these fees Payment stub ACCOUNis UMMARY ° iE9° _---- Y your Y ----------------------------- _ PAY THIS AMOUNT will apply to each account. The fee that applies to our account •°'°'° ----_wYm°^ -- PAY Y PP y e�.a 1� �° .M Yp° ACCOUNT NUMBER W w w 5]40 is stated on the front of the invoice.For further information please 'z3as7e90 gIUUNG DATE ML ENCLOSED INVOICE NUMBER 00/00100 visit the website listed below or contact our customer service 1a34s67990 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04292712619 000391049 2004 16 Amount due regulations promulgated by the Federal Food and Drug 1.1n e Administration(FDA). iGE MOUNTUN`v,A C°MRA K '�ysraies o0000 ,g •, ° Submit your 8.Your first invoice indicates the products delivered on your first 0048-9Bgg NRCUSTOMERSER KE`""'" a delivery,along with any applicable bottle and account deposits, 1)6p"t."M4f'6a«a �P e.e„°'e payment by this redemption fees,and any dispenser charges.All future invoices date will reflect charges for water delivered and dispenser rental,bottle „G„oPFo,FReE"N,oP""s"nOpR 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF$ P. O. Box 856680 Louisville, KY 40285-6680 $10.24 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 2201 1 12FO117821082 1 42-389.001 $10.24 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 r Wednesday�uly 11, 2012 .Street Commissioner Title v v v 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)) 07/03/12 12 FO 117821082 $10.24 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer service.icemountainwater.com 17,TA"m #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 12FO120095351 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MON- JUL 23 0120095351 TUE- AUG 21 THU- SEP 20 THU- OCT 18 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 Your prompt payment is appreciated. For your 'I' IIIII II fill lll convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. ,cars sa s ..,� .�rsrr"= g,.�*d='s` a , x9^ ._r.sgs°' °xrrx a. =...,e air. ::':.° '. .'_x, p' 4 �k:ur� .`.. ....oA , Reftreshing Dclnks.�Refreshing-Savtngs;�For a-`Ilmttedttmeerijoy$,1 off.sefect=cases of TRADEWINDS,B� SWEET LEAF Be=eraes `4brtn f6n—lthe�t eatlLo'�o to sery ce`icemountainwater cam or, �.� g With�prtces�thls�cool g g„ _ tf'�.k s,sa;,<✓;ar,°sr�r,>arHIxrrsb`"=4��8z"2�` r. ca11,1=800 472 988$-to,y'add.to vqr�neztRord'e`r.. .�J^-u�-�,��,_,, =��s.�y '�, r '`r rs ,ys r ..z.. "^,�,'-, '. -�+^s.,:"£ ,2-• ,r,.e �.a. ,a-M,�,gya& :-a`�`��-�„ .., " ':zu ,dam" ^" s °s,r�°.., ;'ys' z'+ .�"„s,�r"' � '° "z �';', '';'r..7k•>t. ,,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: P CARMEL CLAY PARKS AND REC DEPT.,1427 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 81.45 6/10 909549 PAYMENT-THANK YOU -42.68 6/21 0781457734 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 19.95 1 9 OZ PLASTIC CUP 50C/SLV 3.29 BOTTLE DEPOSIT: 5 CHARGED, 5 CREDITED n .00 6/30 0783664113 1 OIL/FUEL SURCHARGE=hase o CE"WED 2.96 F2826449 RENT Dosrription Y �{`1 r1 9.98 TOTAL P.O.#��j�i3 — R Or � �U�� 74.95 G.L..# `T35cooc). �n Lineb*. l► r '� �y Gine`Llesc Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT y Subject to terms on reverse side. 81.45 — 42.68 36.18 = 74.95 v� J ---------------- - ` 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 I-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 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. " 1234567890 Your Account Number You do not have to pay the disputed amount while it is being / ool00100-00 ooioo investigated.During the investigation,we cannot report your account r 173456789 as delinquent or take any action to collect the amount in question. THR-oa a MOH-Da:9 Watch here for a GENERAL INFORMATION wED-NDV_' nE-DEC 19 personalized account I.Payments received after the billing(INVOICE)date will appear on Important „dIt1,I,tpL«dtltlnit«{tddtl as°me<sema t-aoo>7 2.9BmB ILp«dIl«BLdIIIId message your next invoice.Past due invoices(not paid within 30 days of news and Tna°Ry°°'°•°�^9"`M°"""I°r° offers billing date)may be assessed a late fee as allowed by law not to lizs st a„au,�ma. o,y,state Now exceed$20 per month.Additionally,third party collection/attorney t dtl•L.d«tV««dL«dL,•n.Lt1..4«LL4t.d•tl «„�,✓ E I, expenses may be assessed at a rate not to exceed 100%of the Pay electronically unpaid balance or the maximum allowed by law. 2.Each returned check is subject to a service charge subject to the _ •I"'. v a�,q(p•.0elfier.es,,-'l.SS €*4+'.4:"": psi:l"'2'/�.Y•a'•;',,.I.°' c ,.,',✓ maximum check return charge allowable in your State. •fir;,,?;,r.:.::??;"'` " ,'w;::,,_ - °^ Make sure this z '.. 3. All bottle and equipment deposits are shown as CURRENT Activity �ri°'`�"°"-"x't'"° ACTIVITY. since your ACCOU NTAa"tn „°« " ^¢ amount has been • 173 MainSt'eet.GtY.Aace00000 aid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice �cei��eryAaa.e:: mn°ooe. P stolen,damaged or not returned. p,ee,°°,ea kyW sow avoid late fees 5.In accordance with NWNA's Terms and Conditions("T&C"),your s wa1:. -so w 90131 afi1098 BGallon Natuea15pn15 „I 3v9esw M°°tansGalD p°u' Monthly Oil Equipment Lease and/or Service Agreement account may be ,„ 3ne9s3aaaa s meM°°°1a�nswlRewm. . "�� Y subject to minimum monthly purchases and/or early cancellation .1 3v09s""'" wei s°mna.e g Oy1", ....091' Re°, , Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the u9n� ' 9' 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 uo"T in which service is discontinued. aRENT aEy = '"yT"" nao 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or "' Information") Deliver Fee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUMMA0.y ° ____ Delivery y y y au PAy THISAMOUNT will apply to each account. The fee that applies to our account �,a>a" _wY^"" oo o0 PPY PP Y wends ACCOUW NUMBER 9 is stated on the front of the invoice.For further information please ',, 791- B'W c DATE MT ENCLOSED INVOICE NUMBER wlwlw visit the website listed below or contact our customer service 1730567990 center. zoo" ' 7. As a food product, bottled water is subject to the rules and Oyz0696307 0`12.2712619 000391049 Amount due regulations promulgated by the Federal Food and Drug I°nn tax Administration(FDA). _ ,CE MOUNruN WATER c°M �y s sow, 8.Your first invoice indicates the products delivered on your first Submit your 0.CUSTOME0.SEWICE CALL e-099-�7T908B payment by this delivery,along with any applicable bottle and account deposits, fO , Indadn ypL,•„IL.�dL.�tl.La«L..F.LLi�d..tl AmcN�,a,RM,,,sa• redemption fees,and any dispenser charges.All future indices ,°,�,aao°R�xSiee date s,GRu, ,EE AU*oPAnsg"u° 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 v_ service.icemountainwater.com O I #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 12FO121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g 9 e ECE' T MON- JUL 23 0121202766 YZ v ED TUE- AUG 21 THU- SEP 20 JUL 0 9 2012 THU- OCT 18 CITY OF CARMEL PARKS DEPARTMENT BY 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 II"�I�I�II�III'1'�IIIIIII�I��'1���111'�I"'III"II�'1'llll'lll�� convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. r Refreshiri'" Dr.,�iiks.°Ref es,in fS,avin ss ForaJimifed�tlrrie',en o "sl; off�select cases of:~TRAD,EWINDS B�. ' e,."yxy ;3y? ,�:i'."f `; r`.d'"•"^s .YU�:4;"t'virt?3. i L"Q."=,•;d;.°ate*»,'; kroP:n tea.:.✓sv i SWEET°LEgF Beverages Wit 1p a this t ool, bring�an�the heat Log�onto sen rce:ICem tainwatercom orr _ 111"1 300-.7, #o acicl tabour rtpxp order!¢Offer-,explres4$%31�! � �r %` a.r�' ' - .!' :®6,,: � „x:,�snr���-'' Y`�.✓ ""��,�, :�.:-.yrTm°,'+�. ,r;'h;.::i�':-°sY,rv'��` '.di ':°+ �` `�:": "z�;.,,, _�- g, r`.�a's .'mod' '" �' � � 4_a»'.''w'>®'..P.�✓s";'�dF°Y' "n°.'�L,".;� ej'.1x,�„ ',r' ,r«¢'°Y;�'T,�<K:°fir; 'Y,�q� -;:,^.�'�` v .� tr+` �,;;G ,wa,> »r :�".:;�9.rte. 'Ez°,xa'�uu.`�u"�..,'";✓,%:;G�-'�-�'��.z;.�F.� .,F.r'»`:,.�:�-:�' �, _'..r;°." �d.'<�_, ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. B ' AR 9 B ® O Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 84.42 6/10 909548 PAYMENT-THANK YOU -50.67 6/21 0781457783 1 .5 L NATURAL SPRING WATER ICE MTN 6.49 3 9 OZ PLASTIC CUP 50C/SLV 9.87 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 19.95 BOTTLE DEPOSIT: 5 CHARGED, 6 CREDITED -6.00 ^ ` \M _ G 6/30 0783681158 1 OIL/FU Purchase EL SURCHARGE U t� \ 2.96 F2909095 RENT Description 't� — 5.99 TOTAL P.O.# P or F 73.01 G.L.dget 1091- 4-350900 Line Descf},j-1 (1.Dw CCNC5 - Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 84.42 — 50.67 + 39.26 = 73.01 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR I. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we SAMPLE 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. OMM00=4 123+s67a9D Your Account Number You do not have to pay the disputed amount while it is being / oolD J"o 00100/00 investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. m0-aT a 123456789 MON OCr 29 Watch here for a WED NOV 2, GENERAL INFORMATION IDE-DE<,B personalized account M9unWn 1.Payments received after the billing(INVOICE)date will appear on Important "IIU•L164,ttlp,g„tIJJp C.—erxr�.,-w"P n 0 0.p.r,1p:96dfil{J+� pr^d^'° message your next invoice.Past due invoices(not paid within 30 days of news and billing date)may be assessed a late fee as allowed by law not to offers 12 S,00000 ,d emaa C"'Sule exceed$20 per month.Additionally,third party collection/attorney �JUa.d p6,,,,iL.Ji.•n,46»4.44t�1d-tl . . & expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. Pay electronically A n''a Yo,&i4-*T�Ya!„'9m-qtly_""atmum, p jy_r,~s;s: ;...�r✓'I .Each returned check is subject to a service charge subject to the- -hsi,:exel. .�.k"wasiraf.�ids•""J-( �� maximum check return charge allowable in our State. 4. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity m -•^ amount has been ACTIVITY. since AC our UNrACrrvITM Y „3Nw,nS,re�,ons`aLppp00° „� aid in full to 4. Equipment replacement costs will he charged for bottles lost, ar,.,eryAddress lonno^e -„"� P stolen,damaged or not returned. last invoice %ter �aMMe +_� avoid late fees 5.In accordance with NWNA's Terns and Conditions("T&C"),your ,890 p ymem ,ai pOA, 'Ill B SGall^n Natur ISpnn9 Wattt .50� Ill I[e 1MUnn6Ga�D"R°^I Equipment Lease and/or Service Agreement account may be J„ s ReMn9n,a^sw,we,"�a"°'-- -' ,.9" MOnthly0il 18BB,+M+ 09111 3,J806,M++ 5 FuN 6urcharye.';,, r is.ir subject to minimum monthly purchases and/or early cancellation Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the o9n7 ��+°"' :;-,-.� - ." 51+° 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 ral Gene in which service is discontinued. " "r"""r” _ .,..TNT: J40 "General 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or eReA "N"”` -�nD.T+ 9a..• - ACCOUNT SUMMARY Delivery Fee as described in your T&C. Only one of these fees Payment Stub -----_-- ppy er y ppV THIS AMOUNT will apply to each account. The fee that applies to your account --°-"_" �,a,ti,.�;;;Y;R•+^'"`M• ACCUUMNUMBER w o is stated on the front of the invoice.For further information please 123+567090 B,LL,NG DATE MT.ENCL06ED INVOICE NUMBER 00100100 visit the website listed below or contact our customer service ,z3+s6Je98 center. P subject D9282712619 tlee391099 20DV lA 7. As a food product, bottled water is sub-ect to the rules and Amount due regulations promulgated by the Federal Food and Drug innn D^" Administration(FDA). ICE MOUrrwNW"„�°MA°:�. �Lys�acesLOOOOD ,�aW.a Submit your 8.Your first invoice indicates the products delivered on your first ° ToR<usroMER SEnvrtE<""".B payment by this delivery,along with any applicable lbo[tle and account deposits, � e„ReW^• 4,J9J.J..tl4•�JL..JL.,tI«4FI,.4.L44LJ,rtl sb: redemption fees,and any dispenser charges.All future invoices ADTDVnnsn°„pp�.�°�R "4°e date will reflect charges for water delivered'and dispenser rental,bottle swN�REORNBE deposits and credits plus charges for any additional products - - - ordered by you. Deliveries are made every three or four weeks,for a total of I6-17 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 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 7/3/12 12FO120095351 Drinking water& cooler- Maint $ 36.18 7/3/12 12FO121202766 Drinking water& cooler- MCC $ 39.26 Total $ 75.44 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$ t $ 75.44 ON ACCOUNT OF APPROPRIATION FOR 101 General & 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1125 12F0120095351 4350900 $ 36.18 1 hereby certify that the attached invoice(s), or 1091 12FO121202766 4350900 $ 39.26 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 12-Jul 2012 Signature $ 75.44 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund ATRA"� A service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 12F0120048525 LOUISVILLE KY 40258 5 B e ADDRESS SERVICE REQUESTED SI II I I I I i l l�11 l 9 I I I I I I I II I 'I! JUL 06 0120048525 MO N- 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 'I�II�III'I'I""IIII'll'lll�'�"'��"��'ll�ll"11111"IIIIIII�'1 convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. =KefresningADrinKS:Refresning�S"avings r� or�a;liriiited'time,enjoy<$1Roff, select cases;ofTRADEWINDS q&� . SWEET. Bevera s.Witfiqri s th s cool brinry on'ah`e FieattLo onto seni c ce ountainwater comp ot° °.�E!,,ar-t,;r v rrr g_> - itn,/p.' '`�`�'',i%��r"✓; `g�on3s g,o�' ervi, ,xxy.e " hWii" ------ a�i 1-=SFfC��,�=g��o�«-add��a� otc� r�ktgoi-dei,l=O�t,G�-Ex ��eo{3-�'/1� �✓ ��`:�. _�. a ��- a='�� a'as .�.s.1..n"s.;s; `�^- R y a�� �'" � �` s a� `'` �»� ;a° �"' a" a'v ,�s� �` .rte F' r,�ar!;�.✓�",�^."�..�f:�' :�'"�'�'. 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 BALANCE 6/29 015014 PAYMENT-THANK YOU 42.68 �— -21.44 6/06 0778742072 1 9 OZ PLASTIC CUP 50C/SLV ` , 3.29 6/30 F2811243 RENT � ��� 3.99 TOTAL ' 28.52 C' ILL C!: v 1i2 ti� ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 42.68 — 21.44 + 7.28 = 28.52 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 1-800472-9888 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 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. PIMP You are obligated to pay the parts of your bill that are not in question. Your Account Number You do not have to pay the disputed amount while it is being J 0010°100-GO/W°loo investigated.During the investigation,we cannot report your account r 23456789 as delinquent or take any action to collect the amount in question. MDN OCT 29 Watch here for a GENERAL INFORMATION WEE-,uE-DEC DEC 3, IB personalized account 1.Payments received after the billing(INVOICE)date will appear on Important mn�an.n4dn141.,1 @,Lln{,„alln.n„n,l,tp a.m�e9 au00 P7�98 message your next invoice.Past due invoices(not paid within 30 days of news and N„„ky^o«„^ billing date)may be assessed a late fee as allowed by law not to offers X123-S '^a aem.e= exceed$20 per month.Additionally,third collection/attorne ons`a”° p n•►0.6.61,[,{.1.0 P Y Party Y laaaa"a.e6,. expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. v--.;: "” j` ,,,a 6 ', h "PMT" Pay electronically rom�naimmrma. 4x1r1�Y„+"�0"- 2-Each returned check is subject to a service charge subject to the °' mh:? '°""''"`°`d''IcravCO °."•as" `v" '.t�^� `:•%.�3`;r ."',' J g J .aA'«er��;±amewraa.r�-:r,-:•° �; .';�i,r-��,^ maximum check return charge allowable in your State. <£_"v Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity 'f ice"-�'=""' I"ae^°^""°'""' ACTIVITY. � amount has been since your pccouNTpcTnn' OWED 4. Equipment replacement costs will be charged for bottles lost, last invoic ceu•erynadress:mn^DVe.123Nam"ep1' >> paid in full to e stolen,damaged or not returned. 24s avoid late fees payment-Thank Y^u Wzter 5000 5.In accordance with NWNA's Terms and Conditions("T&C"),your oer31 W1896 5 scan^^Namraisvrla9 -so 6W g651M4a ke MOUntainSGal Depauc '96 Equipment Lease and/or Service Agreement account may be �;; �ness,,,44 s IceM^„^t„^s°""""'"�- 199 � Monthly Oil 09111 31J0651444a q,Kl5u.c6ar9c subject to minimum monthly purchases and/or early cancellation W9n2 3182636611 , Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the 66113 3 ''°'91 5710 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. ”' n4o 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or VIE ` ”" Information") ACCOUNT SUMMARY Delivery Fee as described in your T&C. Only one of these fees Payment Stub „„ __ PAY THIS AMOUNT DO DO will apply to each account. The fee that applies to your account __ ----„,„,a,--o�>'^`"`„ pCCWNrNUMBER �Y � 57.10 is stated on the front of the invoice.For further information please '23456769E BILLING DATE MT ENCLOSED "volcE NUMBER 00�001W visit the website listed below or contact our customer service 1234567890 center. 7. As a food product, bottled water is subject to the rules and 0,2oD963G7 04282712619 °°°391°49 200° 1 Amount due regulations promulgated by the Federal Food and Drug ion^D« Administration(FDA). IcEMOUNTa"`"ATE,RC„°M„A c ma,n$1004°° Submit your 8.Your first invoice indicates the products delivered on your first TAm scat, ERSEMKE CALL I-800<)i-9888 delivery,along with any applicable bottle and account deposits, °R payment by this 6aa.L.aunMwtlw�aL.�tIrLLI,.E.6k66a,.n e �v^„,unerom•+W^n�"u see redemption fees,and any dispenser charges.All future invoices ❑sKNOV.OREREE.EIOPNWSg^EVBa9W�aeo•"^"y5ie 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 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 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 7/3/2012 12F Water Cooler $ 7.28 Total $ 7.28 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. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF $ Louisville, KY 40285-6680 $ 7.28 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 12F 2200-4239099 �.2a 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 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 12FO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® 9 $ I I �I �I� MO JUL 06 0121776199 MON- AUG 06 WED- SEP 05 THU- OCT 04 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING 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 !In��lllllnl�Illlln��llllll�!Ill�llll�lllllll����l�l�lnll�lll MM "°K e;� 1 Refrdighing�Drinks:�Refresii ng Savings: Fgiglimitedatime;enjoyl$l�, seiect case"ict-R`ADEiNINDS r a'i:t�'z ;r ^=a"� z';"-�� ,dl aw'-`rfz ` �'�-� °s'� s,,,°.v`� :�'�z�:��°�s »_ :��'.,✓.r': :�°r°^'�asr�; ;Y SWEETr:LEAFiBeverages With" vices°.this-tcool brmg'on=the heat!Logtonto=service:!cemoUntainwater:com>or o,1y:�;' 'S`?x' -- - "'Iu SO °'- ` .a;�a k»x.. ' nay�iF�� .^,�,' .rf ,:°,,1�,S,J.'•�"' ...i` ,li.',�':;5' -6� `� � M� � s� .^» �z� 7l�+:a'`ras?.�rx..-•`d%�`�.°'.<"Y.'=.:;�" ,,", .,°�.�`e"'" F,�.s. e�.r��;'"M 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 20.80 6/10 909551 PAYMENT-THANK YOU -10.36 6/29 015011 PAYMENT-THANK YOU -10.44 6/06 0778742114 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 2 9 OZ PLASTIC CUP 50C/SLV 6.58 BOTTLE DEPOSIT: "1 CHARGED, 1 CREDITE .00 6/30 0783690662 1 OIL/FUEL SURCHARGE D Q 2.96 F2803429 RENT c 3.99 TOTAL JUL 16 2012 I 17.02 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 20.80 — 20.80 + 17.02 = 17.02 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 I-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.ieemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. ff 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. z3asb7s90 Your Account Number You do not have to pay the disputed amount while it is being t 0000100-°0100100 investigated.During the investigation,we cannot report your account ° 123456789 as delinquent or take any action to collect the amount in question. MoN-oGT 39 Watch here for a wEO-Nov 2' GENERAL INFORMATION UE-DEC'B personalized account 1.Payments received after the billing INVOICE date will appear on Important Ym g( ) PP Ibp„dO.pLdalLi,«UtLLlgb�.Ititl«N„Ilddq a:mmelx rno«1nv�'n4P.od�ae message your next invoice.Past due invoices(not paid within 30 days of news and ,nanv.r"•ro• billing date)may be assessed a late fee as allowed by law not to offers 1123M11 St .«aaenmea. exceed$20 per month.Additionally,third party collect ion/attorney otr,sta a WOOD 1«43,.d.96-A•«tLyn.Ltl"L«LLLLd.a expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed b law. "�'s"21"�"`° dagd,N91!v.- bb�++t�!;?`- °I ,, Pay electronically P Y ,„r...ann.mtleraare`"cmun;ain?aii�. �yrtnua0ca� ,gym^ 4`?.t�x'3 2.Each returned check is subject to a service charge subject to the OW maximum check return charge allowable in our State. 8 Y Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. CTviTV e amount has been since your ACCOUNT 4. Equipment replacement costs will be charged for bottles lost, Oewe Add,esa bhnoce•Ix3MmnstreeLO stmeo°°°° „99 paid in full to last invoice " stolen,damaged or not returned. ianCe avoid late fees Paymenomankroo 58 W 5.In accordance with NWNNs Terms and Conditions("T&C'•),your o&3, +6,898 s 0anan Nawlal sP�9w"" -soW Itt 3170�5,4M4 S Ice MOOnla�n SGal DeposM1 96 Equipment Lease and/or Service Agreement account may be B+„ BnseI s I�eMOUntamSGalRewm Monthly Oil Wm 3,7ee1141aE fle^i w,cna,9e:• subject to minimum monthly purchases and/or early cancellation 3,B363e6„ r+ Surcharge,Fuel fees.(A complete version ofthe currentT&C maybe viewed on the Wn3 ,664Da9> 5748 Surcharge or Delivery webstte 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. RR Mme — 17 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or - _ Information") Deliver Fee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUMMARY ao. ou _____ Delivery y y y HIS AMOUNT �— ——— PAY BY will apply to each account. The fee that applies to your account -----`-a'a••� ' -m�*,W-wr^•^`" ACCOUNTNum.ER s7ao is stated on the front of the invoice.For further information please •.. a,a,w,"w",«• 1334567890 BIU,WIDATE MT.ENCLOSED INVoICE NUMBER w1w/00 visit the website listed below or contact our customer service 1234561890 center. 16 7. As a food product, bottled water is subject to the rules and °42U0963U7 04262712619 °°°391049 2pp9 Amount due regulations promulgated by the Federal Food and Drug pnn Do Administration(FDA). ICE MOUNENN WATER COMPANY cty,s�amst00000 Submit your 8.Your first invoice indicates the products delivered on your first "DrvM°�d USro,,,EPSEmKE UU'-8004179880 delivery,along with any applicable bottle and account deposits, «aM«d6«d«« DR e ro payment b this redemption fees,and any dispenser charges.All future invoices !"dam 1„oPpnsg•opPa9�,•ao"R`Ye"sw` P n 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 Nest16 Waters North America Inc. Form No.NW 709 11/08 service.icemountainwater.com o service.icemountainwater.com ®� #215 6661 DIXIE HWY,SUITE 4 06/01/12-06/30/12 22F7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g ® a H I�I I ��I� I���I III I I II I MO JUL 06 7220327048 ill MO WED- 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 by phone at:1-800-472-9888.It's free! CARMEL IN 46032-2584 Retreshin Drinks Refresti'in " SaVins 6 "&$1fo TeseIect1baS—e—S F I I"A1. NINDS°8��F ag g� g Fora mited time erijo .,�"M ..: .r<wifl^A'. . 7.°T'" l SNUEETaLEAF"-6everages.'VVith prices this cool,Fbringanthe heat.Logonto servoce.tcemoun{tamwater.>:com�or:F . :rcall�9�"800°°-,472=9.8,8,8to;:acid�to'yoir.next�orcler W i sw";�y_a,.�.».:» ._. aas :" "S'�:� n��7`:•"sr."'�e`� u ». w:c. �.--•,., "—_,..r �., °'='svS^ r vr'��r' r'fia;' ":.,,:::. x;, f ,d's.'2��' .Z.• ✓=Y ..s s"::i^r° rr. ✓SR6 £�;"P .�°,° � Ar.'1'^' a,,;,a"L: �s�� xr%,?,C.,,,,'r„'1p� 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, CLERK I REAbURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 10.44 6/29 015013 PAYMENT-THANK YOU -10.44 6/06 0778742247 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 6/30 0783761232 1 OIL/FUEL SURCHARGE 2.96 F2840330 RENT 3.99 TOTAL 27.69 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 10.44 — 10.44 + 27.69 27.69 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. 12}456]990 Your Account Number You do not have to pay the disputed amount while it is being I 00100100-00100100 investigated.During the investigation,we cannot report your account A }23456]99 as delinquent or take any action to collect the amount in question. m9-ocr°' MDN-ocT 19 Watch here for a wro-Nov n GENERAL INFORMATION 0E-Mc 1. personalized account Important cl_ILp„all«auntta.ama,lab.aue"8"ttaau emce.l-000-4]2-9698 1.Payments received after the billing(INVOICE)date will appear on Im P your next invoice.Past due invoices(not paid within 30 days of news and k Yo^ 'ce Mounlal^vba�" message billing date)may be assessed a late fee as allowed by law not to offers 121-1 s1 exceed$20 per month.Additionally,third party collectionlattorney CaY,srace 000°° Laad..a9�•,�"at"'Mbtl.b»bbbba.a �.,r,�; expenses may be assessed at a rate not to exceed 100%of the ,. „ - P Y Pay electronically unpaid balance or the maximum allowed b law. --j:Rn+an+9c raxeaacfceY?'"..ri.dd�.• -:.': s 2.Each returned check is subject to a service charge subject to the _ Cr _ ';�: * .s"•'1. «-�= tea.. maximum check return charge allowable in your State. { o-, Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity g _�”t '`" pma e °°° "'u ACTIVITY. amount has been since your ACCOUNTACT�m M mSit—01y,Aa[e00000 ,, aid in full to last 4. Equipment replacement costs will be charged for bottles lost, invoi ce e,YAaalea+ b^n0°°' 99 P ce stolen,damaged or not returned. P„.a.aw^a 145 avoid late fees g Pay,,,¢m-mankrw soon 5.In accordance with NWNA's Terms and Conditions("T&C"),your m,31 o51e9. 5 50anon -so oo Equipment Lease and/or Service Agreement account may be "' }18851 ""A—'^sG l0•w^ "" "' 96 Month/ Oil g Y ,3, 3va.s44a4 s N.99 y Ice Moun[a�n 5 WI0.?^[^: subject to minimum monthly purchases and/or early cancellation °'^' 0q„] 31.]638811 6e.[ Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the S'� 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. T...TN1AT*"'^ _ '""""w 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or BP, Information") Deliver Fee as described in our T&C. Only one of these fees Payment stub ACCOt SUMMARY •c ou Delivery y y __ PAY TNIS AMOUNT will apply to each account. The fee that applies to your account ' -°�,,,�,,,„*�,L^w^^°”„1-nCCOUNT NUMBER PAY 6Y 11. •••�„a,,.,m. ao ao 00 is stated on the front of the invoice.For further information please '13651890 BILLING DATE MT.ENCLOSEO IN`101C45'89o0. w/w/0 visit the website listed below or contact our customer service 345'890 center. 04262712619 000391049 2004 16 h. As a food product, bottled water is subject to the rules and a4z00963o7 Amount due regulations promulgated by the Federal Food and Drug ^n^on Administration(FDA). ICE MOUNrNNAwTE "', ysrnm5 or000 8.Nbur first invoice indicates the products delivered on your first °n^°'°” Submit your delivery,along with any applicable bottle and account deposits, bbtwo �e ❑p,.c,,uAsmrooM..Ex�e9.E0er^¢BUU,a payment by this redemption fees,and any dispenser charges.All future invoices 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 _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. 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 IN SUM OF $ 0 Lt $ a� ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or P� "00q 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 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ PO Box 856680 Louisville, KY 40258 $17.02 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 12F0121776199 42-390.99 $17.02 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 Monda , July 16, 2012 Director, Ad4nistration 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)) 07/03/12 12FO121776199 $17.02 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