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211791 08/14/2012
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER s i CHECK AMOUNT: $191.20 CARMEL, INDIANA 46032 PROCESSING CENTER h PO BOX 856680 CHECK NUMBER: 211791 LOUISVILLE KY 40285-6680 CHECK DATE: 8/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 46 . 67 02GO1212202766 1125 4350900 59. 37 0260120095351 1205 4239099 13 . 62 0260121776199 1701 4239099 13 . 65 1267220327048 2200 4239099 49 .46 02GO120048525 2201 4238900 8 .43 0260117821082 service.icemountainwater.com •D / # 15 6661 DIXIE HWY,SUITE 4 07/01/12-07/31/12 0260117821082 LOUISVILLE KY 40258 e B e ADDRESS SERVICE REQUESTED 111111111111111 HIM �1'11III 1II FRID 0117821082 SEP 14 MON- OCT 15 MON- NOV 12 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT 3400 W 131ST ST Pay your bill online at:service.icemountainwater.com or CARMEL IN 46074-8267 by phone at:1-800-472-9888.It's free! .e Ref eshing Dr nks Refreshing Savings Fora limited time;enj,0y, 1 offtselect cases-of TRADEWINDS LL SWEET LEAF Beverages With prices thiscool, bring on the-tieat!Log onto service icemountainwater.comor _ cai'11-800-4729888 to_adtl to_vour next order! Offe r expires 8/31/12 ° r,_. ,. OA ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1.800.472-9888 or visit service.icemountainwater.com. ® B Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 10.24 7/31 188615 PAYMENT-THANK YOU -10.24 7/17 0784896128 2 9 OZ PLASTIC CUP 50C/SLV 6.58 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 7/31 0788189728 1 OIL/FUEL SURCHARGE 2.88 G2953845 RENT 3.99 TOTAL 8.43 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOU' Subject to terms on reverse side. 10.24 — 10.24 + 8.43 = 8.4. z s , 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 a the arts of our bill that are not in question. ` g PY P Y q 1234567990 Your Account Number You do not have to pay the disputed amount while it is being t °0100100-0°10D1� investigated.During the investigation,we cannot report your account r 1*3456789 as delinquent or take any action to collect the amount in question. n19-00 M _w z9 - Watch here for a GENERAL INFORMATION wEo-Nw=' DEC 1UE- ,9 personalized account I.Pa Payments received after the billing INVOICE date willa ear on Important ILp«dlt"pLdp01•IIllilp6�plp"p�dWdp Cmnm".sow°1-goo-3]z-9985 Y is ) PP v 1 MW"1,mwoa"•„ message your next invoice.Past due invoices(not paid within 30 days of news and n,,,,Ayo„1«"^9 billing date)may be assessed a late fee as allowed by law not to offers X123 m.i�51 00000 exceed$20 per month.Additionally,onally,third party collection attorney t0..dl.Na4.al.4°,.uaML46�"a expenses may be assessed at a rate not to exceed 100%of the ----�"�'��.�,,,°.,ebvr."' s unpaid balance or the maximum allowed by law. Pay electronically 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. s- ^a�- _ - ----^�" _•- Make sure this 3. All bottle and equipment de oasts are shown as CURRENT Activity ,.,,o,�.-• - I, amount has been ACTIVITY since your ACCOUNTARnm '1:3Na slree C .5 1.00000 aid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice ce"""''Adl "" P stolen,damaged or not returned. p,r W,9.�M. ♦]AS avoid Tate fees pmmzm-ma"EYw -m.ao 5.In accordance with NWNA's Terms and Conditions("T&C"),your ov31 �'� 5 swia,Namr.'Sw �i Equipment Lease and/or Service Agreement account may be m ;vees,aw ke,, d0•ws' - -- i� g y 3„�5,,,,, 5 Monthly Oil Mo"�u�swl ^'- subject to minimum monthly purchases and/or early cancellation °'"' 3']ees" ' 1„ds""'"'9`I'i„ jr'.;? ,t Surcharge, 89,17 319]638911 n°", : • FU¢I fees.(A complete version of the current T&C may be viewed on the 09"7 16bO"7 s'w �. i Surcharge or Delivery website listed below)Upon service discontinuation,rent for the rora — 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 Information°) Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUM SUMMARY 99 i ry Y Y Y a"ice•° _ pAY TNIS JAOUM wills I [o each account. The fee thata lies to our account ___"_______--- pAY 9Y apply PP Y v' a +" ACCOUMNUMBE ��w 5�a is stated on the front of the invoice.For further information please »• 123156]890 g531NG OATS MT.ENCLOSED INVOICE NUMBER /W/08 visit the website listed below or contact our customer service 123.56)890 � center. 7. As a food product, bottled water is subject to the rules and 0,20096307 00.252712619 0°°391099 a°0° 15 t Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). KEMou_I AnRR,c„°M� 123W�51000°° 8. Your first invoice indicates the products delivered on your first ^°^""°tlf""�' Submit your w0.cWoMER S9wlcE UUI-eow�]nm9 b this delivery,along with any applicable bottle and account deposits, aW,aL„11.40«u.44Ll,a.a s� ❑ s0is;,.. payment Y redemption fees,and any dispenser charges.All future invoices �sw” RrE" "rs�.,"pR•AU,�O.�•"• date will reflect charges for;eater 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. El&e M ountain Spring Water Company,a Division of Nestle Waters North America Inc. Form No.Nw 709 11/08 mountainwater.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)) 08/02/12 0260117821082 $8.43 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 $8.43 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 2201 02GO1 17821082 I 42-389.001 $8.43 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, August 09, 2012 Street Commissioner cam,+.2„+ �,.........,.....,,... Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.icemountainwater.com p #215 6661 DIXIE HWY,SUITE 4 07/01/12-07/31/12 02GO120095351 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g TUE- AUG 21 0120095351 THU- SEP 20 _ THU- OCT 18 FRI- NOV 16 :z J r � CARMEL CLAY PARKS AND REC DEPT. AUG 06 2012 Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA Pay your bill online at:service.icemountainwater.com or 1411 E 116TH ST t. —_dy phone at: 1-800-472-9888.It's free! CARMEL IN 46032-3455 �' 1111111111'11111���111���11111�'III�II'll'���"III�1�111'll'I�III Refreshing"D'rinks-°Refreshing Savings.For a limited time, enjoy $1. off select cases of TRAD,EWINDS 8 _ p a. ..rtt SWEET�LEAFr�Beverages�With�pn' s this cool; bring_on�t e`1%atlLog onto se Mcelddmountalnwater.corn'or 1call 1 800-472-9888 to add1to;your next order! Offer expires 8/31/12. a. IV- .� t r ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. _ v — g , Delivery address: P CARMEL CLAY PARKS AND REC DEPT.,1427 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 74.95 7/22 147594 PAYMENT-THANK YOU -38.77 7/31 188617 PAYMENT-THANK YOU -36.18 7/23 0786023515 7 5 GAL ICE MOUNTAIN DIRK W/HANDLE 27.93 2 9 OZ PLASTIC CUP 50C/SLV 6.58 BOTTLE DEPOSIT: 7 CHARGED, I51GREDITED 12.00 7/31 0788214377 1 OIUFUELSURCHARGE -!`.cription irl d r'""w`' '" 288 G2980995 RENT O.# t,, 1 �I PP orr F,, 9.98 TOTAL ^.L.# ��:J �`� l� tj �J�x�W 59.37 J e.Rescr&'fir' C r• � urchaser Date proval _Date B0/tI60LMN'ON wjoj w00'J91emuiejunow901'901/u9S V 'oul e0u9tuy y1JON SJ9jeM 914s9N 10 u0!S!A!d a'Auedwoo jaieM 6uudc wmunniAi ani onAl 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 we SAMPLE INVOICE sent you the first bill on which the he error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice • The dollar amount of the suspected error. Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. "• tz3.sa7e90 ,l your Account Number You do not have to pay the disputed amount while it is being / O01D0100-00100100 investigated.During the investigation,we cannot report your account tii'i 123456789 .I as delinquent or take any action to collect the amount in question. AWNDET:9 I Watch here for a GENERAL INFORMATION NE-DEC.• personalized account I.Payments received after the billing(INVOICE)date will appear on Important 140utn,�OydwL1,;11164104�d00„thUddU your next invoice.Past due invoices(not paid within 30 days of news and rynky.t• ke Mwnt P^ _ i, message billing date)may be assessed a late fee as allowed by law not to offers ,23li St ie ” exceed$20 per month.Additionally,third party collection/attorney °ry•s`a1e 00000 d4 g6L0.4.4t,4parU expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. q-- n�v. r .r«�'$"°"'°'?f ^ Pay electronically ro,.4.+9.rA+ , rax+aen'< r .core, 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. e F _,,.._ - y Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ,�„A,,.w,..•aY"^a:"*_".... '- - amount has been ACTIVITY. since your ACCOUrrrAaMTM -°= - ,n",5q Otr.s,,,eoo1w o.s9 paid in full to 4. Equipment replacement costs will be charged for bottles lost, De.YeryAeere+ last invoice stolen,damaged or not returned. e,;a,s.,mxe 12.45 avoid late fees P` r„.nkYw 50.W .f 5.In accordance with NWNA's Terms and Conditions("T&C"),your mn, .A3a9e Ilt 31]0.514H. 5 Ce MOUnmIns Wl Depovt_,,, Equipment Lease and/or Service Agreement account may be 3v.su.•• s 'keN.4„u;os�p�new.A" _�..rJ ,.99 Monthly Oil subject to minimum monthly purchases and/or early cancellation o9n, 3nees"•" ; waw`m•^x11`, '- „r 3,azwaen ae11 r r (7_t } Surcharge,FU¢I fees.(A complete version of the current T&C may be viewed on the Osr17 '6" 97 r ( S'� Surcharge or Delivery website listed below)Upon service discontinuation,rent for the m]At ---•--�' t Fee(S¢¢#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. A�,re.Y = ,,,,,,,: s.N�• 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or P.mW wA --�9nMeM ,�„�. t Information”) Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUMAraaY •, ....�„ ouNr tY Y Y Y PAYE PAY TMsw will apply to each account. The fee that applies to your account L"-•w-•�? „-,„,,----r^Im ACCOUNT NUmsm 57. is stated on the front of the invoice.For further information please %p°"" �� 73567.90 e'o oo DAR E ENCLOSED ,NVO,CENUMer. visit the website listed below or contact our customer service 323s17s90 mtmtm center. 1e .t 7. As a food product, bottled water is subject to the rules and pV2CO96307 04282712619 000391049 2p°" Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). w>o K e µw,8 Ea"CO ch•.,eS°0°°° Submit your 8.Your first invoice indicates the products delivered on your first � "a4�dcU:;,ao.P,tme s mt.46u,d.0 ID.CasoM.sm payment by this deliver,along with any applicable bottle and account deposits, redemption fees,and any dispenser charges.Al future invoices --__ date will reflect charges for water delivered and dispenser rental,bottle ❑s,crwvw.r.PE• -- - 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. service.icemountainwater.com ®® ® • •� © #215 6661 DIXIE HWY,SUITE 4 LOUISVILLE KY 40258 07/01/12-07/31/12 0260121202766 0 , ADDRESS SERVICE REQUESTED DID�DD�DI�ID�aIII �I aIII DIDI �I �� �I� ` Y �� TUE- AUG 21 0121202766 T " �i,', THU- SEP 20 THU- OCT 18 AUG 0 6 2012 FRI- NOV 16 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1-800-472-9888 MANDY SPADY ' 1411E 116TH ST Pay your bill online at:service.icemountainwater.com or CARMEL IN 46032-3455 by phone at: 1-800-472-9888.It's free! Refreshing,=Drinks Refrest ing Savings.4For a limited t me, enjoy $1"off select cases of TRADEWINDS`& w. SWEET LEAF Bev6'rages With prices this cool, ring dh the heaftp onto service emou tainwater corn or call 1-800,-472 9888 to add to�iourtinext orders Offer expires 8/31/12 7 m T o-. ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. UV Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 73.01 7/22 147595 PAYMENT-THANK YOU -33.75 7/31 188616 PAYMENT-THANK YOU -39.26 7/13 0785598293 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 7.98 BOTTLE DEPOSIT: 2 CHARGED, 2 CREDITED .00 7/23 0785598210 3 9 OZ PLASTIC CUP 50C/SLV 9.87 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 19.95 1 .5 L NATURAL SPRING WATER ICE MTN - C-&-tQCl-_l-EV BOTTLE DEPOSIT:DEPOSIT: 5 CHARGED, 5 CREDITED .00 >u,chase ,� �r`�a�cv m m 7/31 0788231108 1 OIUFUEL SURCHARGE- G3063575 RENT „criptiori _ P or p 5.99 3088541 RENT -, FREE C g0 TOTAL '' 3.L.# ' ' r �J� Ve .534-6- eoi<<soy MN'ON w,oJ woo•Jaiemueiunowaor oowas N lM 911aN;o uolslAlQ a Auedwoo jejeM 6uudS ulelunoyV aol 8002 n 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. 6661 DIXIE HWY.,SUITE 4 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 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 ®� 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. ,z3+s67090 Your Account Number You do not have to pay the disputed amount while it is being 1 100100.001 /00 investigated.During the investigation,we cannot report your account 123,56789 as delinquent or take any action to collect the amount in question. i R-oa Da MON W z Watch here for a WED-NON 11 GENERAL INFORMATION ,DE-DEC 10 personalized account I.Payments received after the billing(INVOICE)date will appear on Important an;„1lt,;al;dlllldn�tlad�i @k„d11pNt1„Ildda Cmmmtt SerrKe-1"80 729PP8 Thank MounulnptaA�N message Y our next invoice.Past due invoices(no[P aid within 30 days of news and billing date)may be assessed a late fee as allowed by law not to offers °z"3 &n ana u es WOOD exceed$20 per month.Additionally,third party collection attorney City.state i"goy d.N„,„11,,.dt..dGbnn6.4664q^p ;�--_ expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. Pay electronically 2.Each returned check is subject to a service charge subject to the x„q«,wDmmmnkryE,,anrmD73E �.+: �egarks,anal 6om°u' maximum check return charge allowable in your State. - - •_� Make Sure this 3. All bottle and equipment deposits are shown as CURRENT Activity _ _ �•^• '°°'" N,. —_°° x .- amount has been ACTIVITY. since your ACCOUNT AICrllnrY -` ctysare 00000 4. Equipment replacement costs will be charged for bottles lost, last invoice Der ens"* '°"°Oe'123M s ��.� paid in full to stolen,damaged or not returned. p,er;np.aaw^” <7.,s avoid late fees Payment-TNankYOU Water 50 UD 5.In accordance with NWNA's Terms and Conditions("T&C"),your s sca�^u'nswi s21 Equipment Lease and/or Service Agreement account may be m 3O�'a°'a Mo Monthly 011 al7eeslaa•N s - subject to minimum monthly purchases and/or early cancellation D9rn 318763001+ wars°"Nar9e,p �, Surcharge,Fuel D9I17 Pent fees.(A complete version of the currentT&C may be viewed on the N ,N1 97 _ Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TOTAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. _ °•�^ 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or E1,p,,,,a,,,„e Dt77�w `s w'Ta s'°0 _ Information') ACCOUNT SUMMARY 199 Delivery Fee as described in your T&C. Only one of these fees Payment stub �.,,.,�..au _ p.YTN.sgMDUNr will apply to each account. The fee that applies to your account ____•- wnw•�+^"'""°"P'�'°` gCCOUM NUMBER PAY BY sza is stated on the front of the invoice.For further information please „#•°"'mom 1234567a9a B0a1NCOAre Mr.ENCLOSED ,,cE NUMBER DDIDO1Do visit the website listed below or contact our customer service 113x567890 center. 7. As a food product, bottled water is subject to the rules and p42DD96307 04262732619 000341D49 2004 16 Amount due regulations promulgated by the Federal Food and Drug ro"n- Administration(FDA). ,CE MOUrrruN Wq,EPo ManP,„eA aNM cyswies'DOODD 8.Your first invoice indicates the products delivered on your first •D °^""°"""""'N Submit Your delivery, P cunoMEa sEPWCE UU+aDD 77-9aaa b this ry along with any applicable bottle and accoun['deposits, �,a,4Ne,u Yee. redemption fees,and any dispenser charges.All future invoices I.aa Md.a6..db..ab.,tt.6awy.�bbt.d.D payment Y will reflect charges for water delivered and dispenser'rental-bottle ❑swNDP7pq°PEE"UfO°""�'"°p ae9D^"�`je51°` date deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or fourweeks,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. 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 8/2/12 02GO120095351 Drinking water&cooler- Maint $ 59.37 7/3/12 02GO1212202766 Drinking water&cooler- MCC $ 46.67 Total $ 106.04 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$ $ 106.04 ON ACCOUNT OF APPROPRIATION FOR 101 General & 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1125 02G0120095351 4350900 $ 59.37 1 hereby certify that the attached invoice(s), or 1091 02GO1212202766 4350900 $ 46.67 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 9-Aug 2012 Signature $ 106.04 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com 0 Q #215 6661 DIXIE HWY,SUITE 4 07/01/12-07/31/12 02GO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 010 D DD��1 010 I II�01 III I I BBD 0 DID MOD- AUG 0 0121776199 WED- SEP 05 5 THU- OCT 04 THU- NOV 01 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 Refreshing Drinks.Refreshing Savings'IFor d limited ti ne; enjoy$1 offselect case's°ofTRA►b9W1 MS & SWEET LEAF Beverages With prices this cool,'bringxon,the heat!Log onto sew ice Icemountalnwater com or call-800-472 9888 to add to,you next order! Offer expires 8/31/12. - . �— - y M. a 9 zt ACCOUNT ACTIVITY For questions ora 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 17.02 7/31 188619 PAYMENT-THANK YOU -17.05 7/06 0783253297 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 9 OZ PLASTIC CUP 50C/SLV 3.29 BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED .00 7/31 0788240232 1 OIL/FUEL SURCHARGE 2.88 G2958451 RENT 3.99 TOTAL 13.62 p Q � AUG 13 2012 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 17.02 — 17.05 + 13.65 = 13.62 " ---------- -------- ---------------- ............. - ----- -------- ------ ---_-- ----------------- 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 we SAMPLE INVOICE 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 l 0°100100-00/ 100 investigated.During the investigation,we cannot report your account • 123956789 as delinquent or take any action to collect the amount in question. MON OCT M Watch here for a yED NW 2+ GENERAL INFORMATION UE-DEC 10 personalized account 1.Payments received after the billing INVOICE date will appear on Important ,.BDD 72-9Bee Ym g( ) PP �ll,t,tp4„dtttl"n�tudu c�sLOme<se^^`°. message your next invoice.Past due invoices(not paid within 30 days of news and top°111^p`d "' manE YO"'m ua�^9 g billing date)may be assessed a late fee as allowed by law not to offers 12 M111 S 1 exceed$20 per month.Additionally,third party collection/attomey 9,y'sute 000°° h nn4a.4o6LLi.d.a expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. .ma..ayiwfa,,,; k °'8a"` m'ac wC0`""'0 I Pay electronically 2.Each returned check is subject to a service charge subject to then=rr jpjgNV°'"',,; ,,, raa ` eAd"'.°""�"`s maximum check return charge allowable in your State. - Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ° . _-- ...-•ae^ °I'°"”`".°'• �--' amount has been ACTIVITY. since your Accourrr4Cm"TM "°°""`•- - cabs =00°°° aid in full to 4. Equipment re replacement costs will be charged for bottles lost, ceu.»:nA°d'^::�"^D°`�123M s "" p P last invoice stolen,damaged or not returned. P,e•IaaBalame az's avoid late fees Payme^,-t"anEYOU sO.DD I 5.In accordance with NWNA's Terms and Conditions("T&C"),your vent wte9e s swnD"w+w<ai sRa^Dwa"` -sO.oD Ill 31780S1NM ke Mamuln$Oal DepoaR 295 Equipment Lease and/or Service Agreement account may be �„ 3n0evaw 5 ,ceMOUntnf^syaiRnwn ,,.99 - Monthly Oil subject to minimum monthly purchases and/or early cancellation 09r" jO�s"ate wets°""""�" i' Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the wn 3s � RM1 r s'w 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. Da N.aNDY = •"Y TM"i w` 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or „aMk -- "�,.,eM` "' , Information') SUMMARY 99 Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT -- "a•W rpr rdrs pMOUNr will apply to each account. The fee that applies to your account - -- I--- -- X* -pccouNr NUMBER PAY By maD _�•��gy,dp mO nwm MUD 123x56)890 ��� ENCLOSED is stated on the front of the invoice.For further information please AWOKE NUMBER MWNLDATE BIT, visit the website listed below or contact our customer service o0/oo/DD 12345fiJ890 center. 7. As a food product, bottled water is subject to the rules and _ 0420096307 04282 zsi9 000391oV9 zoav 1B Amount due regulations promulgated by the Federal Food and Drug ph^0« Administration(FDA). KEEMMoUrR� „o„°A' cL3y.ts00000 Submit your 8.Your first invoice indicates the products delivered on your first ray LDnoAA,___CALU.8 02-98^° delivery,along with any applicable bottle and account deposits, umd..a ^Jt«d4 0,4a„4,u4t.d;a ❑om• payment by this redemption fees,and an dispenser charges.All future invoices 5iO` ,•"w„,o^R date P Y P �' swND•.DALnecAUaPns9OCxdwem will reflect charges for water delivered and dispenser'rental;bottle 0 -" deposits and credits plus charges fort 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- 0 2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. Form No:NW 709 11/08 Sservice.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. Term s Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 08/02/12 02GO121776199 $13.62 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 Ice Mountain IN SUM OF $ PO Box 856680 Louisville, KY 40258 $13.62 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1205 0260121776199 42-390.99 1 $13.62 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, August 13, 2012 Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.icemountainwater.com O D O #215 6661 DIXIE HWY,SUITE 4 07/01/12-07/31/12 02GO120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED e ® e MON- AUG 0 0120048525 WED- SEP 05 5 THU- OCT 04 THU- NOV 01 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT OR JUDY STOHLER YOUR ACCOUNT IS PAST DUE and is subject to 1 CIVIC SQ additional late fees.Water delivery service may be CARMEL IN 46032-2584 interrupted. Please make your payment today. For your convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. ��, '�!.�,� . :•'a;,, �-�.�.�._ a .,..+m .:. ����-g .3 ���. .gym � ' � - x�xa��,.,. Refreshing Driis. RefrsMingSa�ings. Fora IirnitecJ time,enjoy$1 off s_e,tect cases of'TRAD;EWtND,S78- SWEET LEAF;Beverages.Wlthmprtees�this cool, bring on'�the heat!Log onto�senr�ie�rn``�`ountaInvliaterrcorn or , : call -800-4729888 to°adcl to=y�our next-.order! Offer expires 8/31 1r2:� �° >� �• ~. �� P ✓4� � �� fir. �f ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 28.52 7/31 188618 PAYMENT-THANK YOU -7.28 7/06 0783253255 1 9 OZ PLASTIC CUP 50C/SLV 3.29 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 20.94 6 5 GALLON ICE MOUNTAIN 6 5 GALLON ICE MOUNTAIN DEPOSIT RETOURN Sji�$� 00 7/31 G2966115 RENT / r �a� 3.99 TOTAL ' 49.46 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q Subject to terms on reverse side. 28.52 — 7.28 + 28.22 = 49.46 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 p an error. You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being I 00100100-00100[00 1234567890 Your Account Number investigated.During the investigation,we cannot report your account < 4 1234567 as delinquent or take any action to collect the amount in question. TH8-OCT MOH-W 29 Watch here for a GENERAL INFORMATION personalized account I.Payments received after the billing(INVOICE)date will appear on Important @ ON10«6LdU11,Iwt1thl:laL;MdtIa.�I.+Ndk annnw S<,vic<:1-e0oa7z-9s°° your next invoice.Past due invoices(not paid within 30 days of news and g e I„nn man%M«•,,,a,9k`M`"" messa billing date)may be assessed a late fee as allowed by law not to offers 121 Mlis u ° exceed$20 per month.Additionally,third party collection/attomey cnys,m< 00000 I.doa.d m•at.« d4«tl„b0 G 66b4d.EI � expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. t y m•m�`ya* ,. ,I Pay electronically 2.Each returned check is subject to a service charge subject to the order maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ''* .,.,,... '` •..� •^°”"°°"' I amount has been ACTIVITY. since your ACCOUWACT^REY ° p1X 4. Equipment replacement costs will be charged for bottles lost, Add 123 Son„Oe<,,z3Mama,«,.cm,�lppp0°° n.99 t paid In full t0 last invoice stolen,damaged or not returned. °,<„ouaalaK< 42A5 s { avoid late fees ( ) y 5 Galbn Natual5p'^9 -S 2% Y 5.In accordance with NWNA's Terms and Conditions "T&C”, our Den, ab,�e S 71, 3,7ea5,44e+ 5 k<MOUntain s6alcew�^. ... ��? x.96 Equipment Lease and/or Service Agreement account may be ,,, 3,7easi4 5 ,«tun«nc�nsrupl-8�eamt i 1799 Monthly Oil subject to minimum monthly purchases and/or early cancellation p9"' 311�5'4MH 'op5ur6a9`g '€)tit.' It Surcharge,Fuel fees.(A complete version of the current T&C maybe viewed on the Surchar a or Delivery g website listed below)Upon service discontinuation,rent for the TorAC -- Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. °"YTM""a� - -•^^�"� `"`-"-`=� — Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or w"•a 99 , Deliver Fee as described in ourT&C. Only one of these fees Payment stub ACCOUNrsuMMAay EeYK Y Y Y ✓ r ...arc PAY THIS AMOUNT GAY 8Y will apply to each account. The fee that applies to your account ______� ,�,„„.„,,;,a,,;Gm�^+ ACCOUNT Nua4sEx w100 5,+0 is stated on the front of the invoice.For further information lease 123+567890 onTE Mr.ENCEOSEO visit the website listed below or contact our customer service ,NVoICENUMeEB e1�"�1� 1234567890 center. 1 0,20096307 0,262712h19 0003910,9 200, 1L 7. As a food product, bottled water is subject to the rules and ,} Amount due regulations promulgated by the Federal Food and Drug pnn o9< Administration(FDA). iC,McUrnr ATER COMr,a".ti a.sue 5[000°° Submit your 8.Your first invoice indicates the products delivered on your first •DN"°”" ET,,EE,.em,7z98aa delivery,along with any applicable bottle and account deposits, t.�, a,t,a„t,,,yaui®. ❑ �, ,�96�. -j, payment by this redemption fees,and any dispenser charges.All future invoices u,ownSm000•9�Len,e<«,�• - _ ,.,,,m,..�. date ,w oew�a .,, 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 08/03/12 15: 37: 37 EOT *** FAX ON OERANO *** Page 2 of 2 #42546 I7= MaMV Mal '! .• dr. i CCU PU t'a' #215 6661 Dixie 14"Suite 4 7 2*0 6*0 7 ACCOUNT NUMBER PAYTHIS AMOUNT PAY BY Louisville,KY 40258 0120048525 42. 68 06/22 FOR CUSTOMER SERVICE CALL INVOICE NUMBER INVOICE DATE AMT.ENCLOSED 800-472-9888 02F0120048525 05/31/12 PAYMENT ADDRESS: BILLING ADDRESS: CITY OF CARMEL DEPT OF ENGINEERING 1 CIVIC So CARMEL, IN 46032 ADDRESS CHANGES: ❑ Check Box and Print Addmw Change On Reverse Side Of This Stub -----------------lhncb TVs sla6MaReamrwrtbroc,ra-- ---------------- FOR CUSTOMER SERVICE CALL— ACCOUNT 800-472-9888 ACTIVITY DATE REFERENCE NO. QTY, DESCRIPTION AMOUNT PREVIOUS BALANCE 174. 90 05/13 761652 PAYMENT-THANK YOU -24. 53 05/10 EA1832369 WATER ADJUSTMENT -129. 13 05/07 0774302517 5 5 GAL ICE MOUNTAIN DRK W/HANDLE 17. 45 05/07 0774302517 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 0. 00 05/07 0774302517 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN 0. 00 05/31 E2657935 RENT 3. 99 TOTAL 42. 68 PREVIOUS BALANCE PAYMENT/CREDIT CURRENT ACTIVITY PAY THIS AMOUNT 174. 90 153. 66 + 21. 44 42. 68 Refreshing Drinks. Refreshing Savings. For a limited time, enjoy $1 off select cases of TRADEWINDS & SWEET LEAF Beverages. With prices this cool, bring on the heat! Log onto service. icemountainwater. com or Gall �o��e +., add is yewr RON4 erEIeF-!-9Ffe-r erEPj:res 7{3112 DELIVERY ADDRESS: UPCOMING DELIVERIES ACCOUNT NUMBER PURCHASE ORDER . 72*O6*07 CITY OF CARMEL MON-AUG 06 0120048525 1 CIVIC so WED-S E P 05 INVOICE NUMBER INVOICE DATE CITY ENGINEERING DEPT THR-OCT 04 CARMEL, IN 46032 THR-NOV O1 02F0120048525 05/31/12 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 8/2/2012 120048525 Water Cooler $ 49.46 Total $ 49.46 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 $ 49.46 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 120048525 2200-4239099 49.46 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 8/13/2012 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund se rvice.icemountainwater.com ®0 0 1111-am #215 6661 DIXIE HWY,SUITE 4 07/01/12-07/31/12 12G7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g MOD- AUG 0 7220327048 WED- SEP 05 5 THU- OCT 04 THU- NOV 01 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 ANN DAVIS Pay your bill online at:service.icemountainwater.com or 1 CIVIC CARMEL ION 46032-2584 by phone at: 1-800-472-9888.It's free! Il�l����l�illl�llll�l�ll�l�l��llll�llll��lllll�ll�lll��l�l�l���ll Refreshing Drinks. RefreshirgSa�ings. For a lirnitedtime, enjoy$.1 ofF select cases of TRADEW.INDS & S�INEET LEAF Beverages.With prices th,is�cool; bring on the heat►Log ont"o�se ce cemountainwater corn ors °call 1 800-472=9888°to.atic!to your neztorderl�Offer�expir�es�831/�12 � `"�°� �'�- 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 TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 27.69 7/31 188620 PAYMENT-THANK YOU -27.69 7/06 0783253438 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 5 GALLON ICE MOUNTAINDEPOSITRETURN .00 1 9 OZ PLASTIC CUP'50C/SLV, 3.29 7/31 0788314409 1 OI UFU EL SURCHARGE,",, 2.88 G2994643 RENT 3.99 TOTAL 13.65 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT ��r Subject to terms on reverse side. 27.69 — 27.69 + 13.65 = 13.65 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. •• 1z3ase]890 Your Account Number You do not have to pay the disputed amount while it is being I 00/00100-00100100 investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. HR-CCI w 123456]89 MON-W 79 Watch here for a GENERAL INFORMATION w ], nE.DEC Dfc,e personalized account I.Payments received after the billing(INVOICE)date will appear on Important lnu»intauwaoua»,npxina.�dt�a«�«Haan c°�°""'Sen7MO9n1a�Prod9uctz message your next invoice.Past due invoices(not paid within 30 days of news and nanRYweo,^�^9'Ce billing date)may be assessed a late fee as allowed by law not to offers 123 M-il s' ana.e •, exceed$20 per month.Additionally,third party collection/attomey Cjystlte 00000 m.tl„6a.0^u LWA I:dn.L a ar._I.1.... .. ..... expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. Pay electronically d'.[aASSLL'CE} kKCP1A s 2.Each returned check is subject to a service charge subject to the • rdlr�.wY� J .. '� ��a xr` y maximum check return charge allowable in your State. � �• ° Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ' °"°^”" amount has been ACTIVITY. Since your ACCOUNT acT'vm 4. Equipment replacement costs will be charged for bottles lost, last invoice 'DerrvenAddrPSS:,On^ •13Ma'^s,. .C'w.5ta'epp00° paid in full to 99 stolen,damaged or not returned. Prey....B...... z<s avoid late fees Payment-ThanEYw 50.08 5.In accordance with NWNA's Terms and Conditions("T&C"),your osn, a6,898 5 s�aiwn Na,^.a'sPd^9"'atp1 -so ge Ilt 3,78851aa� Ice MOUnuln$WIDeWsR ,- 7"� Equipment Lease and/or Service Agreement account may be vees, + s me MO^^tans IR 99 Monthly Oil o9n 3neRS.aa fle^i s�,mar9 T 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 ��'] 166pp091 1 s7 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 PAyHI5MO0N in which service is disconnnued. AC,NI,r = s1.w , 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a,,,,,,, ' `"`+COP`"`s°° _ Information") Delivery ee as described in you T&C. Only ne of these fees Payment stub ACCOUNT SUMMARY eo c99W ry y y ✓ " -- PAY THIS AMOUNT - PAY BY 5].M will apply to each account. The fee that applies to your account ___"-" ;,�„�em.�N ya�Pm • ACCOUNT NUMBER � is stated on the front of the invoice.For further information please 123CE NUM gILLIND DATE MT.ENCLOSED INVOICE NUMBER visit the website listed below or contact our customer service 1234567990 w/wil center. 7. As a food product, bottled water is subject to the rules and D92UD96307 ❑42°2712619 0003110'19 Amount due regulations promulgated by the Federal Food and Drug Ia,nD« Administration(FDA). ICE MOUNTAIN MATER COMPANY 123 Main St „aN•„aw.u„N•,e,.�. 00000 8.Your first invoice indicates the products delivered on your firs[ C State Submit your POR COSTOMER SERVICE CALL 1 800-t)1-9888 delivery,along with any applicable bottle and account deposits, • payment b this .aaa9a.w6 y.as.,nneaA6.uu6r,a�oRre,,. ❑Nm date y redemption fees,and any dispenser charges.All future invoices ❑sION P`ORfREEA,rOP,,s,Y^OPR•Re�. - 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 O service.icemountainwater.com — Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.207(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. �I ,n ALLOWED 20 IN SUM OF $ To I Lu q-cmi $ (�, ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#//TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the �] materials or services itemized thereon for which charge is made were ordered and received except /4 ' 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund