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213054 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $261.66 s�lofi�o. PO BOX 856680 CHECK NUMBER: 213054 LOUISVILLE KY 40285-6680 CHECK DATE: 9/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 72 . 51 02HO121202766 1125 4350900 58 . 59 02HO120095351 2200 4239099 38 .29 02HO120048525 2201 4238900 78 . 70 02I0119252823 1701 4239099 12H722032704 13 . 57 OTHER MISCELLANOUS service.icemountaInwater.com ®® 0 0 #215 6661 DIXIE HWY,SUITE 4 08/13/12-09/12/12 0210119252823 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED THU- OCT 04 0119252823 H�����I��I���IN II II fII� I M DID THU- DEC 01 TUE- DEC 04 MON- JAN 07 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at: 1-800472-9888.It's free! CARMEL IN 46074-8267 Save now through 10/31/12 on cases of"TRADEWINDS Cans. At dust 2 cases for$13,syou can mIX and match , from a variety of refreshing flavors. Offer includes cases of"�1RIZOIV?�Arnold Palmer: Call;1-800-472-9888 or .lo ddto your next delivery=!t "`- a a _ .. e. 7 A ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. --- Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400W.131ST ST,CARMEL IN 46032 PREVIOUS BALANCE 31.22 9/09 407762 PAYMENT-THANK YOU -31.22 9/06 0792339533 17 5 GAL ICE MOUNTAIN DIRK W/HANDLE 59.33 17 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 102.00 16 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -96.00 2 9 OZ PLASTIC CUP 50C/SLV 6.58 9/12 0795071349 1 OIL/FUEL SURCHARGE 2.80 13315762 RENT 3.99 TOTAL 78.70 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 31.22 — 31.22 + 78.70 = 78.70 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 sent you the first bill on which the error or problem appeared.You can SAMPLE INVOICE 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. I21ase]890 Your Account Number You do not have to pay the disputed amount while it is being 00100100.00100100 �r - investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. 123ase]a9 MON-OC,M Watch here for a µE6 NOY 21 GENERAL INFORMATION uE-DEC 1S personalized account 1.Payments received after the billing INVOICE date will appear on Important ,-,18.9]2-1888 Ym g( ) PP IbB�111„nldtn6lwlnLLlnL.;Jtln"a;Jlddn aaca"tts"""" mesa e your next invoice.Past due invoices(not paid within 30 days of news and n„".Y°°+"'°al^910`M°""°'"p g billing ate may be assessed a late fee as allowed b law not to ,"a um,• g ) Y Y offers c"Ys n exceed$20 per month.Additionally,third party collection/attorney c'"r.$td1 00000 I.d�d J aL.dl.".IL.dI b0 b"LLLLJ.tl expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. Pay electronically 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity �..v amount has been ACTIVITY. since our AccouNrACmn " paid in full to P g Y ceuarvAaare »n"0«,23Mamscrre alY,snl=00000 99 4. Equipment re replacement costs will be charged for bottles lost, last invoice stolen,damaged or not returned. P.raa°aBa�aMa a<s avoid late fees PaY"K^'-Twnk VOU 51.00 5.In accordance with NWNA's Terms and Conditions("T&C"),your , 96+098 s s�alm"Naw.al spa"9 wales -soo0 Equipment Lease and/or Service Agreement account may be m 3veas""` s ke Ma+p�l^swl ceps' - 2.96 g Y „ 31]8853HM M°""Mmsw °°"" _ 99 Monthly Oil subject to minimum monthly purchases and/or early cancellation IN I 3"0g51'°` '°esurtNl9" ° r Oy„2 3,826388++ ee", 5,.o Surcharge,Fuel fees.(A complete version ofthe currentT&C maybe viewed on the o9+'2 16fi40"' Surcharge or Delivery website listed below)Upon service discontinuation,rent for the IoTAL — Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. L c--------aY = •^Y* siw 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or E,,, ,AIAH --'��"rt .- , _ Information') Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUNTSUMMARY •,cou _- rY Y Y Y o ppY BY PAY THIS AMOUNT will apply to each account. The fee that applies to your account „-ales,-----w"^^"X-_ACCOUNT NUMBER sr,,o M•' „ay,en,�rtum..+u 123456]890 pp 00 00 MT.ENCLO5EO is stated on the front of the invoice.For further information please NvolcENUMBER 51, OAT visit the website listed below or contact our customer service pojo0j00 123956]890 center. 7. As a food product, bottled water is subject to the rules and 0,20096307 0"282'112619 000391049 20°° 1B Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). ICE MOUMPINµATFR COMPANH cns�a°es`00000 8.Your first invoice indicates the products delivered on your first ,owe”"111`"1"""""""'"` 0o.o]9eae Submit your delivery,along with any applicable bottle and account deposits, w cusT°MER5Em9cECU5,-° b this I.dad..J,.aL"JL.,.IL.d1960"b.LbLLd.a ❑aim Mn cw.,9•+au.a„•s;x. payment Y redemption fees,and any dispenser charges.All future invoices oPIPEEM„o,^n5;9"0P8.9w,aa0�"an,usw`_ .J. date will reflect charges for water delivered and dispenser rental,bottle O NLHO" -- 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 Sir service.icemountainwater.com NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER r ain IN SUM OF $ CITY OF CARMEL 856680 An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by KY 40285-6680 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. $7$ 70 Payee Purchase Order No. OUNT OF APPROPRIATION FOR Terms armel Street Department Date Due Y. -,: Invoice Invoice Description Amount INVOICE NO, ACCT#!TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s)) 0110119252823 42-389.00 j $78.70 1 hereby certify that the attached invoice(s), or 09/14/12 0110119252823 $78.70 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 A n �IFriday, Septeniber�21, ?012 St net,Commis�sioner�er Title :ost distribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance laim paid motor vehicle highway fund with IC 5-11-10-1.6 , 20 Clerk-Treasurer service.icemountainwater.com o #215 6661 DIXIE HWY,SUITE 4 08/01/12-08/31/12 02H0120048525 l it LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED THU- OCT 04 0120048525 BIDOB NMI �I I�ID�II II DI I��I00 DID THU- DEC 01 TUE- DEC 04 MON- JAN 07 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT OR JUDY STOHLER Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 �. .. v- r-: �a �e Save now througFi40131f12�on`cases of TRADENVIPIDS.Cans.At just 2cases for=$13;youcannix and match from a variety of.refreshing flavors;Offer includes cases of..ARIZONA=Arnold Palmer: Call-1!-800-4-72-9888,or . _ log onto service.icemounf`ainwater'com 4o add to your next delivery!,, . _ _�� A, a � . ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SO, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 49.46 8/26 331406 PAYMENT-THANK YOU -49.46 8/03 0788524247 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 8/06 0787816305 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 772 20.94 6 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT n��` ,�� .00 3 9 OZ PLASTIC CUP 50C/SLV N 4 sa 9.87 5 5 GALLON ICE MOUNTAIN DEPOSIT RETURN �+ RECEIVED j .00 8/31 H3127107 RENT / 3.99 TOTAL Q SEP 2012 � 38.29 M Cd CARMEL 4 CITY ENGINEER ti Ge tiZ S-6 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 49.46 — 49.46 + 38.29 = 38.29 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. 2 Your Account Number You do not have to pay the disputed amount while it is being / 00100/00.00100100 � investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. THR-D w 23456789 MOD-OCr M Watch here for a GENERAL INFORMATION MIJo-NM lUE-DEC 1B personalized account 1.Payments received after the billing(INVOICE)date will appear on Important Ibn„tn:nLatma�,nila.mua.tun"n;.uaan c a+q r x^�w"U00 message your next invoice.Past due invoices(not paid within 30 days of news and m,,,E,.a,l«q re"` loan DO. t .oe.arvl•... billing date)may be assessed a late fee as allowed by law not to offers 123 MB . exceed$20 per month.Additionally,third party collection/attorney an.stare 00000 expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. Pay electronically 2.Each returned check is subject to a service charge subject to the o ate; "'e"p�' BaB�9R 't °" maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ACTIVITY. ACCOUNT amount has been since your ACTNIT ° p9g123Ma1 s Fgt,orys ppD00 �= paid in full to 4. Equipment replacement costs will be charged for bottles lost, ceu�nAear�:_>on ,�.� ' last invoice stolen,damaged or not returned. Pm o.,BaRU�okYa sang avoid late fees 5.In accordance with NWNA's Terms and Conditions `T&C", our (� ) y BBI31 161890 5 SGalbn NawraI5D,1^9 Watn 5000 Equipment Lease and/or Service Agreement account may be m s Ike MOUntams_al, g Y wBB$I— gMwoumswlRpom u.99 Monthly Oil subject to minimum monthly purchases and/or early cancellation IN "'B"s""• ,, „B26308ll q.t Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the 9B1'= 16640"' ,�:�-;, ;_ 51- 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. __ Dta_�+Mt•' _ `A"""s7o 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a BawK 99 EHt L s„ _ Information") Delivery ee as described in our T&C. Only one of these fees Payment stub ACC U"SUMMARY c99w -------------- rY Y Y Y _ PAY THIS AMOUNT will apply to each account The fee that applies to your __°_°__-__---- PAY BY PP Y pp Y w6 W wm N F pn ACCOUNT NUMBER 5 40 is stated on the front of the invoice.For further information please °°•°�•",� 1234567890 9UU DATE MT.ENCLOSED NVOICE NUMBER 0U1D0100 I visit the website listed below or contact our customer service 12N567890 center. 7. As a food product, bottled water is subject to the rules and DV20096301 04262712619 000391049 2004 16 Amount due regulations promulgated by the Federal Food and Drug �oDn DOe Administration(FDA). IcrMouNra�NWATER °M,,,,�,." ys„ies`00000 8.Your first invoice indicates the products delivered on your first •0"^'°""° Submit your delivery,along with any applicable bottle and account deposits, wgcD3TDMEg3FwlcEUU, -' b this „aai wa.al•9�F,.6n,.,n.Ln„L.LLLLa"a �P MMRSEWKE RB. payment Y redemption fees,and any dispenser charges.All future invoices 0r0.ans9.0PR<wlrt600Rr•„<s�°e .` date will reflect charges for water delivered and dispenser rental,bottle s,6D0PE0RrREEA - deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Form No.NW 709 11/08 O 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 9/4/2012 02H01 Water Cooler $ 38.29 Total $ 38.29 I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6. ,20 Clerk-Treasurer ------- VOUCHER NO WARRANT NO. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF $ Louisville, KY 40285-6680 $ 38.29 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 02H01 2200-4239099 38.29 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 9/24/2012 Signature D� V r � Cost Distribution ledger classification if Title claim paid motor vehicle highway fund I' service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 08/01/12-08/31/12 02HO120095351 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g B e THU- SET 20 0120095351 THU- OCT 18 FRI- NOV 16 WED- DEC 19 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA Pay your bill online at:service.icemountainwater.com or 1411 E 116TH ST by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-3455 =IMPORTANT;Please be advise*at the involc n for�yo r ne delivery- ill reflect a ,rice Increase on select ._ 1. products:Please call us if you have any questions w� a _ i n_ s 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 59.37 8/26 331403 PAYMENT-THANK YOU -59.37 8/21 0790404107 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 23.94 3 9 OZ PLASTIC CUP 50C/SLV _`-- 9.87 BOTTLE DEPOSIT: 6 CHARGED, 4 CREDITED .`�• � 12.00 8/31 0792937765 1 OIL/FUEL SURCHARGE 5EP 0 d 202 g80 H3141621 RENT li uPfOWEL , ,\ 58.59 Description_C1�R� �� --_�------ P.O.# P or,; Budget ) C� i /CS L•,nE Descr Purchaser Date Approval ___`Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 59.37 — 59.37 + 58.59 = 58.59 1 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-80OA72-9888 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 t 00100 00100100 investigated.During the investigation,we cannot report your account .'I ' as delinquent or take any action to collect the amount in question. mB a 123456789 MDNDa:9 Watch here for a wF6 NW�� GENERAL INFORMATION NE-DEE,B personalized account 1.Payments received after the billing(INVOICE)date will appear on Important ih0:,ip;Ot,dWid+Al141,IN4'„At1A.il�llddtl anI�9sNe your next invoice.Past due invoices(not paid within 30 days of news and TH4nE Y°•'iuru message billing date)may be assessed a late fee as allowed by law not to offers 123 l�sl °„a,e..aa. exceed$20 per month.Additionally,third art collectionlattome ocys,lle X00 P Y party Y wday.d.m•-•n'^d4"tl'6(1 1..661.I,d.a expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. -;r°wna2v>q�`�'6FN•y�P"' i #CQ" Pay electronically 2.Each returned check is subject to a service charge subject to the 6 �",;;, `Y yota�� *•f°"° "a`H ' 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 AarvrTM s -" o`y"l OWW 4. Equipment re replacement costs will be charged for bottles lost, - 39nnD«, paid in full to P � •Delivery Addres 123M 5 1,.99 last in stolen,damaged or not returned. Prevl9usBa k 42's avoid late fees P1LIV-T6an" 5.In accordance with NWNA's Terms and Conditions("T&C"),your �,,, m,B9B 5 Sa°,wnN°,�,°ISParew°� /11 31786514 ` 0.e MquMain 50NDe— 9'� Equipment Lease and/or Service Agreement account may be 3vBes+•41 s meM9a�i„sw� Monthly Oil 5 Fuel SUiclu.9 ,r, subject to minimum monthly purchases and/or early cancellation o9n' 3'7Pas"'•° SurChar g e,Fuel fees.(A complete version of the current T&C may be viewed on the s'°0 N� Surcharge or Delivery website listed below)Upon service discontinuation,rent for the ToEAL — - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle s,�,q,H, "General in which service is discontinued. ,,,,,/.Pry D•* + ----- � •°YTM s'°0 Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge of 99 , Delivery ee as described in our T&C. Only ne of these fees Payment stub AccouNTSUMMARr .°•' W _ __--- rY your Y — BAY THIS AMOUNT will apply to each account. The fee that applies to our account °_______-- PAY BY PPY PP Y --•a,a,y,y,0.,e•m,�.,,.nN ra•vf"1°"°,•-ACCOUM NUMBER silo �� is stated on the front of the invoice.For further information please ,231567090 BI00 Coo DATE MT.ENCLOSED NUMBER /�/� visit the website listed below or contact our customer service INVOICE,234567690 center. 16 7. As a food product, bottled water is subject to the rules and 0420096302 042"2212619 000391049 zaD9 Amount due regulations promulgated by the Federal Food and Drug ionnI9 Administration(FDA). CE MDUN3NN WATER COMA Cry,5 Iy$1DD000 Submit your 8.Your first invoice indicates the products delivered on your first • Bo.7:9nBB delive 00.CUSTOMF0.5EMNEGLLIA payment b this ry,along with any applicable bottle and account deposits, I�ty,.64.•36•�db„gbp..G•bbWd^a "`•`"`sm`. P y redemption fees,and any dispenser charges.All future invoices nonmsa4w^�1pe°�^"�`�'° _ date will reflect charges for water delivered and dispenser rental,bottle - 0 y UP/ uFN 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 se rvice.icemountainwater.com MPAW.,FAY #215 6661 DIXIE HWY,SUITE 4 08/01/12-08/31/12 02HO121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED g ® e ME THU- SET 20 0121202766 THU- OCT 18 FRI- NOV 16 WED- DEC 19 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1-800-472-9888 MANDY SPADY Pay your bill online at:service.icemountainwater.com or 1411 E 116TH ST by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-3455 of � Save now through 'I O1,3=1I12�on cases of l RADEWINDS Cans. At just 2 cas s for$13; you'can ri ik and i>la from a ariety of re thing flavors. Offer chides cases of ARIZONA►Arnold Palmer. Call 1�-800 72-9888 0, x "log orifo<serviceacemo taitwater:ciim to add to your.nezt�dellve_syd s :✓u.. .q a%. a >e.'a.., >:: .. ^` �_,`a' 5e'a_ 0. .` 9.rY N.J` .. ap,.:. ". ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. B ® B 8 Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 53.16 8/26 331404 PAYMENT-THANK YOU _ _ -46.67 8/07 HA1895121 PACKAGED WATER ADJ ru" "�< _ 6.49 8/06 0788659951 7 5 GAL ICE MOUNTAIN DIRK W/HANDLE SEP 0 7 2012 27.93 1 9 OZ PLASTIC CUP 50C/SLV 3.29 BOTTLE DEPOSIT: 7 CHARGED 9,CREDITED -12.00 8/21 0790404156 2 9 OZ PLASTIC CUP 50C/SLV L 6.58 8 5 GAL ICE MOUNTAIN DIRK W/HAN&phase _ 31.92 . BOTTLE DEPOSIT: 8 CHARGED, MOREIDAREDD TEI�- !Y�CC 6.00 8/31 0792954356 1 OIL/FUEL SURCHARGE P.O.# P or F 2.80 H3222765 RENT G.L.#_J 09 I 5.99 TOTAL Budget 72.51 Line Descr Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT ��Subject to terms on reverse side. 53.16 — 53.16 + 72.51 _ 72.51