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215668 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $408.46 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 215668 LOUISVILLE KY 40285-6680 CHECK DATE: 12/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 314 .47 02KO121202766 1125 4350900 51 . 34 02KO120095351 1205 4353099 3 . 99 02KO121776199 2200 4239099 21 . 24 02KO120048525 2201 4238900 17 .42 02KO117821082 service.icemountainwater.com ®® N #215 6661 DIXIE HWY,SUITE 4 11/01/12- 11/30/12 02K0117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® e THU- DEC 13 0117821082 1I 1 111 1111 I N1 I I I I BI1 d I IMINH N WED- JAN 16 FRI- FEB 15 TUE- MAR 19 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT 3400 W 131ST ST Did you forget about us? Kindly pay upon receipt. CARMEL IN 46074-8267 Remember,past due accounts are subject to a late fee. Your prompt payment is appreciated. For your III"ICI"��"I'III'llll"II'II'lll�'��II"III�'I"�I"I'�'llllll convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. , ..x;i a =: es;i' .'r . '.`xsr,.:� .. F Be read gfor,.a11'thi ears° X t ratu - Mow hrough 1'2L31- 5 ` e „* -. Y -> f Y� m INN' ., �4,th . .�12;Pen�oy saving's onhca"se5 of�iAC:Qt1AaPAlV[VA h �" ....v_.. .n>.� .SM,.,,a,^.a',. '>. .,'�ii'' ,;:t :yr,^.�:sr ".z -S.PELLEGRINO SAN;PELLEGRIiVO SP�ARKLIiVG FRI)IT BEVERAGES &tlPERR1ER=NCall 1=800=4.72-9888For=logy ''` service icpmossriti»seiter�'�ca�a to iar"riP av .✓ �.�. ,1 .P,';' F 6vvd� 'q.�'P. �C ✓9�.n. `F. �^,.�'f�ias_: v'y.Y.' %j� �,�d'q�"P 07, , C", ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 34.20 11/04 710514 PAYMENT-THANK YOU -17.06 11/13 0802582031 3 5 GAL ICE MOUNTAIN DIRK W/HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 11/30 0806539953 1 OIL/FUEL SURCHARGE 2.96 K3593055 RENT 3.99 TOTAL 34.56 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT _ CURRENT ACTIVITY 'PAY THIS AMOUNT Subject to terms on reverse side. 34.20 — 17.06 + 17.42 = 34.56 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2• Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800472-9888 OR WRITE US AT: your 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 pp� ® must hear from you in writing no later than thirty(30)days after we SAMPLE P L E I IV VOI C E 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. 00/001°° z3ascrevo Your Account Number You do not have to pay the disputed amount while it is being oo/oo/ao- , investigated.During the investigation,we cannot report your account . . ° as delinquent or take any action to collect the amount in question. ta3ase7a MU+OR Watch here for a GENERAL INFORMATION No- ,A personalized account 1.Payments received after the billing(INVOICE)date will appear on Important 16A.•1p..G6alAM•�tIQ•4IB6.JFItl.6,�flJaP! your next invoice.Past due invoices(not paid within 30 days of news and message,i„�,a°.�°9k• billing date)may be assessed a late fee as allowed by law not to offers !i h�s exceed$20 r month.Additionally,third f'0''s�" 00000 _ h per y party collection/attorney ,at..n.6u-�•-wM+<Wtl �,,,� expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed law. • ., "^s. <. 0" is? ;""'e; rd %.y` [ Pay electronically P by < £wms bran crnereYa e 2.Each returned check is subject to a service charge subject to the ? ecru»m ;,,,& "" �.•#3° '„`;�<,, "�? x' { q;:t., •ems.*k�aee`troc"°°f,.�"` wt:..:: "s,. maximum check return charge allowable in your State. Make Sure this 3. All bottle and equipment deposits are shown as CURRENT Activity 'e�;�%t r` -..�.- " yam' °'°"`""°°"""�� ,,,,,�•�•�<��^'"""m"" amount has been ACTIVITY. Since your ACCOUMACmm 4 4. Equipment replacement costs will be charged for bottles lost, ,omooe,z3rnamsne•consmceow0u i paid in full to Eq P aB 4 °cei«en Addresx �� t last invoice stolen,damaged or not returned. p,e"u,:T�iw�wrw x.Ax avoid late fees 5.In accordance with NWNA's Terms and Conditions("T&C"),your Equipment Lease and/or Service Agreement account may be zees«« s eMW�u',�sc°ia�°•^�'" ,, Monthly Oil p9/11 31r�51M.4 subject to minimum monthly purchases and/or early cancellation 31036,x„ w•'s°"""� t,°(•.';�i�'a'.'z,'. >a Surcharge,Fuel E fees.(A complete version of the current T&C may be viewed on the 041,1 "bgp1z Surcharge or Delivery website listed below)Upon service discontinuation,rent for the FCC(See#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. " `"" = M.m+x" t Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or ,.r„o„wA•« ,a.,oc Delivery Fee as described in your T&C. Only one of these fees Payment stub AccouNrsuMMARV pgYlNisAMOUNr will apply to each account. The fee that applies to your account AccouNr euMaEa "AY B a is stated on the front of the invoice.For further information please � ,zusczavo a wNG SATE .O+aosro i 'VOICE NUMBER � visit the website listed below or contact our customer service ,z3 1 78 /W `4 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 °0°391049 2°°4 is Amount due regulations promulgated by the Federal Food and Drug !on�ooe Administration(FDA). ICE p=WMN wAM C„°� c,ysamst0oo°0 8.Your first invoice indicates the products delivered on your first 'R ,awzzv,,, Submit your delivery,along with any applicable bottle and account deposits, 6atayJ�d6"a6 n.t•a•d<„tt,6t,aa hm .SEMCE ,I payment by this redemption fees,and any dispenser charges.All future invoices ,un�•edO^^`"`°`s'Oe _ _ ,...._-—� 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 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 08/12 service.icemountai nwater.com VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $17.42 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members 2201 102KO117821082 I 42-389.00 j $17.42 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 Friday, December 14, 2012 P f' Street,Commissioner Sweet 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)) 12/04/12 02KO117821082 $17.42 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 ®� #215 6661 DIXIE HWY,SUITE 4 11/01/12- 11/30/12 02KO121202766 p LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® 0104 9 W 01 a I e II�I II I�I I I SDI I I I III I I I I I I I II B 811 WED- DEC 19 0121202766 WED- JAN 23 ----- FRI- FEB 22 MON- MAR 25 CITY OF CARMEL PARKS DEPARTMENT DEC Q Ruiz Customer Service: 1-800-472-9888 MANDY SPADY Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST I�t� CARMEL IN 46032-3455 �L3 j ; Remember,past due accounts are subject to a late fee. Your prompt payment is appreciated. For your IIII"1111"III'1'lllllll'II'II�II�IIIIIIIIIIII'lllll""III'll" convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Be�reaciy for all=this=year s celeb afions i�ow°thro,:ugi 12t31/12,4ipp�,oy�sawngs:on:cases.of ACQUA�PANNA;r` S PELLEGRIN6W10"J NkPELLEGRIIN0,bFAKKLINGIFRUIT BEV,ERA'GES xPERRIER�Call 1 800=472 888 or log° - "'r'as,- �»`':° F ' i� r °svl.- `'•'� .�z:ire^: W�"_,wt i�water-conto service icemouritai �r ..*,r�;?, rL" ,+-" 'a' , ..ta' �' _�a• ,i• _�,�.. �',Y�""^� ., �,,.1'`�,Cr'-. r:__ �z�e:.��S�°.�uua'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 PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 109.19 11/04 710510 PAYMENT-THANK YOU -86.52 11/12 0803424795 18 5 GAL ICE MOUNTAIN DIRK W/HANDLE 71.82 BOTTLE DEPOSIT: 18 CHARGED, 7 CREDITED 66.00 11/16 0803508332 17 5 GAL ICE MOUNTAIN DRK W/HANDLE Ole(] lanadri ' 67.83 3 9 OZ PLASTIC CUP 50C/SLV ale(] Jeseuoand 9.87 BOTTLE DEPOSIT: 17 CHARGED, 2 CREDiTFD 90.00 Jose(]eurl 11/30 0806576088 1 OIL/FUEL SURCHARGE I pn'c,1 2.96 K3704767 RENT 5,99 Purc lase � y'A �'l��' Des ription TOTALD: Gli f!U d Jo d #.O.c' 337.14 P.O.# P or F urn(1.1)oF-ar; G.L.# X09/- Budaet Linn Des Purchaser Date "'-�vai ACCOUNT SUMMARY US-BAt p'C'E—PAYMENT/ADJUSTMENT tRENT ACTTY PAY THIS AMOUNT Subject to terms on reverse side. 109.19 — 86.52 -¢- 314.47 = 337.14 0. 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 an 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. •,iP� You do not have to pay the disputed amount while it is being oo/oaroD- OWOOIDD 1234567890 Your Account Number investigated.During the investigation,we cannot report your account 1 2345678 as delinquent or take any action to collect the amount in question. 1HR-oa a NON-oa ! Watch here for a WEP NOV 11 GENERAL INFORMATION NE-Mc personalized account 1.Payments received after the billing(INVOICE)date will appear on Important �at16N6 as°a;,gddtl ascanR W.laO0 472-9686 message your next invoice.Past due invoices(not paid within 30 days of news and t68.°116gbaAGt, n„°EY°"1« 9'R'"°'""''"P'v°"' billing date)may be assessed a late fee as allowed by law not to offers 123 exceed$20 per month.Additionally,third party collection/attomey m MO,,,,a,.,n.t,a,.¢. •t�d'•a expenses may be assessed at a rate not to exceed 100%of the Pe Y unpaid balance or the maximum allowed by law. Pay electronically 2.Each returned check is subject to a service charge subject to the--- _ _ ___ _ xs ^�"�^ ar• V -- maximum check return charge allowable in your Stale. - y'= "-'�- -• � ' .�"'".a°:.' a " `1=8 °.,.-- �R.,,.•,°,,,,. i Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY, Since your ACCOUtrt ACTM1Y 4. Equipment replacement costs will be charged for bottles lost, last invoice O+N.rvMdm b6RDce'23W Stnc,.Cry5b20R90R xxxx paid in full to stolen,damaged or not returned. °,.e=we x avoid late fees 5.In accordance with NWNAS Terms and Conditions "T&C", our Rem .e,e9RLm4_ ( ) Y s s"c,i�,wR�saM9w°nY pia ,l 3,]8e614M4 5Ga1 DeR°�' Equipment Lease and/or Service Agreement account may be �„ 3,]aes,4w s ,4�OUpvnrtan3GalRewm w '_ „I x � Monthly Oil 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 Surcharge or Delivery website listed below)Upon service discontinuation,rent for the roru Fee(See#G under Leased Equipment is charged through the end of the billing cycle ° in which service is discontinued. General� °"`"°°°`x = MY�xx�` Information 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or °„D, �++ ,aw+ „°,R, _ Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMW M°..a -- RprTM1S ouN will apply to each account. The fee that applies to your account " - «, -M* �c�uuNrNUMUR my BY is stated on the front of the invoice.For further information please "^ ,234567-90 swNCO6n c ENCLOSED �Ny12[567990 OOIW/eD visit the website listed below or contact our customer service u3+s6]a90 t center. 7. As a food product, bottled water is subject to the rules and 0420096307 04262712619 000391049 2004 16 Amount due regulations promulgated by the Federal Food and Drug 4,,,,049 t Administration(FDA). i� ,".w,..,co--° - _ caM eupppp0 Submit your 8.Your first invoice indicates the products delivered on your firstLU L,.eep.1]1-9e� delivery,along with any applicable bottle and account deposits, payment b this redemption fees,and any dispenser ch arges.All future invoices El 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 Nestl6 Waters North America Inc. Form No.NW 709 08/12 service.icemountainwater.com service.icemountainwater.com ®® #215 6661 DIXIE HWY,SUITE 4 11/01/12- 11/30/12 02KO120095351 G LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED �I�D�0�10�I I ����01 NMI MUM����I� �I� WED- DEC 19 0120095351 WED- JAN 23 FRI- FEB 22 . �� MON- MAR 25 DEC CARMEL CLAY PARKS AND REC DEPT. D 0 2012 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'I'll"I�I'III'�II'llllllll'1111'I�'llll'll��l'I�'I'�'�I�I"I��I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. -- 1 , .,9,�3`:a,. - =Be ready ig,all'this�year's�elebrations: Now"throu fi 12L3.1i/1>2 enjoy avin s1onPca ACQUi4�PANNA �. . . _ate r T X g. a,. >g 6 sespof "' £S RELLEGRINO�SANxPEL�EGRINO SPARKLING FRUIT BEVERAGES`8«PERRIER: Ca11 1=800 4T2=9888 or log -°; ✓��°�? ontoservlce:'iGemo ri a4 wa - -- U t n ter!:corn,,voralirltocia, �. % ,¢,' ,die° ` °P"'.r% rY:zT^t.`" v _ •, :,,� �.� 'z^" ,r ->a� �.�"`. '" ::n �� .,�•, „9'�'�Yy�,,:".� ems- 6,.r_e. :,. M' £., -- x�.-^J e,� .d°�.F.r�.srp, ''s.,:i`gym. ..a'=, ,C'..' n`Q.'�✓:°� �" °,�'�' >r'' '` �"�.";' z, 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 38"72 11/04 710511 PAYMENT-THANK YOU -4.61 11/16 0803508290 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 19.95 5 9 OZ PLASTIC CUP 50C/SLV 16.45 BOTTLE DEPOSIT: 5 CHARGED, 5 CREDITED .00 11/30 0806561247 1 OIL/FUEL SURCHARGE 2"96 K3623916 RENT o,aa I?AO.:ddV 11.98 t !rchass TOTAL alea aasEgo:nd 85.45 Descrip�;.on � aose.C,aur-I P.O.# P or F �Pnd Budget :4 Jo d #'O'd Line Descr uo:id!jos:=U Purchaser _Date asi yoar•d 4pproval DL4e ._ � ���„� �, sl.� �_� � VCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 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. !6216 6661 DIXIE HWY.,SUITE 4 If you prefer,you can pay your bill online at serviee.icemountainwater.com 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. 3z3+s67s90 it Your Account Number You do not have to pay the disputed amount while it is being 00100100-00100/00 investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. 10 2N5678 MoN-ar z9 Watch here for a wEo-Nov n GENERAL INFORMATION UE MC t8 personalized account 1.Payments received after the billing(INVOICE)date will appear on Important W96�dlla.tl.�lddG ,a„N SwR=3�Bo-o1'9eBB ; message your next invoice.Past due invoices(not paid within 30 days of news and M�"' fa @ATM ,i,„,E, ,•� R"`"'°""'°P" j billing date)may be assessed a late fee as allowed by law not to offers iiiwi St Eta exceed$20 per month.Additionally,third party collection attorney cnsn" 00088 i,m+na.u6.,.n•-.a.a.►ay^ l,J„a -_ expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed b law. --• 'r' -` 'imi'�e'+'ia'^ '"ap1` "o`O1Yf6:'r_”j - P Y , .. � cw +>'"". aW, Pay electronically 2.Each returned check is subject to a service charge subject to the "��'. i3�ACerceR �°-•�„ ar���"'"t..� ��.,t.''+'.v,;j,l p maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity .° ,= .`' p°""` ACTIVITY. ��� amount has been since your ACCOUNT 36wosee,.am—000 paid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice •0�^°'%pdd— xxxx stolen,damaged or not returned. ,s u avoid late fees 5.In accordance with NWNA's Terms and Conditions("T&C"),your W3, C5,09B s0a n 31r080,aM4 Equipment Lease and/or Service Agreement account may be 3, " G«^p Monthly Oil aw„ 3,r00s,•M4 s r„N wrcw�= E-: subject to minimum monthly purchases and/or early cancellation � '° ', Surcharge,Fuel 0911] 31016308„ Pmt i t/�, �„^�'' � �.� 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 rorAL - Leased Equipment is charged through the end of the billing cycle Fee(see#G under" General in which service is discontinued. '"""""` - M%TM�:' Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or .NAND x>va w< _ ,,,,,� - Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY— '"W _ PAY THIS AMOUNT t will apply to each account. The fee that applies to your account ___"" �, wrm°°• AccouNr NurAeen m/v xxx% is stated on the front of the invoice.For further information please ,0,,67890 WWNC wrE r.ENaosEo MVE NUMBER Wimm visit the website listed below or contact our customer service ,134,67890 center. 7.As a food product, bottled water is subject to the rules and 0420096307 042x2712639 000391049 200° �� ; Amount due regulations promulgated by the Federal Food and Drug tw.ox Administration(FDA). KE WMNNWAT RRCoMPAW_ pryW-s`o0o00 8.Your first invoice indicates the products delivered on your first • "° u.e0w7z-,888 Submit your roR<OnpMERS""<E`A _ payment b this delivery,along with any applicable bottle and account deposits, tw6a,u.a.ut«�a s,,, P Y y redemption fees,and an dispenser charges. M'rn �a __.._. P Y Pe arges.All future invoices O wroxrucAUroeArs�wR.w,nO^RM"`zde �""• -• __,__ t 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., service.icemountainwater.com t` �-+ya fi : 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 12/4/12 2KO120095351 Drinking water&cooler-Maint $ 51.34 12/4/12 2KO121202766 Drinking water&cooler- MCC $ 314.47 Total $ 365.81 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$ $ 365.81 ON ACCOUNT OF APPROPRIATION FOR 101 General & 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1125 2KO120095351 4350900 $ 51.34 1 hereby certify that the attached invoice(s), or 1091 2KO121202766 4350900 $ 314.47 bill(s)is(are)true and correct and that the mbterials or services itemized thereon for wich charge is made were ordered and received except 13-Dec 2012 Signature $ 365.81 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 11/01/12- 11/30/12 02K0121776199 p LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® g e 10M I HUM 9I I I I N B N MON- JAN 07 0121776199 uJ WED- FEB 06 FRI- MAR 08 TUE- APR 09 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM S ING Did you forget about us? Kindly pay upon receipt. 1 CIVIC IC SQ SQ Remember,past due accounts are subject to a late fee. CARMEL IN 46032 2584 Your prompt payment is appreciated. For your IIII�IIIII�II�I�II��II�II��I�I�I�IIIIIII�IIII"'�I�IIIIIIIII'll'I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. ..,�,._..... r ,� ;�.- .,..� 'fira � %a, , :Beyreadyfi f6r aIIAh sx'year s ce)et rati6,S ryNo;W,through 12/31°/12, en�oy�savings on�cases.of CQUA PANNA; =S:PELLEGRIIVO SARI�PELLEGRINO SRARKLING FRUIT BEVERAGES 8�PERRIER Ca11 1=800=472=9888 or to M± ' _g-•° c.?5.e^.'=>.::m�^a�,fi,_.' r,1 ;1-;' �s« ::_.�,%,�?° �� `'O.tlfO SP.t,VIGehIG�rT1o1J11Y� nW�ter !$�nr,nr'r �ilq ..l,.tOd3 �„ .�.�^:,F'-%S a°-rv.` ra': she. �..�;.� �,�..,r'"F, dj:;"^ f �=',y'����''''C_ .L E.rr'{'' �i-�.,.'r'",s'} °�„'",'{ •r�i ' N 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 30.71 11/04 710515 PAYMENT-THANK YOU -17.06 11/30 K3598402 RENT 3.99 TOTAL 17.64 D 17 2012 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 30.71 — 17.06 + 3.99 = 17.64 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.4 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 DIXIE IiWY,SUITE 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 sent you the fast 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. E f 0 00100 You do not have to pay the disputed amount while it is being 00)00)00 0 1234567890 Your Account Number ' I , investigated During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. 12345678 1 µON-OQ 29 Watch here for a GENERAL INFORMATION personalized account ��c ie 4 1.Payments received after the billing(INVOICE)date will appear on Important �$ar"7-9p1a taw taadtpn•tutuae C lomm 5eM` message your next invoice.Past due invoices(not paid within 30 days of news and 0.p°'t16'b6'tin�t°� TM„A �• ","'°'"N,"° billing ate y EprynDpe .�+•^^•°'. is g )may be assessed a late fee as allowed b law not to Offers 123 Mmn X exceed$20 month.Additionally,third pry's— pppp0 664dA per y party collection/attorney expenses may be assessed at a rate not to exceed 1009/6 of the - aid balance or the maximum allowed law. �amwr«>*gl�+^"'�!' #jpi9ew' ' "s.• Pay electronically unpaid by 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 .;_-;„. -=-- N,.me••K,..w�•R°°°""°'°"m amount has been ACTIVITY. since your ACCOUNrAC7mn' 4. Equipment replacement costs will be c for bottles los nacre=b^^o°° "scre`cn.su:90009 paid in full to Eq Pm charged t, oaten uc xx E last iuvoice stolen,damaged or not returned. e�^k w x'x i avoid late fees 5.In accordance with NWNKs Terms and Conditions("T&C"),your Lease and/or Service Agreement account may be �" 31reez,«41 s EaNa 1nz� �- _ Monthly Oil Equipment l Y n, 98511111 N,Nw"re"s aPea" subject to minimum monthly purchases and/or early cancellation 99n, 1n99z"°" ; r„Nw�w�9• '� fees. A complete version ofthe current T&C "'r'x ;18163M�� "•"` -�=f�. %- z Surcharge,Fuel ( p may be viewed on the 99n ye1o19, `' xxx+ I Surcharge or Delivery website listed below)Upon service discontinuation,rent for the roru _d; "P; Leased Equipment is charged through the end of the billing cycle Fee(see l under in which service is discontinued. �t -General 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or ,�,� ,,,.w --",; l rxxx _ l Information') Delivery Fee as described in your T&C. Only one of these fees Payment stub SUMMARY x tx __ --------- pCCOUNr --MIS AMOUNT { will apply to each 8Ce0ant The fee that applies to your account _ -„�,;,�,m, ,m^*+• ACCOUNT NUMSE0. xxxx 00 is stated on the front of the invoice.For further information please 1267990 eEUUW GATE .ENCEOSEO 346 visit the website listed below or contact our customer service NVOICENU3 ooim/w 123156)890 center. 7. As a food product, bottled water is subject to the rules and p420096307 04262712619 000391049 2004 16 'E Amount due regulations promulgated by the Federal Food and Drug 10n Administration(FDA). ICEMOUNTMN WA .,c CM.Sw X80000 S 8.Your first invoice indicates the products delivered on your first °^ "°"""`°' CAU a99.7799M t Submit your delivery,along with any applicable bottle and account deposits, MR L,at1J.�-®^^il"I6'�t°69.F.46t.F�-a �• " v9• ? payment by this redemption fees,and any dispenser charges.All future invoices ,,,�,.�� ^• _ _ N�,.s date will reflect charges for water delivered and dispenser rental,bottle snNww9Twlow�ns� 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 08/12 O service.icemountainwater.com ww- VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ PO Box 856680 Louisville, KY 40258 $3.99 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 02K0121776199 43-530.99 $3.99 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 Monday December 17, 2012 Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 12/04/12 02KO121776199 $3.99 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer service.icemountainwater.com ®S 8 o . #215 6661 DIXIE HWY,SUITE 4 11/01/12- 11/30/12 02KO120048525 G LOUISVILLE KY 40258 @ ADDRESS SERVICE REQUESTED ' �I��B��I�II �IuIdIOI��II 11110 � IN MON- JAN 07 0120048525 WED- FEB 06 FRI- MAR 08 TUE- APR 09 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 'll'I'�I'III"'�"II'1111'I'll'III�I'�IIIIII'�I�II���llil�lllllll convenience,pay online:service.icemou nta i nwater.com. If payment has been made,we thank you. =Be read ¢ r;allthi at onsNow hrou h 1.2 !a1 ° y or a,e s year s ci3leb�r t ,e t rc.y g a %3: %12 enjo , aVfi s on1,cases ci;#AGQUA PANM'A'�_ .i- .....,,Ear., :.ai dr ;�,�. 3' ?r {. � �:;q.�-";-„,:�cp.ws.•—:,:��:y .. ��r.m- ��,..:, yS _ � FI= �BE.PELL EGRIND;SAN P,ELLEGRINO�SPARKLING RUTVERAGES 8�;PERRIER Ca11 1:=800=472=9888 or log .,,: '�'�`..•°...a-� ';.a�.rd�, '.e%"as'�. ' rrg,.F1 .!'. .. s+ 1 dirBe' d. �v* ,'sis, ...8r*; ;�r , ,s, .,r ar,J` a's.. ,n A, PIyV/,C'P_ P_. 1►',tt`.'�1i�.W�tPt',;�A�Y.m.:tR1. r♦nr�4” t .�''„^' c': ”�? r";;^® ;=:xt,.- y' .._e;, %§-;"' ':3''".=-.�.��'` u,`, C -,'`�' .r�.:,.�✓"j. ..°rz��.; .,d'� .,,�rs'3F�" °:">" �.���„�1:�d�.r3s`s.,. .Fr rya <a�^;''. ,5✓.r.;�ao...'' sS 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 42.28 11/04 710513 PAYMENT-THANK YOU -24.53 11/01 0801329145 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 4 5 GALLON CE MOUNTAIN/ LDEPOSIT RETURN r.. D,,C 8 9'07'' 3.00 11/30 K3607116 RENT �j 3.99 TOTAL E<�E/VFD 38.99 20j2 NA CIIyFN � GlNFE2 ,Lto t'Z£ZZZ�'L� ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 42.28 — 24.53 + 21.24 = 38.99 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 2, Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing later than thirty(30)days after SAMPLE INVOICE sent you the firs[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. ,z3s67avO Your Account Number You do not have to pay the disputed amount while it is being 00100100-00!00100 investigated.During the investigation,we cannot report your account E ,23456]8 as delinquent or take any action to collect the amount in question. mP-Da- M«+-«*z9 i Watch here for a WE6 NOV 31 GENERAL INFORMATION personalized account 1.Payments received after the billing(INVOICE)date will appear on Important c4. sa�+T=�-84P'2'-'� IdWRf,..RIR..R=�RddR NeM��^re. m¢SSa g e your next invoice.Pas[due invoices(not paid within 30 days of news and I6R^dtbRhdNbl.=t menEr+lw°.kn billing date)may be assessed a late fee as allowed by law not to offers 123-1 x exceed$20 per month.Additionally,third party collection/attomey c"r'$tale o" ,pYi1JA.,6+k6Mt"1+a 1 expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed b law. 'x'° 'Dnpt` iedtYtp4u VM Pa Y <aw �. ,nauam p 0""4 `•' Pay electronically 2.Each returned check is subject to a service charge subject to the =- Y0°""` wto^��"•' '"=0ap`fi � ,1esavMtaano,u :f,y -i�' 'r maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activityr,�: ACTIVITY amount has been since your ACCOUN7ACTMTY s,reecuro•s�emom 23 Ma" aid in full to 4. Equipment replacement costs will be charged for bottles lost, •DNrveryAdE=�� xxxx I P last invoice stolen,damaged or not returned. aMa+ xv f avoid late fees Payne",-r,„"Erw 5.In accordance with NWNA's Terms and Conditions("T&C"),your �, en,e4P s sc,�„r,.,",a,sw�•n`N+re' .......- , xx�, Equipment Lease and/or Service Agreement account may he "1 3veesi "`"'°"°`"„sw,Dev�" n, 11reB5,IMn 5 Ia Mwnwms GalPetw° r Monthly Oil subject to minimum monthly purchases and/or early cancellation �r11 E„dw"""�` �'� -;i<i Surcha��-ppe,Fuel p9112 31P26TBE11 Pent li�f" -.J -b fees.(A complete version of the currentT&C may be viewed on the 0n2 Surcharge or Delivery website listed below)Upon service discontinuation,rent for the Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. °"" = Myers i Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or „ ,.N.PC= w wO,T 1 -- = s Delivery ee as described in our T&C. Only ou one of these fees Payment stub AccNrSUMMARY ry Y •J Y -aou •uw _ACCOUN MY PAY TNIS AMOUNT E. will apply to each account. The fee that applies to your account � �„„,,,•.„�,W on^-�°* T NUMB" ��r� Wx is stated on the front of the invoice.For further information please 12345 m890 Nw,w DArE .ENCLOSED ,"VOICE NUMBER 00100/00 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 0420096307 04262712619 000391049 army 16 Amount due regulations promulgated by the Federal Food and Drug wn D°e i Administration(FDA). ,CEMWNTNN WATEPCOM SPANK C Y• teSl�pe 8.Your first invoice indicates the products delivered on your first ����^",�""""°tt°,°+'•p„,R„ „ � ❑r O�"p1°SmTOc1�AE"SE�P"`L - Submit your delivery,alon g with an y applicable bottle and account de po sits, payment by this his redemption fees,and any dispenser charges.All future invoices �o,,,,y,,,,,pPew.•60^"�""s .__ date will reflect charges for water delivered and dispenser rental,bottle v`ryp°`�T�EA _ _ - — 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 08112 �_ service.icemou ntai nwater.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 12/4/2012 02k Water Cooler $ 21.24 Total $ 21.24 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 VOUCHER INC WARRANT NO. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF $ Louisville, KY 40285-6680 $ 21.24 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 02k 2200-4239099 $ 21 24 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 1 12/20/2012 ii Signatu 1�i - 1�I,bavt� City Engineer ' Cost Distribution ledger classification if Title claim paid motor vehicle highway fund