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216427 01/15/2013 *f CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER i Q � CHECK AMOUNT: $103.36 CARMEL, INDIANA 46032 PROCESSING CENTER a _o PO BOX 856680 CHECK NUMBER: 216427 LOUISVILLE KY 40285-6680 CHECK DATE: 1/15/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 02LO11782108 30 . 16 02LO117821082 2200 4239099 02LO12004852 21 .24 02LO120048525 1205 4239099 02LO12177619 4 .20 02LO121776199 1801 4350900 02LO12197559 30 . 58 02LO121975593 1701 4239099 12L722032704 17 . 18 12L7220327048 service.!cemountainwater.com 9 4 0 9 Is MCI ' 111A"M VA #215 6661 DIXIE HWY,SUITE 4 12/01/12- 12/31/12 02L0117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II11II I I II I II I I I I II II I I I I I I� III III WED- JAN 1 0117821082 FRI- FEB 15 5 TUE- MAR 19 THU- APR 18 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at:service.icemountainwater.com or 3400 W 131 ST ST CARMEL IN 46074-8267 by phone at:1-800-472-9888.It's free! I�IIII�IIII�III�IIIIII�IIIIIIIIIIIIIII�IIII�I�I�IIII�I�II�II�IIII Be�ready for all this yea r'srcelebrations Now tF rough 1/6/13,enjoy a ings on case of ACQUA PAN NA, S.PELLEGRINO, SAN_PELLEGRINO_SPA_RKLING-FRUI ,TI3EUERAE S &.PEl2RIR. Gal!1-840-4?29888.ot.Iog onto service Icemountainwater.com to order today) 4 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 34.56 12/09 897416 PAYMENT-THANK YOU -17.14 12/27 997563 PAYMENT-THANK YOU -17.42 12/13 0807258504 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 24.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 12/31 0810579391 1 OIL/FUEL SURCHARGE 2.92 L3751503 RENT 3.99 TOTAL 30.16 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q,. ., Subject to terms on reverse side. 34.56 — 34.56 + 30.16 = 30.16 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.If you #216 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 SAMPLE INVOICE writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: • Your name,address,telephone and account numbers. 113,567890 The dollar amount of the suspected error. 00,00,00-00100100 • Describe the error and explain if you can,why you believe there is loss 113AS67890 an error. M0.'aT 00 oNocr Your Account Number You are obligated to pay the parts of your bill that are not in question. wEaNw�' DEC 19 You dg not have pay the disputed w amount port your is being 161Y.;,06{a.9lod:diH•49iL,.AI6,.a,aan c"„«nnsM^.•.1s00.o'.'nee investigated.During the investigation,we cannot report our account as delinquent or take any action to collect the amount in question. °1n Dx Watch here for a 1 1 5t c lys aoD p ersonalized account GENERAL INFORMATION Important ud - I message 1 Payinents received billing will p news and your next invoice.Past dueinvoe (not paid with n30days of S- offers .Na� »+a^+'*.w»Yo1n °"'»"',•a a, billing date)may be assessed a late fee as allowed by law not to exceed$20 per month.Additionally,third party collection/attomey ,,-. ., ,;,...,_. tla ,�,,;°., Pay electronically expenses may be assessed at a rate not to exceed 100%of the ACICOUNTAC IV •",« "`•`"""•'�^�� unpaid balance or the maximum allowed by law. 3 11M 1S.�,,ornsmm ow"9 i19s Make Sure this 2.Each returned check is subject to a service charge subject to the ,a>i>^.. °�<s amount has been maximum check return charge allowable in our State. Activity �r«'^'-"""k°°" so.w aid in full to S Y "e,n m,e9e sc>i«,N>.°„ism"9w>•^ .saro since our �1„ 3oees,w MW ^sc D w' 9a P 3. All bottle and equipment deposits are shown as CURRENT Y s , ”" avoid late fees ACTIVITY. last invoice �” n°ees" F-1 S"""« 4. Equipment replacement costs will be charged for bottles lost, o�9ni ' S7 stolen,damaged or not returned. ,oTAL Monthly Oil 5.In accordance with NWNA's Terms and Conditions("T&C"),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be _ r».wq _ subject to minimum monthly purchases and/or early cancellation Your new �.... Surcharge or Delivery fees.(A complete version of the current T&C may be viewed on the delivery ACCOUNT SUMMARY e.tpy1>.a - „K,".�•^,•0o-!,�"°° Fee(see#6 under -r---- website listed below)Upon service discontinuation,rent for the calendar. -- pelrvenes rccou ,�E "General Leased Equipment is charged through the end of the billing cycle 'D'indicates Information") in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a scheduled ;, n HM hii Mm» » » no>e•'n delivery Delivery Fee as described in your T&C. Only one of these fees ,"» n o, will apply to each account. The fee that applies to your account ,> �' is stated on the front of the invoice.For further information please M;,6L »'„°'• »•"•» . .,..»»»,• » visa the webstte listed below or contact our customer service �.o v »• » -- Payment stub -"" ---- center. - - PAYTHIS AMOUNr 7. As a food product, bottled water is subject to the rules and -_ — .« aoiaD „--- ACCOUNrNUMBE0. MY Y s,w Amount due Doi regulations promulgated by the Federal Food and Drug 113,56,690 B1LUNC DATE AO NCLOSED ,NJO2C[N78 001001"0 Administration(FDA). 113+s6�e96 8.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, 0120091307 OVa..71aL59 000391019 aoD�07D3 Submit your redemption fees,and any dispenser charges.All future invoices will 0M— payment by reflect charges for water delivered and dispenser rental. bottle icEMOUN,ANwA,,;,oM,vA"Y 123 wtes�D0 this date deposits and credits plus charges for any additional products a w�, E6sEw,cE<�"000'"'"9868 ordered by you. Deliveries are made every three or four weeks,for i« ,�a„1a,,..a1,.di•,n,•i'a,a-t•�d'u'G,0 »s 0`»"^,M,�s,,,«,D„a"""s, a total of 16-17 deliveries per year.You will only receive irnoices �,�""„”^,BEE^'"°°''"sro°u°�°-•^On 12 tin3es 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 708 ei08 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/11/13 02LO117821082 $30.16 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 $30.16 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 2201 102LO117821082 I 42-389.00 $30.16 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, January 11, 2013 Street Commissioner JAI CCL vl�i i n i naoivi icy Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.Icemountainwater.com ®® _ #215 6661 DIXIE HWY,SUITE 4 12/01/12- 12/31/12 02LO120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® 9 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 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 ? Be ready for all this year's celebrations. Now through 1/6/13, enjoy savings on cases of ACQUA PANNA, .&PELLEGRINO, SAN PELLEGRINO SPARKL INS-FRUIT�BEVERAGFS-&P-ElI BIER.-Cal!-1-800-472-9888-or lecg=, i onto service.icemountainwater.com to order today! b I e 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 SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 38.99 12/09 897418 PAYMENT-THANK YOU -17.75 12/27 997567 PAYMENT-THANK YOU -21.24 12/04 0805830957 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE 0��e 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 12/31 L3765338 RENT 3.99 TOTALV 21.24 CIO ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 38.99 — 38.99 + 21.24 = 21.24 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed,include your account number on your check,and do not send cash.If you #216 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 SAMPLE INVOICE 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 telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: • Your name,address,telephone and account numbers. 1234s67B9D • The dollar amount of the suspected error. r ootootoo-ootootoo • Describe the error and explain if you can,why you believe there is r$7 1234567890 an error. TH9'�w You are obligated to pay the parts of your bill that are not in question. WEC o i? Your Account Number NE-DEC 10 You dg not have pay the disputed w amount Sport your is being ma",t t�,n�,ata,L;,nuasicMtno,.a�u,t,tu C".,°,,,�,x,,,;c,.,,BOO.,r:9BBe investigated.During the investigation,we cannot report our account 'c`MW"°'"p'°0u"' Watch here for a as delinquent or take any action to collect the amount in question. to"^o°` aw•`^""' 123 Ma"s1 personalized account GENERAL INFORMATION Important „mui.WOO L°'�'"s�"'''�'L'i"a message I.Payments received after the billing(INVOICE)date will appear on news and ilm..Nrt ws,w your next invoice.Past due invoices(not paid within 30 days of offerswm+�aBa>'°" �td"` A�gaBwLAres�'°" te� 4~ billing date)may be assessed a late fee as allowed by law not to exceed$20 per month.Additionally,third party collectionlattorney - •"„o„n,w°, Pay electronically expenses may be assessed at a rate not to exceed 100%of the N °"""""'" •��-� ACCOUUNT ACTIVITY Mra' C"SN'.ooB Make sure this unpaid balance or the maximum allowed by law. - D ,ynm,a,.,°„�.123 Mains �� 2.Each returned check is subject to a service charge subject to the p U.— Activity <z.e amount has been Activity waa paid in full to maximum check return charge allowable in your State. oe=n e6,ep6 sw6°n Nawol sP,in9 -so oB since your o91n ,,,BB6,4.a4 ' kaManul"3Ga Ioaoml, i96 3. All bottle and equipment deposits are shown as CURRENT ) s It ACTIVITY. X99 avoid late fees ACTIVITY. last invoice .... J..805j14 31B:63aen 1 Red w,.m,e• ' . . 4. Equipment replacement costs will be charged for bottles lost, 57.6 stolen,damaged or not returned. rorA1 - Monthly Oil 5.In accordance with NWNA's Terms and Conditions('T&c°),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be cBNRH..r^"" _ '"'"°'"nom subject to minimum monthly purchases and/or early cancellation Your new „qp., _ Surcharge or Delivery fees.(A complete version of the current T&C may be viewed on the delivery ACCOUNT SUMMARY - �a,i oa °° Fee(see#6 under websitc listed below)Upon service discontinuation,rent for the calendar. Nlypelrvenes.«oD IGeneral Leased Equipment is charged through the end of the billing cycle `D'indicates � Information") in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a scheduled .'So f=f""' n• ;:oP�8a I;mm Delivery Fee as described in yourT&C. Only one of these fees delivery " will apply to each account. The fee that applies to your account is stated on the front of the invoice.For further information please IN visit the website listed below or contact our customer service {t„° - - center. Payment stub 4f PAY BY PA HIS gMOUM 7. As a food product, bottled water is subject to the rules and -_-_p„-,6uawn«a mwwr^"^� Accou TNUMBER I. n.B Amount due regulations promulgated by the Federal Food and Drug 1234361690 a,,,C A. NCEosED IM C,ICE NUM BED WIWIW Administration(FDA). ....s67690 8.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, 0,20096307 0'1262712639 0003910,9 zoo,o7D16 Submit your redemption fees,and any dispenser charges.All future invoices will ro""o« payment by 23 Ma."u reflect charges for water delivered and dispenser rental, bottle IcMaiNrAINwAMEH,c„°M„"p,,,,K. clryso,. ° this date deposits and credits plus charges for any additional products w �� opc MI6 sa6vica cAl�'a00-jj 988° ordered by you. Deliveries are made every three or four weeks.for 6��•Ian,,,,11..a1.Al.aa.a..LlbLd•11 �`� cD,,,,,�,�,p«•,a si°= a total of 16-17 deliveries per ear.You will only receive invoices P Y Y �slc""o.o8,6cE.w 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 708 5/08 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 12/31/2012 02101 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 NC 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#/TITI- AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 02101 2200-4239099 S 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 J received except 2/vl 7 zr� /14/2013 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com ' 0 0 #215 6661 DIXIE HWY,SUITE 4 p LOUISVILLE KY 40258 12/01/12- 12/31/12 02L0121776199 ADDRESS SERVICE REQUESTED _ MON- JAN 07 0121776199 H08H101 HUN 1110 8HII II 0M 010 WED FEB 06 FRI- MAR 08 TUE- APR 09 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING 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! e — - . Be ready for all this year's celebrations. Now through 1/6/13,-enjoy,savingson cases of A QUA PANNA , S.PELLEGRINO,-SAN`PELL"EGRINO SPARKLING FRUIT 13EVERA0ES &'PERRIER.°Call 1-800-472-9888 or log I onto-service.icemountainwater.corr to order today) nd 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 17.64 12/09 897415 PAYMENT-THANK YOU -13.65 12/27 997566 PAYMENT-THANK YOU -3.99 12/04 0805831005 1 9 OZ PLASTIC CUP 50C/SLV 3.29 BOTTLE DEPOSIT: 0 CHARGED, 1 CREDITED -6.00 12/31 0810621367 1 OIL/FUEL SURCHARGE 2.92 L3756766 RENT 3.99 TOTAL 4.20 Dz JAN 14 2013 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT S11 Subiect to terms on reverse side. 17.64 — 17.64 + 4.20 s 4.20 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.If you #216 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 SAMPLE INVOICE writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: • Your name,address,telephone and account numbers. ta3�ssre90 • The dollar amount of the suspected error. , 01100,00-00,01,°0 • Describe the error and explain if you can,why you believe there is 1234567890 an error. TMg'0C`p1 You are obligated to pay the parts of your bill that are not in question. wEO w;; Your Account Number NE-DEC 10 You do not have to pay the disputed amount while it is being ,.goo-,)39g88 investigated.During the investigation,we cannot report your account a,tl.,nWnt.moa.ala't'��°ntn"a"na'� m�•rW ",�,<,r.+�^+•"'o'o°""' Watch here for a as delinquent or take any action to collect the amount in question. ro^^D°` •^a••^"`° personalized account C",51- 00001 p Important L"aa,a.w. a L„16i�ua itaa i n GENERAL INFORMATION P -;; n �� message 1 Payments r billing otl will P and your next invoice.Past dueinoiices(not paid w th n30dav of Offers billing date)may be assessed a late fee as allowed by law not to Pay electronically exceed$20 per month.Additionally.third party collection/attorney ”. .�-- ,,,,,<;,o,,,,,,,,.,.�...ame'aw�-w,.9..N,a..^,4.• expenses may be assessed at a rate not to exceed 100%of the C •w w+ °""" ACCOUNT ACTIVITY ,S'a 00D91 unpaid balance or the maximum allowed by law. '--D n YpOe,•,,.-,n 1« 3Ma S Cry �� Flake sure this 2.Each returned check is subject to a service charge subject to the ,"",g,�a^<. <n� amount has been maximum check return charge allowable in your State. Activity o.i3, n�ms.... s swnrnww,nilsp �=' -� paid in full t0 3. All bottle and equipment deposits are shown as CURRENT Since your mIU i mss,,,,, s Ma^u^' gg„« :M^” ^sw'"-° "" avoid late fees ACTIVITY. last invoice o9m ; .".s".m•.9•' "„ "W1.11. 4. Equipment replacement costs will be charged for bottles lost, Zw �ab.o• ^' .r s'.o stolen,damaged or not returned. ^E Monthly Oil 5.In accordance with NWNA's Terms and Conditions("T&C"),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be _ _ ..•^ATM'" _"""�"s au subject to minimum monthly purchases and/or early cancellation Your new ..Y�w �..w „q,,, Surcharge or Delivery ( p y delivery AccouNrsuMMAgr Fee(see#6 under fees. A complete version of the current T&C may be viewed on the __ __----- website listed below)Upon service discontinuation,rent for the calendar. f• "General a Deliveries.ccouM Leased Equipment is charged through the end of the billing cycle M y Information") in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a scheduled delivery Delivery Fee as described in your T&C. Only one of these fees will apply to each account. The fee that applies to your account is stated on the front of the invoice.For further information please visit the website listed below or contact our customer service ;•v ° ° ° .-�. caner. Payment stub - p Y TNIg AMOUM 7. As a food product, bottled water is subject to the rules and ten;;,- ,•„•",..�•ww^�" ACCOUNrNUMeEn �� nm Amount dug regulations promulgated by the Federal Food and Drug "g'^ gIWNC DATE NCLOgED INVOICE NUM0E0. W,OO�W Administration(FDA). 1234 ss�e90 8.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, O,069630i 04202T1ab19 1003910V9 z11°°'°6 Submit your redemption fees,and any dispenser charges.All future invoices will 1123 payment b)' Main A reflect charges for water delivered and dispenser rental, bottle icEouNTw^mEg,,;oM.m',-ANr on.s.<e0 this date deposits and credits plus charges for any additional products• K w„cWo..1u ^Er^`E'°°°"'gpAB Y every L..In,s.t..lw..,.u•.a6:a6aaLa.a.ua,3„Ii ordered by you. Deliveries are made eve three or four weeks,for won.«•«:a•. ❑.,un.mU•^9••^^.....KV"• a total of 16-17 deliveries per year.You will only receive invoices ❑s,o„"......EE""'°°""'"^""`°"° 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 706 5/08 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/03/13 02LO121776199 $4.20 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 $4.20 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 02L0121776199 42-390.99 $4.20 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, January 14, 2013 Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund / service.icemountainwater.corn 0 D 0 #215 6661 DIXIE HWY,SUITE 4 12/01/12- 12/31/12 02LO121975593 / LOUISVILLE KY 40258 e B e ADDRESS SERVICE REQUESTED 111111 I I �I �I �I' WED JAN 09 0121975593 FRI- FEB 08 TUE- MAR 12 THU- APR 11 CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Did you forget about us? Kindly pay upon receipt. SUITE 220 Remember, past due accounts are subject to a late fee. CARMEL IN 46032-1938 Your prompt payment is appreciated. For your I��I�'llll'I"�II1111�1""Illllll�llillil�l�l��l�l"II"�II'IIII convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Be ready foi all tfi s yeai celeb ations',e Now t`hrougl h /6/13; enjoy°savings�on cases-of ACQUA P�4NNA, S.PELLEGRINO, SAN PELLEGRINO SPARKLING FRUIT BEVERAGES& PERRIER. Call 1-800-472-$888 or log onto service icemountalnwater corn to order todayr A" - c �_ - ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Mm Delivery address: CARMEL REDEVELOPMENT COMMISSION,30W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 18.62 12/06 0806149183 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 13.38 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 12/31 0810624213 1 OIUFUEL SURCHARGE 2.92 L3830167 RENT 10.99 TOTAL 49.20 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURREVAICTIVITY PAY THIS AMOUNT S.— Subiect to terms on reverse side. 18.62 — 0.00 + 30. = 49.20 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.If you #216 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 SAMPLE INVOICE writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: • Your name,address,telephone and account numbers. Ez3+ssrevo The dollar amount of the suspected error. oolootoo-ootootoo • Describe the error and explain if you can,why you believe there is tZNSAreso an error. rHP.ocTw You are obligated to pay the parts of your bill that are not in question. o-,,,°C°`„iP, Your Account Number UE DEC,0 You dg not have pay the disputed amount while it is being tl,n«pi„acutaa.dN+OtL"eta.lL�ua,at c°,,,,«,s,,.l<arv0oo-°rr-ve00 investigated.During the investigation,we cannot report our account m nP YU•',u,vY^91<.Mau^uM PeEUau as delinquent or take any action to collect the amount in question. ion^o« ,ne„°,<... Watch here for a ,z3 Ma^si GENERAL INFORMATION personalized account P rys,a,a Important L.a,La.p DOWO•ItmaL"IL.Laa.rLt+A.,i•a message ° a 1.Payments received after the billing(INVOICE)date will appear on news and Y our next invoice.Past due invoices(not paid within 30 days of offers billing date)may be assessed a late fee as allowed by law not to Pa electronically exceed S20 per month.Additionally,third party collection/attorney ..� „ ,,:,.awn MM'"'"r y y expenses may,be assessed at a rate not to exceed 100%of the ACCOUMACTIViTT •-' - ,,CIry.5uu 00000 unpaid balance or the maximum allowed by law. - D n„ywam wnaD«.EnM,ms I�� Make sure this 2.Each returned check is subject to a service charge subject to the Paia^<. pj° amount has been maximum check return charge allowable in your State. Activity Pryma^,-Tm^E.^^ ry„„ s°00 ovil °x'098 swims N,m,a`Plcei o paid in full to 3. All bottle and equipment deposits are shown as CURRENT since your „TPPS' uM^ ^swiP.w „” avoid late fees ACTIVITY. last invoice 4. Equipment replacement costs will be charged for bottles lost, wwi 1e 97 `^` S1.40 stolen,damaged or not returned. To- Monthly Oil 5.In accordance with NWNA's Terms and Conditions("T&C"),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be subject to minimum monthly purchases and/or early cancellation Your new Eras..�"P w•"�` ,,,y,,, _ Surcharge or Delivery ACCOUNT SUMMARY 00'°'MB Fee see#6 under fees.(A complete version of the current T&C may be viewed on the delivery ••°" c"","" ^°•°"°'" website listed below)Upon service discontinuation,rent for the calendar. Mypelivedes,aw� 'N'°'B "General Leased Equipment is charged through the end of the billing cycle 'D,indicates Information') in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a scheduled Delivery Fee as described in yourT&C. Only one of these fees delivery >." "" »»o „nr„, ,..••-m• will apply to each account. The fee that applies to your account »,, ';,;,L is stated on the front of the invoice.For further information please o,',;,;. M '`'o;;;;; °"�"� "•' ^'° visit the website listed below or contact our customer service °t center. Payment stub u""N"" ---- r ------------ pAr THIS AMOUNT 7. As a food product, bottled water is subject to the rules and --------- mw.mww,*""` ACCOUNT M6EA D0001w n Amount due regulations promulgated by the Federal Food and Drug INJOICEN,IMIE nwNCDAT Administration(FDA). z14 7B90 wrwl0D S.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, Dvzoo963oT DPZez�u619 DDD3v>,oP9 zooPo'+D>.e Submit your redemption fees,and any dispenser charges.All future invoices will 1oH^oaa payment by reflect charges for water delivered and dispenser rental, bottle IcEo aNTnr+wATE",J; ,,,. ias M,m s, this date .^w a,r.suie 00000 deposits and credits plus charges for any additional products "., w M EoP CUSroMEP SEIm<E U«+ep0-"''M° ordered by you. Deliveries are made every three or four weeks,for 1..au,L,a„m,,,,,n.�+1„,u,.i.n..l..LU,L+°il P ew5ie, ❑^�"'°"^•'"°�P••`"`siee a total of 16-17 deliveries per year.You will only receive invoices ❑,�"o.E PEPEE"'"°°"..w°°°P•^�ieOO^ 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 708 5/08 service.icemountainwater.com Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. MM I Payee T Ce 1 idun�kill D re �� Purchase Order No. P • . �S668o Terms L ouiS Vl lie , k I"02g5 -660 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) ��3-13 b 91SS9? �ve�er or CRC o�iG �.� 20 Total 49.2,b I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. M 1 ALLOWED 20 IN SUM OF $ P.o . QnX gs668d _ X0285— 6680 $ - '36 Sg ON ACCOUNT OF APPROPRIATION FOR l01 � 435 0106 Board Members PO#or DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), 02L612 5.51 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 - 200 Signature Executive Director Title Cost distribution ledger classification if Carmel Redevelopment Commission claim paid motor vehicle highway fund service.icemountainwater.com ®� d #215 6661 DIXIE HWY,SUITE 4 12/01/12- 12/31/12 12L7220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MOD- JAN 07 7220327048 WED- FEB 06 FRI- MAR 08 TUE- APR 09 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 ANN DAVIS Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's freel CARMEL IN 46032-2584 '111'Jill I111111111 1111I��II��I�I'�III��'�I�I��11��1�1�11�1�1� Be readyafor�aII this year's celebrations Now�th�rough 116/13,q.enjoylavings or°cases of ACQUA PANNA, . - S.P,ELLEGRINO S-1.4 E_LECRINrJ SPAR!(l�II�G�FRUIT BEVERAGES&-PERl�IER Ca11 f4t6 4721-Mv or log onto service icemountatnwater com to order today) R : & ;{ , F 1 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 27.38 12/09 897417 PAYMENT-THANK YOU -13.65 12/21 979990 PAYMENT-THANK YOU -13.73 12/04 0805831179 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC,CUP 50C/SLV 3.29 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 12/31 0810689083 1 OIL/FUEL SURCHARGE 2.92 L3796735 RENT 3.99 TOTAL 17.18 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 27.38 — 27.38 + 17.18 = 17.18 l 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.If you #216 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 SAMPLE INVOICE 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 telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: Your name,address,telephone and account numbers. t 123+5e7e90 • The dollar amount of the suspected error. / D010 D100-00100/00 • Describe the error and explain if you can,why you believe there is + -- 123456]890 an error. THB MDN-DR=9 Your Account Number You are obligated to pay the parts of your bill that are not in question. wEo-l+oY 21 NE OEC,9 You dg not have to pay the disputed amount while it is being nt�iLp601ab�tp�tAi6mala,.apia,at c0swm•1sm,<e:I-9DO�>="9088 investigated.During the investigation,we cannot report our account TnanE YOU Ia,d^9 me MOUnw^p<^°oat Dce „nI« Watch here for a as delinquent or take any action to collect the amount in question. �1=3 Man St GENERAL INFORMATION Important p "ys`d1P D personalized account P message t.Payments received after the billing(INVOICE)date will appear on news and your next invoice.Past due invoices(not paid within 30 days of offers billing date)may be assessed a late fee as allowed by law not to "' � '"' exceed S20 per month.Additionally,third art collection/attorney Pay electronically expenses may be assessed at a rate not to exceed 100%of the ACCOUNT ACTIVITY '" `""`• unpaid balance or the maximum allowed by law. o«,�z71Mai s "Y's"`•00000 Make sure this P D rypdd,ess'1" 11.99 2.Each returned check is subject to a service charge subject to the ,;^.,solo^<e so_00 amount has been Activity maximum check return charge allowable in our State. 08/31 y vm•m-T"anorou wa e scanon Na[u,al5pnn95pp0 P since our m old full t0 I<e Mounwm 9 W D•pp5t 3. All bottle and equipment deposits are shown as CURRENT Y avoid late fees ACTIVITY. last invoice �Il] 119367881, 5,a0 4. Equipment replacement costs will be charged for bottles lost, stolen,damaged or not returned. roT+L - - Monthly Oil 5.In accordance with NWNA's Terms and Conditions("T&C"),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be __ subject to minimum monthly purchases and/or early cancellation Your new Surcharge or Delivery fees. A complete version of the current T&C may be viewed on the pccouNT SUMMARY _.o.1C noU•,u` cam,„,,, unu,woD„<=,,,, Fee(see#6 under ( p y delivery ,.. _°_ - "°" m � �,; "General website listed below)Upon service discontinuation,rent for the Calendar. My Deliveries a --_-- Leased Equipment is charged through the end of the billing cycle `D'indicates _ - Information") in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a Scheduled M-" delivery ver deli ' ° a^ Delivery Fee as described in your T&C. Only one of these fees y o will apply to each account. The fee that applies to your account is stated on the front of the invoice.For further information please visit the website listed below or contact our customer service ° n',Iv center. Payment stub ------ ___ ------_ ppV THIS AAMOUNT 7. As a food product, bottled water is subject to the rules and __------,t,. PAY 9y°,no,",�.aU,aw>'^^" ACCOUNT NUMBER 57.+0 Amount due 00]00]00 regulations promulgated by the Federal Food and Drug 1]3456]090 B1LuNC GATE Na°spD IM'DICENUW wIDDI00 Administration(FDA). Izls9]990 8.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, o.zoo9s3D] zT>'zis9 DD❑39),°99 zoo°°]0>, Submit your redemption fees,and any dispenser charges.All future invoices will ,on0o« payment by Main St reflect charges for water delivered and dispenser rental, bottle °�'""�+ryrpa1Nwpr a °M ays,e oo0 this date ,.900„:-9999 deposits and credits plus charges for any additional products 09cD6roME.7999c ordered by you. Deliveries are made every three or four weeks,for ,n,y,.Jau.dt-�dl^'°"t'a"n"'4u*t't0n ,•�Nee, �E",•,"^+.0"°^'e`°"9ry`°`:a` a total of 16-17 deliveries per year.You will only receive invoices ❑610H0p,aF9o-"'"°"°:" °� 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 708 5/08 service.icemountainwater.com Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee r\ Purchase Order No. Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount W i Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited with IC 5-11-10-1.6. same in accordance 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 1 L�laa a� �� bill(s) is (are) true and correct and that the ICAS materials or services itemized thereon for which charge is made were ordered and received except 20 i I Signature I Title Cost distribution ledger classification if claim paid motor vehicle highway fund