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217680 02/26/2013
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $158.55 ,roe PO BOX 856680 CHECK NUMBER: 217680 LOUISVILLE KY 40285-6680 CHECK DATE: 2/26/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 30 . 80 OlAO121202766 1125 4350900 48 . 67 03AO120095351 1205 4239099 13 . 65 03AO121776199 1801 4350900 30 . 54 03AO121975593 2200 4239099 14 . 26 03AO120048525 2201 4238900 20 . 63 13AO117821082 se rvice.icemountainwater.com 9 215 6661 DIXIE HWY,SUITE 4 �Oi w LOUISVILLE KY 40258 01/01/13-01/31/13 13A0117821082 ADDRESS SERVICE REQUESTED a t3 FRI- FEB 15 0117821082 TUE- MAR 19 THU- APR 18 FRI- MAY 17 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at:1-800-472-9888.It's free! CARMEL IN 46074-8267 rll'�II�'�I�I�I�II�III'I'I'�''�'Irrlrrrrrlrllllll�'���I�III'�'�I� Swrkm NeWeYeAtim tiritill', n wandifeft^eihtnepufR o 't off ses o#;ouc°tCE= OtJhl3AIN°S rlclin °x�s'n �9ai€er��14a�:ca�x�.s�er� $l SSextea>�2R�z:�ar�s�10'�itiseavlceir�ouimS�invrater:com�`ar,�aii�t �-� AaWJ72 9688: vioud ivournext.titrierlgOffer� ;� s' � rs,s, ,h^" � ° C r',v, _ ra `,r; � ap✓" "?; � �v ���i 7 A `�_x. ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-804472-9888 or visit service.icemourttainwater.com. B 8 B 8 i DetnrM address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 30.16 1128 162395 PAYMENT-THANK YOU -30.16 1/16 0811819002 3 5 GAL ICE MOUNTAIN DRK W/HANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 1/31 0815966619 1 OIUFUEL SURCHARGE 2.88 A3908352 RENT 3.99 TOTAL 20.63 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT ` Q Subject to terms on reverse side. I 30.16 — 30.16 + 20.63 = 20.63 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. #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 O ®�s U&s_ 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. 12y4567690 Your Account Number You do not have to pay the disputed amount while it is being 00100100-oo10OW investigated.During the investigation,we cannot report your account t ' 2345678 as delinquent or take any action to collect the amount in question. HB_w p MDN-ocr 19 Watch here for a wEo-NDV n GENERAL INFORMATION 11E-DEC IB personalized account 1.Payments received after the billing INVOICE date will appear on Important np,l,na,edttn•n•iWdn c__s,"'. 80°O3-sasB Ym i (INVOICE) Pda n,n„,tn.nudttad~, message your next invoice.Past due invoices(no[paid within 30 days of news and TIUnEY^^3mmme billing date)may be assessed a late fee as allowed by law not to offers X123 MsL •"'.•..M.• - exceed$20 per month.Additionally,third party collection/attorney c,h,na:e DBDBD c,ty's l.BL«dL•,n,,,n•�p•L•4666d•a expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. , ,; �.,. :�n�aks,,,Ny„rrRai "B� ' Pay electronically 2.Each returned check is subject to a service charge subject to the ,I,, ,.,tae.r ?�w��"'-'"d"';,=y.->„ '< maximum check return charge allowable in your Slate. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity Y �N,�.•.•,..�..> '.� amount has been ACTIVITY. your ACCOUNT S EnsN1 oowO- aid in full to 4. Equipment replacement costs will be charged for bottles lost, Dd•renAadre*s +�*x p stolen,damaged or not returned. last invoice avoid late fees 5.In accordance with N WNA's Terms and Conditions("T&C"),your oer3, w,ese 5 56 ,`w akv,,,yw,m "" 1. Ill 3,1805,MM "e Mwntains WlDeW+�= Equipment Lease and/or Service Agreement account maybe �„ 3naes, s "w,"sc•in�wm Monthly Oil subject to minimum monthly purchases and/or early cancellation °'"' 3'708'MN 31016 80„ 1` 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 TDLAL }` �- ) Po - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or pCCOUM SUMMARY ,"•- Information') ax% Delivery Fee as described in your T&C. Only one of these fees Payment stub ppON -------- ----AMOUNT will apply to each account. The fee that applies to your account •°�,,,, wnrKPOT°"'- ACCOUNT PAY BY ,� is stated on the front of the invoice.For further information please .• ,134567898 Woo .ENCLOSED MVOICE NUMBER Bi UN�O0 visit the website listed below or contact our customer service 1;s67698 center. P subject 04262712619 000391n49 2004 16 7.As a food product, bottled water is sub�ec[ to the rules and Amount due regulations promulgated by the Federal Food and Drug 0 _ Administration(FDA). icEMOUN w"TE„B„c0°M 1c33YSIate5to0888 Submit our 8.Your first invoice indicates the products delivered on your first '°"'•°' r c,,,i,-,w+ll- y payment by this delivery,along with any applicable bottle and account deposits, a iDBCDSTOML65EE I.aoyr.m...a.°d6"tuaa�.t.uuw• �5� 0�M,�.,�D^^�"z°` redemption fees,and any dispenser charges.All future invoices date yrN UPwBrnEL Nnowm sg^'m'"a"'•°O" 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $20.63 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT � Board Members 2201 113AO117821082 I 42-389.001 $20.63 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 Thou gday bruary 21, 2013 Street Com r7f s o n e r Street CommMf} over 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)) 02/11/13 13AO117821082 $20.63 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 • m® e #215 6661 DIXIE HWY,SUITE 4 01/01/13-01/31/13 03AO121975593 LOUISVILLE KY 40258 e ® e ADDRESS SERVICE REQUESTED II I I II II I III ii III II I��I I I I I III II TUE- MAR 12 0121975593 THU- APR 11 FRI- MAY 10 TUE- JUN 11 CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Pay your bill online at:service.icemountainwater.com or SUITE 220 by phone at:1-800-472-9888.It's free! CARMEL IN 46032-1938 ��rIIIIIIIIIIII�IIrrl�l�i l�llrr�lr iiri��lliiiill��lllri�ll ::; r '.��"�n" >�>."E`r__'""•c�er:. ,Y w " '-,�,,✓'//""r��:yr. ,�,,,,��, .,",bra" ,:+. 57='",,r. � '' ,z "°,s'"., .a, .J,,Kpr �u'r�sra�«`. ,�%,+,.. ,�' .,n �. $`�"SP�,'�,r���"''OeT° ✓+� J",4y '.}�' .+' �'.z'�.✓d%��H �� .j "�,"°�` .•-z�"'�a`" Fi'v'°& Stalrt'.t#ie NewxYearroff il��tti Savingssanclg refreshmentl�:Enjoy,,$1ioff cases.ofaau!rdICEfMOUPITAIN Sparkling, " d. , r m*, , �:'r;�'"5°;' <` S9 ?a.'°-aaa;, .d.� ✓. ra�da:.' ;,°' ,� �'�� � � ���f�- f ;r'^�, Y1� r:a �iiell; .s cases ctf 0U'F�NEIN de ar'12 oz"e -1sl�VP�it' rVice.lexM0U-efiWnmva#et:cereJ0r;Cali' ^ ,ycs'k,� fise:.�f'^ :;rr"'x✓°,c . 'u"..!tt:•&. 'd,�_,�ux,✓-'r.3e" .,'.. "�'"' ^r �";°,.. :�yr• 4 -1}Wpt6=adatd> dur=:�ekt-arl�i�rG_ r-dxp :313;11'S:3. - °r°ar,.a..�" .' -W „Ci&'>-"��,'5 °.�„�d !°�»�';sa,o �,', " '''..Cx, � F' - ' ,ea- r„F�° r�'s� 'r - < .°-.,�°»ar'xgv ,,Isle. z .�e° s" ra;,to,", x ter:^ '. .a'°"'"�a�1°,° ,*. Kte .r° '."�_r°;,'✓xi^. ,x.s`-d ,, r;: �,r ''.a✓'Ffd.i � +;%s,`., 'rs,.:"YA4 '°'"°d"':. ,�'^a^'r ;�.s.z? -�r¢,� :s - � �s"' .'`f "r»�""✓ ,a.» °°'"a'�¢"»�:'.;,x,�":may °.l�.s° �.� ✓;r,F.,?.�'"',�".su°""" ""f r, �- r „�,;° ..�- "y r....c, ACCOUNT ACTIVITY For uestions or a re rt on water uali and information call 1-800-472-9888 or visit service.icemountainwater.com. g. - ®. g. . �_ �. Delivery address: CARMEL REDEVELOPMENT COMMISSION,30 W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 4920 1/06 041957 PAYMENT-THANK YOU -18.62 1/28 162398 PAYMENT-THANK YOU -30.58 1/09 0810891713 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 1/31 0816007181 1 OIL/FUEL SURCHARGE 2.88 A3986613 RENT 10.99 TOTAL 30.54 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Sr Subject to terms on reverse side. 49.20 — 49.20 + 30.54 = 30.54 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 ®� 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. •° 1234567990 Your Account Number You do not have to pay the disputed amount while it is being 00/00/00-00/00/00 investigated.During the investigation,we cannot report your account 1 as delinquent or take any action to collect the amount in question. 9R ca 123456799 NON'DET z9 Watch here for a wEo-Nov z, GENERAL INFORMATION DE- 18 personalized account 1.Payments received after the billing INVOICE date will appear on Important $0°jj29�° Y g( ) ppe m ;gt,dapdwt1l1.6IkMd•IBpNb" 'Ip Ca++«+«Y ,�APE. message your next invoice.Past due invoices(not paid within 30 days of news and billing date)may be assessed a late fee as allowed by law not to offers 123�n St exceed$20 per month.Additionally,third party collection/attorney .: expenses may be assessed at a rate not to exceed 100%of the .�e>,- ---"'r; '='ri� „e.�die6,-:o-,'�. unpaid balance or the maximum allowed by law. ,. �,�, nay a ,��;.r, 'f"'°" ;,; %; z"; Pay electronically 2.Each returned check is subject to a service charge subject to the .:s. , #ar's•-,s,X'.. maximum check return charge allowable in your State. ":"' '�. r. - ;', ,=t,x�: , .,:a:•> n,.00+na,� Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ,y " o ,..��> s amount has been ACTIVITY. since your ACCOUNrA ..... - '_ -x51,KC,crosvlc oDDOD 4. Equipment replacement costs will be charged for bottles lost, -' �,�,1.11dd,�..,on„DOe,z3Namx paid in full to last invoice stolen,damaged or not returned. „a.,oseaiaMa x>ux avoid late fees TNnAYw S.in accordance with NWNA's Terms and Conditions("T&C"),your oen+ 61� Lease and/or Service Agreement account may be m 'lvees+«,a ",ceMO,,,,,a�aswiD•wv y �» 3neas+aa4 s 6sw�umscai Ratan, Monthly Oil Equipment Den, 3+7ees,•44+ subject to minimum monthly purchases and/or early cancellation a 112 319M3ae„ lsu""'�` S Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the N++7 1 °0"7 """ Surcharge or Delivery website listed below)Upon service discontinuation,rent for the ,DrAL = Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. w>nKTMED = ,' "° 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or �,,,0,,, +`° xx.xNa Information') ,6„w�a_.A„a � Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUNT suMMAar xzxx - ry Y •J Y ca"�cE"uu -- PAY MN AMOUNT will apply to each account. The fee that applies to your account ___"°° -• :a�,a�^°" "• Accmw NDABEa PAV er xra Do is stated on the front of the invoice.For further information please N• �� 123456789" gIWNC/DATE .ENCLOSED ,,,P CE NUMBER visit the website listed below or contact our customer service 123 567890 center. 7. As a food product, bottled water is subject to the rules and ay20096307 04262712619 000391049 200° 16 Amount due regulations promulgated by the Federal Food and Drug �nnn D9a j Administration(FDA). k ^N;061„ l"sca�$1 e �p0 Submit your 8.Your first invoice indicates the products delivered on your first wR D5Ep5ra,"3.,.sow77-9688 delivery,along with any applicable bottle and account deposits, 6a"b"M{,46t"e sae payment by this t.ttt�t"m " o redemption fees,and any dispenser charges.All future invoices date,aENR0P4OS.mww9•.•6o•aa..,+• .. will reflect charges for water delivered and dispenser rental,bottle swl 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 cos 08/12 service.icemountainwater.com Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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 10 hunt n U i r ce' Purchase Order No. P,O, SOX 856W Terms LOUI 5UJ1�e K I U 2 l�s 6 69U Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 03A612-1975S13 Total 30,s 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. I� 1 ALLOWED 20 r� ��QWr3rliil 1�l CPC f — IN SUM OF $ R0, 13n 8566go $ 30. 5 ON ACCOUNT OF APPROPRIATION FOR ( 4�o I /`t3S�9a Board Members PO#or DE T.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), 1961 QJ S 050160 60 %-54 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 2-25-2017 Signature Executive Director Title Cost distribution ledger classification if Carmel Redevelopment Commission claim paid motor vehicle highway fund service.icemountainwater.com ° ° e b e OHIO. ' #215 6661 DIXIE HWY,SUITE 4 01/01/13-01/31/13 03AO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED FRI- MAR 08 0121776199 TUE- APR 09 WED- MAY 08 FRI- JUN 07 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at:1-800-472-9888.It's free! CARMEL IN 46032-2584 I�IIIIIIIr11111���1111�1�111111111Irrll�llrllllll�llllllrll�� s? w" ,.F--sa :nrxw:: adWrr.»x �,.'r,r:n%e ,�` r-,.r. �✓`, v§;s St&t1#W1New-Yearr,offA Wls"figwancl:refresltmentl_pEnjoys$1Foff,cases of our...iCE MdBut T�►1N9SpartdI' i�` x, r.:.�"°4 'l;i'W', y. `-, 'qr: a r.' ,9` }air' es" ,sdr ount IlVaber asgweil;as�,,�cases:o#naur NEV1f Nestiearl2 oa;cansl Visit>service.iicemalnwater:com<orrCall1.0 .1[ e h. -' u;Fi"":R°: Sstt,1 4. ,s-.s. .»€u�''y,. - ,T°'°v'.::aaaoa .a✓ r e:.r. ,- .: - - `v:y�` ` .=-" - 7 - $tct>t9c!c!a*4gt��Sr neXt�QFI-tleir`eX 's3f3'!/!° . ✓�.., :' ss,`` b.°r_,� "s�`"` ^r. � � .�� r���' "" �;?' `'r �s'e�` °J''�« ',r°"r°.. '� ✓ ;r� s� . i a;-:��,rsr�4.i°_.`_ :�. `"�,;a r � -,$� ,.�.,e'.. ;�P v`` c-:"s.,f x�.�.d�° a�:'�"�'r- �,..�' .� .?fix•..`° ?,�4:- a,��,.f ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800.472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SO, HUMAN RESOURCE DEPT,CARMEL IN 46032 PREVIOUS BALANCE 4.20 1128 162397 PAYMENT-THANK YOU -4.20 1/07 0810246520 1 9 OZ PLASTIC CUP 50C/SLV 3.29 1 5 GAL ICE MOUNTAIN DRK W HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED .00 1/31 0816004832 1 OIUFUEL SURCHARGE 2.88 A3913477 RENT 3.99 TOTAL "" � � 13.65 DL/rp--\-\\ FEB r 2013 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 4.20 — 4.20 + 13.65 = 13.65---------------------- BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 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. You do not have to pay the disputed amount while it is being 00100100-00100100 '��56jg90 Your Account Number investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question, mR oa w 123456799 MON-Da 29 Watch here for a NOV GENERAL INFORMATION WELT ruE- 21 DEC EC,O personalized account 1.Payments received after the billing(INVOICE)date will appear on Important 14tl.,1a„abd[llld,.d @rbltl6n,[tlq„Nn{61dN Customer Sernce�l-000-0298 message your next invoice.Past due invoices(not paid within 30 days of news and Thank r°°'°r°'L"9L"M°°"`aln Proa°`N billing date)may be assessed a late fee as allowed by law not to offers I123Mce St ,na aerM4e* °ry'sAte 00000 exceed$20 per month.Additionally,third party collection/attorney a a.tn,d..bGt,bd.a expenses may be assessed at a rate not to exceed 100%of the 1„dpiwJ,.at•" -°ti"°r"'"""s° 3 ';i .,--;,;,,;'•4wm „m,ntakcaa-'ro-gisai ec°�t.wPt�'r`"°a""°""'P:aru'ro'av°n"c`areh;9 °t°nxGDj1�'9,;;�':'C7..'""'" Pay electronically un aid balance or the maximum allowed by law. 2.Each returned check is subject to a service charge subject to the '-' ,ff,-"+-• ,imt�' „gewyKymir�?!s�??��'�;�"a,;a.""'C,y;�,,,, p;, •gs.' )k!Herks. •."9^atd',.,'q ;� ,j,;:z��,,.:..� x'' maximum check return charge allowable in your Stale. - ,;,, •3'';,;:;F,a��,;,;Y. ,•, ,,, ,,,,....0—`�--- Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity -?b'3?*: n, - `�Y�'�' .,,M..���'a°"" RY ACTIVITY. °a°^�^•a'" amount has been since your ACCOUNT ARIVITY r 4. Equipment replacement costs will be charged for bottles lost, DeB+errAdaen °hno°e•'Z3Ma'ns`ree`r�tYStateooa�R ,% paid in full to last invoice 9alance avoid late fees stolen,damaged or not returned. "e" TnanEY°° "0 5.In accordance with NWNA's Terms and Conditions T&C” our vavmem ( ),y OB131 461098 5 SGallon Natural sPnn9 Water %Y Ill 31)0851 W4 Ice Mountain S Gal Dep°vt Equipment Lease and/or Service Agreement account may be n. 3naBS'44+4 5 keM°°ma'nsGalRet°rn � %%xx Monthly Oil subject to minimum monthly purchases and/or early cancellation 09/11 3,� 5 wel s°rmaye w" 310Q0.1I z63ea„ Rent Surcharge,Fuel fees.(A complete version ofthe current T&C may be viewed on the Surcharge or Delivery website listed below)Upon service discontinuation,rent for the TOTAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. ,,,A�TNrt+' = %x>°xM 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge of •,�„ Aw+ -;,, ` '" , Information") Deliver Fee as described in our T&C. Only ne of these fees Payment stub ACCOUNT SUMMARY °E>M10E ------ Y your Y ----AMOUNT will apply to each account. The fee that applies to our account -_--- ACCOUNT 0/m %0 PP Y PP Y --- ua,rm•mr�nmmN�'w'""°` aolar� is stated on the front of the invoice.For further information please 1234567890 BILLING DATE MT ENCLOSED INVOICE NUMBER visit the website listed below or contact our customer service 1234567890 W1001W center. 19 000391049 2004 16 7. As a food product, bottled water is subject 042027126 ect to the rules and Amount due regulations promulgated by the Federal Food and Drug IPnn o« Administration(FDA). ICE MOUNTaN w^TE,„m,m°, Y,,,. 1,3'S(zce'LXI000 8.Your first invoice indicates the products delivered on your first •�^°^"'"`n""°'"' a96.2290M Submit your {�R C05TDMER SERNICE CAl11 a b this delivery,along with any applicable bottle and account deposits, d6•db„a.eu„u.Lt,Fbd.a I� 5m. �.nn Am�aa�G°^•Mnes,aa payment Y redemption fees,and any dispenser charges.All future invoices �" ' - date will reflect charges for water delivered and dispenser rental,bottle 5wN0.1oRrREEAma4AY�s,9 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.icemountainwater.corn VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ PO Box 856680 Louisville, KY 40258 $13.65 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1205 103AO1217761991 42-390.99 I $13.65 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 Mond y, February 25, 2013 Director, Administratio 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)) 02/06/13 03AO121776199 $13.65 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 JW service.icemountainwater.com ' 0 D e ' #215 6661 DIXIE HWY,SUITE 4 01/01/13-01/31/13 03A0120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED FRI MAR 08 0120048525 TUE- APR 09 WED- MAY 08 FRI- JUN 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 Ilihrrl�llllihli�Irrlllrll�rill�hllllm�mliirlruil�rlll v. ,>x `.,..r.�sw.v�,x�, d. s�' .: °rxrr, IT Swart OWNdw-Near off�vlrttl><jSavings'antlq°refreslinientl�Enjoy$1%off:cases.of;.our'ICE'MOUNTAIIVpS�a[icliilg -.s - a ��'s�s.&�k '�r.�3'✓ 1NallerpaMweibas<�es&our mF-wY Ne'st_ea:E2�.oapcansl Yistt service icemountainwatericom=or w.{%f••: 'K✓ars s�`r .'',sb % 'uraC v. t _ 3 4Tt2= 2 8��to>aa� �t�a��aauP° ad�a ig-mg - -_ - ,- '� -. %, � '`"•"�>a� F ^ Y ' a �:�» ' �� rpm° . •. 9 >.,' .= ... - .. ,: :s' r°v"' :�a' _ >�, ,° r. .^".�:,, :,«mot°".,:: .:s ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. ggp;� mid Delivery address: CITY OF CARMEL,1 CIVIC SO, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 21.24 1128 162396 PAYMENT-THANK YOU -21.24 1/07 0810246470 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 1/31 A3921889 RENT 3.99 TOTAL 14.26 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 21.24 — 21.24 + 14.26 ,_ 14.26 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 1-800-472-9988 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. 4216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: Your name,address,telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. \ Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. °° 1234567890 Your Account Number You do not have to pay the disputed amount while it is being 00100100-omooloo investigated.During the investigation,we cannot report your account e 123456789 as delinquent or take any action to collect the amount in question. MON-OCT 29 Watch here for a WE0.NOV 21 GENERAL INFORMATION roE-DEC,B personalized account Important „9888 L Payments received after the billing(INVOICE)date will appear on P Bt1"lgpp8,tnittwntl blpL^dGtl^b„ILtatl a1lp,pe.se1"`e 1-800-4 message your next invoice.Past due invoices(not paid within 30 days of news and map%r^^�^spa'"9 g billing date)may be assessed a late fee as allowed by law not to offers 123Mce sI ,^6°eal4•a exceed$20 per month.Additionally,third party collection/attorney cryscme 00000 I.aaa"a.aL..,ai..�a4.,11.68„6eLLLLa.n � ; expenses may be assessed at a rate not to exceed 100%of the � �,,,z ,.-�--•— ^'�°"°” a,,;;,,;;e tre4, -- unpaid balance or the maximum allowed by law. .r•d-'?"'"- ,n,,,,,L�„yl�;,aw`r >a9^4"`^ �"wxg'.,ia "pm{n4iQ'” Pa electronically rf" "mxma4i6 aeab .^p9°!'"`, s.°:..r,e`.,X> �;. Y Y 2.Each returned check is subject to a service charge subject to the , maximum check return charge allowable in your State. 3. All bottle and equipment de 081[8 are shown as CURRENT Activity _ `�'""" � •.Mappa4=-�aa"'""', Make Sure this ACTIVITY. since our AGCouNTACTIVrrY °� amount has been 4. Equipment replacement costs will be charged for bottles lost, Y •Delrverynaa,ea5 ipn^ppe•123Mmn5"eet'Gty.AxteIIONO paid in full to last invoice `% stolen,damaged or not returned. p„„pp,Bala".• %%%X avoid late fees ThanEVpu K%%X S.In accordance with NWNA's Terms and Conditions("T&C"),your w, 461698 s �m�en, xxxx ,„ 31]685,4444 SGallpn Natural SpnM Water X%% IcemWn SGZlDepua^ %%%% Monthly il Equipment Lease and/or Service Agreement account may be 6,,, 31]BBS,444a s 1cPM^pnta�nSGaIRew1" xxxx Y subject to minimum monthly purchases and/or earl cancellation 89^+ 31 21,944 well""haa9e J Y P Y 626386,1 R- fees. Fuel fees.(A complete version of the current T&C may be viewed on the 09n2 ,564wW xxxx Surcharge or Delivery website listed below)Upon service discontinuation,rent for the roTAL - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Information") Deliver Fee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUM o%x%MO Delivery y y y -c •' PAY THIS AMOUNT will apply to each account. The fee that applies to your account -,,o„�w„^.°...- pnyBr ACCOUM NUMBER °%,x„un wn.^°^"""`"6h 00 00100 is stated on the front of the invoice.For further information please 1 234 5 67 890 BILLING DATE MT.ENCLOSED INVOICE 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 04282712619 000391049 20°° 3 Amount due regulations promulgated by the Federal Food and Drug ph,,D. Administration(FDA). ICE MOUN*AIN W'ATFR COMPPNV 123 Ma1"St p M NN,m WN^N.,,h4m°^ 'M clryM11 a0000 Submit your 8.Your first invoice indicates the products delivered on your first cUSTOMERSEmKEUU1-66^'73-9888 delivery,along with any applicable bottle and account deposits, DB payment by this n«t,n..L.MWLa��,p�u5�e. ❑e,�",•n,E6•"9"°^B�eS� redemption fees,and any dispenser charges.All future invoices SIw+UpEORiREEMRDYAV`69"Up 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 tw•o deliveries. ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No.NW cos 08112 service.ice mountainwater.com Prescribed by State Board of Accounts City Form No 201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee 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 2/22/2013 03A water cooler $ 14.26 Total $ 14.26 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 $ 14.26 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 03A 2200-4239099 $ 1426 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 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com g 0 _ #215 6661 DIXIE HWY,SUITE 4 01/01/13-01/31/13 03AO121202766 n LOUISVILLE KY 40258 . O ADDRESS SERVICE REQUESTED MM � � FEB 22 0121202766 MO N- MAR 25 APR 24 Y l ei, FTA7ED THUD- MAY 23 FEB 1 1 2013 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1-800-472-9888 MANDY SPADY 1411E 116TH ST �y'°�---•- Pay your bill online at:service.icemou ntai nwater.com or CARMEL IN 46032-3455 by phone at: 1-800-472-9888.It's free! r±- ^x? - '�..•as:.:°^M.k» dae-:6�z A,"�`�•�..:°` y °• -`e�°^ _ ,' ,", v,:t,£°",°v :, 1>':,,".-:°F;,;..".�"C`^^ ''u'mi. -rya>'^�.�.... :=: :: •. Start_the°New Year„off`;withsSavin sand refreshment!:: - g Enjoy$1:off;eases,ofmour iCEMOUNTAIN�Sparkl!n(y w: '�,^iR,... Sa' .�'� ti :.a".•ro>y°.'a ..;::>.� 4:`....,:�:r. . :.:'''ti�x.., .•��, �;;,.,,.� .�.:�'£.�. ti .•.y4' `-ro,'>aae=' »z:`a"F':.'.:, .: �aa..;,_. �,•,.c,... .Water as,.�well as casesYof<your-NEW:Neistea=1'. cans!-Visit service icemountainwater corrt�o"r Ca it i'_1 :1N,� 1°-800=472 9888 to�add to Ybiar nezf order! Offer`ex ices 3131%13 � a .'Q� - -#i�F r..?t,a' °".`'�:e,'`�,�''4.�,.;.., °Aa���• '""-n:«,�'•a j� N 4::,+'c.'S„:�`. Si�, °'s :' •e�-''. Mr�0a:�T«S a.ca=. .=.:A4a�e,e :14, % G ° . ; ' A- .'.'`.:,'m a-':��',`�a"•.��.h_.'.....`a"..\',°�;;',.�°- _,.-_c'`�"x>T•�..�•,r.,"' ya+c Y, y„:.s.4 .,L a�_v—, ..: M", *=-':mss>. :� ` °>s"z�;-.-,�.,a�'�'k.k� r;,.. ""..::��"�.� s..°� r`_ -�S•`c"% ��E;'.. �.,:..,:,,.��,�''�'�.'�:'�.';h��, °. .::�<.� ,.s xw a ro.`F'�m° -�,.''�' `'` u m ,�5,:`S: 14s`�`�i:..sca" t,:"?. ,a"•'.:� .Y•ymi„`.,, _ ,:'*<.:i:. 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 -37.81 1/10 0811860923 1 ICE MOUNTAIN HALF PINT 13.99 1/23 0811861087 12 5 GAL ICE MOUNTAIN DIRK W/HANDLE 47.88 3 9 OZ PLASTIC CUP 50C/SLV 9.87 BOTTLE DEPOSIT: 12 CHARGED, 14 CREDITED -12.00 1/31 0815997994 1 OIL/FUEL SURCHARGE 2.88 A4020454 RENT Purchase TT 5.99 DescriptiondJ�� TOTAL P.O.# 11 P��or F 30.80 G.L.#-1�q� •'14' �a l�lJ Line Des Purchaser ecll&e. Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. -37.81 — 0.00 + 68.61 = 30.80 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 666)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. 123AS67890 • The dollar amount of the suspected error. / 00100100 00100100 + • Describe the error and explain if you can,why you believe there is 123+561890 an error. „R-a a M N-ocr 19 - Your Account Number You are obligated to pay the parts of your bill that are not in question. wro-NO 1, T E-DEC 10 You d� not have to pay the disputed amount while yit is being ��jjyp6®laa.�@���",mtl"Iw,da•a aammersmM.:1"Boo-nx"9888 investigated.Durin g the investigation,we cannot report our account Watch here for a as delinquent or take any action to collect the amount in question. 1.nn D. 123 Main st 00000 personalized account a,YState GENERAL INFORMATION Important e aa,.1«m"•!-1ti'?�'`sa"1'a't'""d messa g 1.Payments received after the billing(INVOICE)date will appear on news and .- 'Z ;^' �,�'.=?'y""u"-`-Ne0^" '��^'• } •c-' "-•-'"`B—w#pinln,Md,.ayP'-•.s<m,uewvne<,ai'mw r«u 'µC„�`;` your next invoice.Pas[due invoices(not paid within 30 days of offers ?, Y.wdkY?� " `. '."'<`" •',} y.N7RnlcupNlnyM�atYp( ? .w ._.'q•l."y a:ptl.•�; billing date)may be assessed a late fee as allowed by law not to __ "' ;;- +• - ' �,�":==�%�,�"r"`�a . exceed$20 per month.Additionally,third party collection/attorney r:'. ?="�'s "�+v^_,"; --;'•'�''. Pay electronically 6 iyy.:.".,'�:A.. w. uw.k.aw•,,.n,.xwm"o,N Nwnn, aaw„+w mBM expenses may be assessed at a rate not to exceed 100%of the ..,a.u�°^'""" unpaid balance or the maximum allowed by law. AccouNT gCTNSTY 113 Ma,n Sorel Ow,State 00000 Make sure this 2.Each returned check is subject to a service charge subject to the wrw°,BaNn<a amount has been P'"m`"� Activity ...RY°° maximum check return charge allowable in your State. paid in full t0 OB/31 5Oa11°n Nawral5p,n9 3. All bottle and equipment deposits are shown as CURRENT since your 0Bm 3n6M0si ; �<a CDep°"`° 166 „eMO"" "5�t - avoid late fees ACTIVITY. last invoice 0911' 1,w,— `+_+ 4. Equipment re lacement costs will be charged for bottles lost, .1 i 3 BBWd91 Qen` `r nw stolen,damaged or not returned. o"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 _ e -°"`Ap5 57 subject to minimum monthly purchases and/or early cancellation Your new Y �.... NN. Surcharge or Delivery ACCOUNT suMMAd epp., 9 BB fees.(A complete version of the current T&C may be viewed on the delivery -Y `"°""'""---,,-r__ c „,,.a•^ Fee(see#6 under website listed below)Upon service discontinuation,rent for the Calendar. aMNOMeER"N%7w ® "General Deliveries Kr. ) Leased Equipment is charged through the end of the billing cycle 'D'indicates M Information in which service is discontinued. , 6.You will be charged a monthly Oil Surcharge.Fuel Surcharge or a Scheduled ,;gym ;ooupAy n Delivery Fee as described to your T&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 M;o,',;,;. �;,(„9;; ;.m,; visit the website listed below or contact our tiustomer'servicAYa';��;;,;;; .n°r:.•v """""' �� __ center. Payment stub =------------ - ' �n PAY BY PAYT5.0MOUNr _______________ 7. As a food product, bottled water is subject to the rules and -------n.nn,^aw AccouNrNUmsER Amount due -- 00100100 11HSB1B90 q NCLOBED regulations promulgated by the Federal Food and Drug - ,NVOICEND MBER Biwr+c oArE Administration(FDA). - = ,13+561890 0o100j00 S.Your first invoice indicates the produc"elivered on'your first delivery,along with any applicable bottle and account deposits, 09200963n7 042a2712639 odo393o99 2oaraTO3d Submit your redemption fees,and an),dispenser charges All future"inboiEes will °nn o« payment by reflect charges for water delivered and dispenser rental, bottle - 1cEouNrAiNwATEM"n0 123 s�=�e5 ppp0° this date w.,«, deposits and credits plus charges for any additional products• - E.SEw��EUln'B°°"'"9Bp° 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 tunes 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 e/08 service.icemountainwater.com INservice.icemountainwater.com • ®� 0 215 6661 DIXIE HWY,SUITE 4 01/01/13-01/31/13 03AO120095351 LOUISVILLE KY 40258 ® s � ADDRESS SERVICE REQUESTED FRI- FEB 22 0120095351 BI I{III I I I IIIII I I II� I I II I� I� II�--- MON- MAR 25 R C'Et IVFD WED- APR 24 THU- MAY 23 FEB 1. 1 2013 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST -" -— Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 Your prompt payment is appreciated. For your 'll'III' '���11'I�IIIII���"II'�IIII'I��Il�rl��lrlr�ll�l�ll�"'�' convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. "y � �,. x.- ¢ ar Stait4ttie:Mew Year offrwith,Savingsµ;axefrelshmen, 1 Eni7oy�$1 off°cases^of�our CEvMOUNTAItd S�arkling� canslavisit serviceadefnountainwater com; `- Waties=:as yvreii as cases;;#dur NEW°Nestear iZo2'. otrpCalf.. ; .3".Y�ry3�dL'_"b' �.qy fib.✓'J.r/r.'rx }'`'�7ii�[^°',:.»J Y 1 �'`i`sr i.'�A+'E'A:s' �.nry. �.t�.y .n v Yo IMA 0%"r=1'1 -»'v° S"'� %..':`;. r 'iii:aJ .�,: x.,`✓ as�°.nAp �<� .(.a:f Ja1 n � ��°_"" " .p.', Y. i` � ��,. J qNk ..—rr[l;f ,�' r;^§A:r. :ir'° .tiv_= ,• y„.t,�f°-° .�.�,.f^�-"w, * `,.?�. '» -• �,,, z s.. .'' M^ .*3y <n n=, y ,. ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. _ i ION Delivery address: P CARMEL CLAY PARKS AND REC DEPT.,1427 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 58.58 1/23 0812918761 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 23.94 3 9 OZ PLASTIC CUP 50C/SLV 9.87 BOTTLE DEPOSIT: 6 CHARGED,-6 CREDITED .00 1/31 0815986005 1 OIUFUEL SURCHARGE Purchase 1188 . A3938190 RENT Dr�� _ r� � TOTAL Description rUJ�I\ 107.25 P.O.# PorF G.L.# 1125— t 13.4--5 SrGDV Lint Line escr Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 58.58 - 0.00 + 48.67 = 107.25 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION,PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 661 DIXIE HWY., 4 If you prefer,you can pay your bill online at service.icemountainwater.com 6 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 an we SAMPLE INVOICE sent you the first bill on which thhe e 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. i You are obligated to pay the parts of your bill that are not in question. You do not have to pay the disputed amount while it is being W100100- 00100t00 1234567890 t Your Account Number investigated.During the investigation,we cannot report your account r as delinquent or take any action to collect the amount in question. "T a 723456789 + MON-xJ 29 Watch here for a Y FP NOV 21 GENERAL INFORMATION ,vE-0EG+8 personalized account 1.Payments received after the billing(INVOICE)date will appear on Important t11p4tlallp"a�•daap c'rt",,,�, ,,�Bo-47z.9eaB M your next invoice.Past due invoices(not paid within 30 days of news and ab„d11" � n,,,,Fra"ra�9�"'°"" message billin date)may be assessed a late fee as allowed b law not to X123 g Y Y offers 1 z3 Mao s, exceed$20 per month.Additionally,third party collection/attorney °ry'Stat` OW, a6.ar•6a .a,666a� - expenses may he assessed at a rate not to exceed 100%of the aaa"a.pr�a6�_ °> - s.��eai unpaid balance or the maximum allowed by law. t,' dn;ed:r�.' a� Pay electronically '4-2emw9eT <a0.WA1dTt118R¢ 2.Each returned check is subject to a service charge subject to the '*�?jF,:,sas�4x �;�„�;;;�btv�x%'"?�'"r�""'� �'• � .'�,,q � s . ddivRla%,. .-4•"�- -- r.. °„�S`e`''tq,;,'`;�>w `'" 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 ACn9rTM 4. Equipment replacement costs will be charged for paid in full to Eq p for bottles lost, last invoice pet"`ryAdd- stolen,damaged or not returned. Ar10,Bala"a xx avoid late fees payment-Twn%Yw 5.In accordance with NWNA's Terms and Conditions("T&C"),your oan, 46,B9a 6 SGa1la NaN alSp°"9Wte _ _ x% Equipment Lease and/or Service A Agreement account ma be 11 J'] 144« s k`'"°"""in5Ga10e ' FF. Monthly Oil g Y n+ n2eeJ, 1«M"vmam seal Pewm iy- subject to minimum monthly purchases and/or early cancellation o9n, 3,M.14° 5 wdwrt6 9a jM1, } " " 3,B M. Pe +_''': _ -1:1 i Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the B9n2 +664049] °-' ` `�` � %" "%�` Surcharge or Delivery website listed below)U d a , pon service discontinuation,rent for the Fee(see#6 under Leased Equipment is charged through the end of the billing cycle J ` "General in which service is discontinued. _ MYTMJ a M 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge of Information") Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY 01 c E "a ______-- -Arrt wills 1 to each account The fee thata lies to our account _• w________- p6r ma AMOUNT t apply PP Y .o a o•— «m�F^Mp^em..0_ACCOUM NUMBER %'Y BY %%%% � is stated on the front of the invoice.For further information please •••• � 1234567890 B00 00 ,ENCtosev ! visit the websi[e listed below or contact our customer service IM'12, 67 90 00Iwra }01 123456]890 center. 16 7. As a food product, bottled water Is subject to the rules and 0420096307 04262712619 0003910'9 200' I Amount due regulations promulgated by the Federal Food and Drug 1 i"n"09B Administration(FDA). KE A4q)MNN WArER"CNOM� Iry State 00000 11 8.Your first invoice indicates the products delivered on your first d"°�"""" Submit your NSMMEP SFPNCE CALL+-000�]D9a66 delivery,along with any applicable bottle and account deposits, FOR I"apy,a„pt„„„a6.a6�a.6p„t,•6G46a.A ❑ payment by this redemption fees,and any dispenser charges.All future invoices date slcuwFOxrnEE r. ..:......- will reflect charges for water delivered and dispenser rental,bottle cl 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 twa deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Form No.NW 709 08/12 �_service.icemountainwater.com ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 051125 Ice Mountain Terms P.O. Box 856680 Louisville, KY 40285-6680 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 2/6/13 3AO121202766 Drinking water&cooler- MCC $ 30.80 2/6/13 -3A0120095351�- Drinking water& cooler- Maintenance $ 48.67 Total Is 79.47 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. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 79.47 ON ACCOUNT OF APPROPRIATION FOR 101 General fund / 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 3AO121202766 4350900 $ 30.80 1 hereby certify that the attached invoice(s), or 1125 3AO120095351 4350900 $ 48.67 bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 21-Feb 2013 Signature $ 79.47 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund it