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218494 03/25/2013
a- CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER 1 CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $246.91 �; o•` PO BOX 856680 CHECK NUMBER: 218494 o„ LOUISVILLE KY 40285-6680 CHECK DATE: 3/25/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 03BO12004852 14 .26 03BO120048525 1125 4350900 03BO12006535 51 . 96 03BO120095351 1091 4350900 03BO12120276 54 . 62 03BO121202766 1205 4353099 03BO12177619 22 . 94 03BO121776199 2201 4238900 03C011925282 31 . 06 0300119252823 2201 4238900 13BO11782108 54 . 93 13BO117821082 1701 4239099 13B722032704 17 . 14 13B7220327048 service.icemountainwater.com NO M-311,O D O ' #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 1367220327048 —ijim LOUISVILLE KY 40258 e B e ADDRESS SERVICE REQUESTED ll I l ll I'I llll l"II I I I I I l I I II I 'll TUE- APR 09 7220327048 WED- MAY 08 FRI- JUN 07 TUE- JUL 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 CARMEL IN 46032-2584 by phone at: 1-800-472-9888.It's free! I'llllllll"11111"IIIII�IIIIIIII'III"IIIII�III�II'lllll'lllllll We are now proud to offer NESTEA products! For a limited time save $1 on new Nestea 11',6z cans and 1/2 Iiter bottles.Visit service.icemountainwater.com.or-call 1-800-472-9888 to addJoyour next'order! Offer expires; 3/31113 -- -_ a ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. B+ ® 119=601=1131ms + Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 17.14 2/22 306596 PAYMENT-THANK YOU -17.14 2/06 0814650719 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 2/28 0820131290 1 OIL/FUEL SURCHARGE 2.88 B4109154 RENT 3.99 TOTAL 17.14 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q.,,.Subject to terms on reverse side. 17.14 — 17.14 + 17.14 = 17.14 BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR l. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL I-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 a sent you the first bill on which the error or problem appeared.You can SAMPLE ®I/C 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 D0I00I00-00/00/00 1234567890 Your Account Number 1 �--zs—3' 1 RET651i113 investigated.During the investigation,we cannot report your account 7345678 as delinquent or take any action to collect the amount in question. TNR-00 a MON-oa]9 Watch here for a WED NDV 31 GENERAL INFORMATION NE-DEC 18 personalized account 1.Payments received after the billing(INVOICE)date will appear on Important ,-eoa'7z-9°BR 16q;,qt,g1id11gdndltlJJg4aJlIU°IL,UJJU c°:1°mer 5try"°' message your next invoice.Past due invoices(not paid within 30 days of news and 6.x la" �Iee Mn"nwn w^ 1t g billing date)may be assessed a late fee as allowed by law not to offers i12 51 •nd"'""° exceed S20 per month.Additionally,third party collection/attorney CIty.StMe 00000 1.J UJJna, 6.t.6 q t.W- _ expenses may be assessed at a rate not to exceed 100%of the , -� � „ unpaid balance or the maximum allowed by law. ;.�Iei „bngy4 � �u Pay electronically Y. 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your Stale. - - Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity t _. . -- - ,•ie,-�,a.,�•.. ^� •- amount has been ACTIVITY. since your AccouNTAa^nTY paid in full to 4. Equipment replacement costs will be charged for bottles lost, DeiKnAae ems e00°°° last invoice stolen,damaged or not returned. avoid late fees gyment-Thank VOU % 5.In accordance with NWNA's Terms and Conditions("T&C"),your �, ,6,690 SGa�bnNatura;sG^"9W="� x%.xx Ilt 31]005,M" 5 Ice MOOnt>in5GZl Equipment Lease and/or Service Agreement account may be mees„w s ReM�,n,,;nscaRet°m Monthly Oil 091„ 3,)BBSIM4' NeI5vrcN9e subject to minimum monthly purchases and/or early cancellation w117 3,87636an Rem Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the .0 Surcharge or Delivery website listed below)Upon service discontinuation,rent for the rorAE - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General B Nww in which service is discontinued. . °""`""'`°"TM = MY °J% Information) 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or ,ReWw wN+r= --xxx'M rR° _. Delivery Fee as described in your T&C. Only one of these fees Payment stub ACCOUNT SUMMARY °c e,u.wt••V --___ Y - PAy T,S AMOUNT v6v By will apply to each account. The fee that applies to your account _ °-°�-�- ,-„ ,a. 'M' A[[OUNrNUMBER > is stated on the front of the invoice.For further information please ••' 173456)890 BiL DATE T.ENaoseo INVOICE NUMBER 00 visit the website listed below or contact our customer service ,7;'567890 001001 center. 3° 7. As a food product, bottled water is subject to the rules and 0420096307 04262'712619 000391019 2001 Amount due regulations promulgated by the Federal Food and Drug 1°;,no°e Administration(FDA). ,[E MOUNruN WATER eo C.. s'0o0o0 Submit your aW 8.Your first invoice indicates the products delivered on your first e wncusroMER SEmncE UU3B°0�73-9°°" delivery,along with any applicable bottle and account deposits, payment b this GJab,J.na.n,q.eau.,n.�o.,u.6rur.J.;q P Y Y redemption fees,and any dispenser charges.All future invoices •6o•R �°e ,_ date will reflect charges for water delivered and dispenser rental,bottle sr+aw FOR EREE AD,DRAnsDR U9 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 70908/12 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) �.�L. S r Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ tPn on. nv ,n ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or D PT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or 1361. bill(s) is (are) true and correct and that the 71)* materials or services itemized thereon for which charge is made were ordered and received except 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.icemountainwater.com ffelm #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 0360120048525 -AJjW LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED TUE- APR 09 0120048525 WED- MAY 08 FRI- JUN 07 TUE- JUL 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 I�IIIIIIIII�IIIIIIIII�IIII'I'I'��I"�I'I�I"IIIIIIIIIIIIII'lll'�' convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. Weare now roudto offer NESTEAproducts! For a limited time;"save$.1 on new:Nestea 1�2 oz cansand 112 p �. liter bottles.Visit service icemountamwater.com or calf 1-800.472-9888 to adcl to your next order! Offer expires _31.31/13 . .. �. W- ACCOUNTACTIVITy 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 14.26 2/06 0814650511 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 2/28 B4078889 RENT 3.99 TOTAL 28.52 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT �� Subject to terms on reverse side. 14.26 0.00 + 14.26 = 28.52 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 1-800472-9888 OR WRITE US AT: your first invoice will Include a pro-fated 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. 12 3+s67690 Your Account Number You do not have to pay the disputed amount while it is being ppj00100-00/00100. investigated.During the investigation,we cannot report your account `y 173456789 as delinquent or take any action to collect the amount in question. THR-OC7 0° ".ocr Watch here for a wEo-Nw x, GENERAL INFORMATION 7aE-mE,A personalized account Important EO A77-98" I.Payments received after the billing(INVOICE)date will appear on P p1Ip4;;dUU"U•�aSp e"+t"Rk•SN.Re. message tLitktpng4dllUdaA" ,ny,y ke MwnuN Pr°A'rtu your next invoice.Past due invoices(not paid within 30 days of news and YkmEyW,^' , billing date)may be assessed a late fee as allowed by law not to offers 123M-M51 exceed$20 per month.Additionally,third party collection/attorney pry Sute 0000°ey 1.maWt.tn,,..U."�-at•bu"6.6W,u.a -. expenses may be assessed at a rate not to exceed 1000/,of the --• '"'—"—%^tri,,,�,¢hc2yneR4� `,' unpaid balance or the maximum allowed by law. ; ����• ,ps ;,,,,,t,mt �+i k+ �� R�f`� Z,4 Pay electronically 2.Each retuned check is subject to a service charge subject to the maximum check return charge allowable in your State. M1 .- it Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity -' i.. -,� amount has been ACTIVITY. since your nccouruAa°nTY u3rAem svRec em sum aid in full to 4. Equipment replacement costs will be charged for bottles lost, - oemen Am"'u rx.xR P last invoice avoid late fees stolen,damaged or not returned. 5.In accordance with N WNA's Terms and Conditions("T&C"),your 5 swamwt"�•�w'"'9'Ni° _.-- ,.,jp10`wt f Ill 3170651NM Ke Mme'^�ynStMt Equipment Lease and/or Service Agreement account may be ,,, 3r7aes,4Ra s KeMw"voswiRn�m M1 Monthly Oil Pyn' 3170R5MN4 may,"Iwge .,". : ; ?"�'. Surcharge,Fuel subject to minimum monthly purchases and/or early cancellation „ ; . , x00 l g, fees.(A complete version ofthe currentT&C may be viewed on the Surcharge Or Delivery website listed below)Upon service discontinuation,rent for the roru - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. „,,<7NR+ _ '"r'"",,,";x' f YM,NIxAONS*"""`+ Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or .eEY�"A"""-'” uxA � _„„.,•,�.. Delivery ee as described in yew T&C. On one of these fees Payment stub ACCOUNT SUMMARY ,axa ---- rY Y ty Y c.... _________ PAY TMIS War will apply to each account. The fee that applies to your account `•"� -_� p1-,�•PM""•'•1M-AccountN°Maut pAYav �oE>a is stated on the front of the invoice.For further information please °"''� m � 123456788" awNC GATE .ENaosw BER } INVo10E NUM visit the website listed below or contact our customer service '234567890 WIOO DA center. 7. As a food product, bottled water is subject to the rules and °,20096307 0,2,2712619 °°0391°49 2°0" In Amount due regulations promulgated by the Federal Food and Drug D« _ , Administration(FDA). ,eE ouNrur+wnTER�coM �3 s�'1es`�oo k� Submit your 8.Your first invoice indicates the products delivered on your first rp8CU5rOME.5FAY10ErA131��)x-9°°' 1 b this delivery,along with any applicable bottle and account deposits, p„6a,u.tt.6WkU Re..,es� payment Y redemption fees,and any dispenser charges.All future invoices n5;,,,, �•eo'�R�••+• date �sKr+uv roR rwE AirteM will reflect charges for water delivered and dispenser rental,bottle - deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. Form No.NW 70908/12 Sservice.icemountainwater.com Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee 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 3/5/2013 03B01 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 PD#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 03B01 2200-4239099 s 14.26 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 ��'?"mz�---'4/22/2013 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com 0 D 0 I kq 101 ' #215 6661 DIXIE HWY,SUITE 4 LOUISVILLE KY 40258 02/13/13-03/12/13 0300119252823 ADDRESS SERVICE REQUESTED TUE- APR 09 0119252823 WED- MAY 08 FRI- JUN 07 TUE- JUL 09 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at: 1-800-472-9888.It's free! CARMEL IN 46074-8267 Spring into refreshing savings. For a limited time, enjoy up to$2 off per case"on NESTEA S.PELLEGRINO, }. SAN PELLEGRINO SPARKLING FRUIT BEVERAGE'S ACQUA PANNA. Visit seryice.icemountainwater com or call 1-800-472-9888 to add to your next order. _Expires 4/30/13 .. _ _ s t` 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.131ST ST,CARMEL IN 46032 PREVIOUS BALANCE -30.65 3/08 0819769704 11 5 GAL ICE MOUNTAIN DIRK W/HANDLE 38.39 11 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 66.00 5 9 OZ PLASTIC CUP 50C/SLV 16.45 11 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -66.00 3/12 0821884137 1 OIL/FUEL SURCHARGE 2.88 C4262334 RENT 3.99 TOTAL 31.06 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. -30.65 — 0.00 + 61.71 = 31.06 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 I-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about - a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing later than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which thhe e error or problem appeared.You can an telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. `" ' 1234567890 Your Account Number You do not have to pay the disputed amount while it is being 00100/00-000 0, investigated.During the investigation,we cannot report your account 123456789 as delinquent or take any action to collect the amount in question. M0H-«F Watch here for a weo-rvov n GENERAL INFORMATION WE DK 10 personalized account 1.Payments received after the billin g(INVOICE)date will appear on Important tLn.dn"n6Atm+I�nn,614L.,.Inn"It.AL Cuz message your next invoice.Past due invoices(not paid within 30 days of news and T,,,^Xr°°1«°•i^9"eM°""°I"p'°""`t. billing date)may be assessed a late fee as allowed by law not to offers 1123�St ,m a•rv1a,. exceed$20 per month.Additionally,third party collection/attorney nr state 00000 I,Atla.,a,+aL, n n.,,n.Ln„L iLLLA"n expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law. mm•^•0ew"'g ro�*W.°, Pay electronically '� 2.Each returned check is subject to a service charge subject to the Fd ,Ha,,, v,,�ae,nar� °`t`a"°'"°``^"'"`.! . maximum check return charge allowable in our State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity '"' a•^pAe '°°""p - _ ,,,. amount has been ^^'"s `rn ACTIVITY. since your AccouNrArnvITM "'W paid in full to 4. Equipment replacement costs will be charged for bottles lost, last invoice Del, ,ygaa 3pn^0«.123 $11P %%x% stolen,damaged or not returned. p,e,iou,Bala^<e x:� avoid late fees Payment-TlunxYOu 5.In accordance with NWNA's Terms and Conditions "T&C ) our 31 461e98 _- %:xx ( ,y OBI 5 SGallon Natural Sprin9wate. % /I1 3178051Ma4 ce Npuntain5ral Deposit Equipment Lease and/or Service Agreement account may be /„ 3vees1+4a4 s 'iaeM«1^tai^SGaIRd°m :n:x, Monthly Oil 09111 31J88514M4 Fuel SurcNr9e subject to minimum monthly purchases and/or early cancellation �n2 ne2638en ne°t r Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the 09/'2 16 9 "" Surcharge or Delivery website listed below)Upon service discontinuation, rent for the 10TAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. C11,,,,,..<.Mt. _ •"yTM':,�,,:"' Information') 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or YIwsM1AH yw „� ' Delivery Fee as described in your T&C. Only one of these fees Pa ment stub ACCOUNT SUMMARY .°.t.° -_____ y pqY THIS AMOUNT PAY x+� will apply to each account. The fee that applies to your account _____-�+w«�«b,.,,m,.,a,wwY^•" ACCOUNT NUMBER 01 0 1234567890 00/00100 T.ENCLOSED is stated on the front of the invoice.For further information please ,we,ENUMBER BIUJ DATE visit the website listed below or contact our customer service BD/00100 12)456)890 center. 9 0003910'19 2009 18 7. As a food product, bottled water is subject 0428221261 ect to the rules and Amount due regulations promulgated by the Federal Food and Drug I-- Administration(FDA)- ICE MOUNFAIN wA1ER MANr 121--Se °0°°° 8.Your first invoice indicates the products delivered on your first •p^^°'aH„aEw'"' SW 779W Submit your delivery,along with any applicable bottle and account deposits, wRC08T0ME"'ERrICEw"- b this I.Atld� n"6n..L..LLL1,J»tl 5i°`. payment y redemption fees,and any dispenser charges.All future invoices 99"„pe.9al,+ao" �°•51de date will reflect charges for water delivered and dispenser rental,bottle yGNOP�DBFeFE� deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No.NW 709 08/12 ��service.icemountainwater.com service.icemountainwater.corn 0 D 0 #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 1360117821082 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED e B ' TUE- MAR 19 0117821082 THU- APR 18 FRI- MAY 17 TUE- JUN 18 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Did you forget about us? Kindly pay upon receipt. 3400 W 131 ST ST Remember,past due accounts are subject to a late fee. CARMEL IN 46074-8267 Your prompt payment is appreciated. For your "IIIII"'�I'lll'I'1'IIIII"I' III"�II"���II'I�I��II'll'�III'I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. 1Ne are now proud to offer NESTEA products! For a limited time; save $1 on new Nestea 12 oz cans and 1/2 I Visit service.icemountainwater.com or call 1-800-.4,7,2-9888 to add,to your nextiorder! Offer expires; –— 31 1113= a n U y 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 20.63 2/15 0816886980 10 5 GAL ICE MOUNTAIN DIRK W/HANDLE 34.90 10 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 60.00 10 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -60.00 4 9 OZ PLASTIC CUP 50C/SLV 13.16 2/28 0820022630 1 OIL/FUEL SURCHARGE 2.88 B4065796 RENT 3.99 TOTAL 75.56 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 20.63 — 0.00 + 54.93 = 75.56 . BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR I. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE Us AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights.In your letter, give us the following information: Your name,address,telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. •• 1234567890 Your Account Number You do not have to pay the disputed amount while it is being + 0°100100-00/00/0° investigated.During the investigation,we cannot report your account 123456789 as delinquent or take any action to collect the amount in question. TMoR--o00 9 Watch here for a WER NOV 71 GENERAL INFORMATION DEC IB personalized account 1.Payments received after the billing INVOICE date will appear on Important �na�kpL4a� tlaltaL.lUp.t�B-alp c"„^�^�Seryke'.1"eo°-']7'Bee Y g( ) PPe 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 12 s' exceed$20 per month.Additionally,third party collection/attorney °ry's`a`e 00°00 at n..La..t„LM,LI„a unpaid d balance or the maximum allowedtbtolaweed 100%of the 6 Rwn,Nmpbkvs �� 64 Pa electronically P Y '"°...`.r, rol^mna+ ,Ywadd�iE>bw �"'° a- Y Y 2.Each returned check is subject to a service charge subject to the am� 1e"”" Y.r1a4Jetp ;e 6 a�„e,l�,mdxcfamw�s Wwe maximum check return charge allowable in your State. -` V Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ,_ ",,,,,„:,..R ^°"•'°'°"'°a"°"` y - amount has been ACTIVITY. since our AccOUNTACmwTY -0008° 4. Equipment replacement costs will be charged for bottles lost, stolen,damaged or not returned. last Y invoice Del ryAddn9>o^D0e'1231"'iRS Cory•s.>'e %Xxx paid in full t0 avoid late fees P>. t-1NnkYw 5.In accordance with NWNA's Terms and Conditions("T&C"),your �B, ,61098 5 SGaI,m N>aui sod^9W='°` xzxx 111 31j51>444 ke Mwnuin50>I Deposit %%%% Equipment Lease and/or Service Agreement account may be „ 3neesu 44 s oeMw°o>I^s°1Re1"I^ 0.0 Monthly Oil subject to minimum monthly purchases and/or early cancellation i EQ°'s""""" ° Surcharge,Fuel fees.(A complete version of the currentT&C may be viewed on the 071'7 '�°0"'] R^ _ "%xX 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. T Information') 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or EYI006wABT w% 9� - Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUMMARY Ewa rY Y Y Y _ — PAY TNIS AMOUW PPY BY mss,e, ^ will apply to each account. The fee that applies to your account ____---w� �e rt•m MN>d.w ACCOUNT NUrneER o0 oB is stated on the front of the invoice.For further information please :3456)890 BiwNC DATE MT ENaosro INVOICENUMBER pp1p0100 visit the website listed below or contact our customer service ,73+567890 ' center. 7. As a food product, bottled water is subject to the rules and 0420096307 OV28,111619 000391099 2004 36 Amount due regulations promulgated by the Federal Food and Drug 1m^- Administration(FDA). ICE MouWAIN WAT C M� cn w�es`0oo°0 ,N. Submit your 8.Your first invoice indicates the products delivered on your firs[ roPCDSTDMERSEm+cECUE1-eao+7>•-'BBB delivery,along with any applicable bottle and account deposits, payment by this 4ddL�J.11M•JL..d4.14La.L.LL41,l.q sd.. ❑nim ancNreE*a`"P^"`sx. date redemption fees,and any dispenser charges.All future invoices :10N0PEORFRErAV,o,,,"zignOpl„°"he°o^"e"u 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 08112 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)) 03/13/13 1380117821082 $54.93 03/18/13 03CO119252823 $31.06 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 $ P. O. Box 856680 Louisville, KY 40285-6680 $85.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 13BO117821082 42-389.00 $54.93 1 hereby certify that the attached invoice(s), or 2201 03CO119252823 42-389.00 $31.06 bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday arch 21, 2013 ua" P._, Street Commi oner Ga....e. /`MmiSSir)nar Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.icemountainwater.com ° ®® #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 0360121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED II�IIII�I"III II'lll� II �I(I I'll Ill 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 Did you forget about us? Kindly pay upon receipt. 1 CIVIC SO Remember,past due accounts are subject to a late fee. CARMEL IN 46032-2584 Your prompt payment is appreciated. For your convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. We:are now�proud to`offer NESTEAprod"ucts! For a limited time;save $1 onnew Nestea 12�oi cansand 1/2 liter bottles-Visit service.icemountainwater.com`or call 1-800-472-9888 to add`to your next order! Offer expires 3131/13. . .,..._._,.. �7 1 o 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 13.65 2/06 0814650552 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 2 9 OZ PLASTIC CUP 50C/SLV 6.58 BOTTLE DEPOSIT: 1 CHARGED, 0 CREDITED 6.00 2/28 0820062842 1 OIUFUEL SURCHARGE 2.88 B4070747 RENT 3.99 TOTAL D /L1\ 36.59 MAR 2013 , By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CUR NT ACTIVI PAY THIS AMOUNT Q Subject to terms on reverse side. 13.65 — 0.00 + 22.94 = 36.59 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 1-800472-9888 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 ser-ice.icemountainwater.com 6661 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing no later than thirty(30)days after we SAMPLE 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. u3+s67s90 Your Account Number You do not have to pay the disputed amount while it is being WIO0100-00100100 investigated.During the investigation,we cannot report your account ' 12345678 as delinquent or take any action to collect the amount in question. 1106-ocr°' T MDN-a3:9 Watch here for a GENERAL INFORMATION ,DE-DEC 16 personalized account I.Payments received after the billing INVOICE date will appear on Important M10.4a"U6dN41.11UrLIB�wttla.a.UJ�a cun"rr�s•"^";1�p472.9666 Y g( ) Pda mpv6K message your next invoice.Past due invoices(not paid within 30 days of news and T kY°•'+n vd"9� "'" billing date)may be assessed a late fee as allowed by law not to offersMD,cemsc exceed$20 per month.Additionally,third party collection/attorney t.isl,.d.at..A..1Ldk411„6.666t.t� expenses may be assessed at a rate not to exceed 100%of the «- "—""�`� ,,.,pm.r•- k' unpaid balance or the maximum allowed by law. �----"° ' a~� v °'��° 1i`'�"ro„NUw , ''r`"""RS6" '`- • Y Y Pa electronically 2.Each returned check is subject to a service charge subject to the k� m "�bA1',v„"'ia ,(r.pw>.a+d"^'"`"'�`xrw+ maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity -.__ °4"°' .,,,,,,",w,,.�. ••aa°" '°°°''p ACTIVITY. s amount has been since your AccoUNTACTwTV paid in full to 4. Equipment replacement costs will be charged for bottles lost, .. DN;�rY°,aeressbhnDOe.+23•^"n5"`chst1t xx„ last invoice avoid late fees stolen,damaged or not returned. A�tetra �Ea 1, S.In accordance with NWNA's Terms and Conditions("T&C"),your �, .6+e9e s sc.emNx�sa^•9"""` _._. - -�} Equipment Lease and/or Service Agreement account may be "' se.Dewm+ Month) Oil g Y nl 317 5; s tt s a6e� / Y 09/11 31)80514W 5 Fuel y,rtN9• •'�'f l(.:., subject to minimum monthly purchases and/or early cancellation X112 31�,�„ ,,, �..� `� Surcharge,Fuel fees.(A complete version of the current T&C may be viewed on the o9n `�'0"' -- - jppp1 '• Surcharge or Delivery website listed below)Upon service discontinuation,rent for the mr°E - ,I Fee(see#6 under Leased Equipment is charged through the end of the billing cycle t "General in which service is discontinued. Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or .,E.9w1w.,35• ,oxrM „p„ - { Delivery ee as described in our T&C. Only one of these fees Payment stub ACCOUNT SUMMAaY wa ry Y Y r -^ -------- rAr m' --r--a AMOUNT t will apply to each account. The fee that applies to your account __- "� ,o,: X Accouw NuM6En is stated on the front of the invoice.For further information please • 1234567690 NW D _u CLOSED INV NUMBER 00100100 visit the website listed below or contact our customer service OICE 123+567890 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04262712619 000391045 zoo4 16 �,, Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). IcEMW+.nA+NwArcaoM°"H �n3,7s„,es`0roo0 8.Your first invoice indicates the products delivered on your first •piFtlo”" � ,ao9,72-96M Submit your delivery,along with any applicable bottle and account deposits, 0.6.6l,6t.�•�8 „x ?. payment by this 4m�am°tu°at tot date redemption fees,and any dispenser charges.All future invoices ��,",,;260.a.�+• _ _�- will reflect charges for water delivered and dispenser rental,bottle `� ,eEEw ^ ... - deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks,for a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximately 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. Form No.NW 709 08/12 Sservice.icemountainwater.com Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 03/05/13 0380121776199 $22.94 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 $22.94 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 103BO121776199 I 43-530.99 I $22.94 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 Tuesday, March 19, 2013 Direct , Administrat n Title Cost distribution ledger classification if claim paid motor vehicle highway fund service.icemountainwater.com 0® 0 ,imp #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 03BO121202766 LOUISVILLE KY 40258 e ADDRESS SERVICE REQUESTED ® B 11111111111111111 IN 1 1 1 1 1 1 IN I �I' WED- MAR 25 0121202766 WED- APR 24 THU- MAY 23 —T! MON- JUN 24 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1-800-472-9888 MANDY SPADY MAR 11 2013 I Did you forget about us? Kindly pay upon receipt. 1411E 116TH ST Remember,past due accounts are subject to a late fee. CARMEL IN 46032-3455 Your prompt payment is appreciated. For your IIIIIIII�II"11�1'�I1�1'I'1'I�'I'�11�1"1111"I1�11'�I�I'I�II!�'I convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. We_are now proud to offer NESTEA products! For a limited time;save $1 on new Nestea 12 oz cans and 1/2 liter-bottles. Visit service.icemountainwater.com;or,call 1-800-472-9888 to'add-to.your next�,order! Offer expires: 3/31113 . `ff` - �; n - _ A.. ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. ®. Ila Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 30.80 2/22 0818021263 12 5 GAL ICE MOUNTAIN DIRK W/HANDLE ""����� � 47.88 x BOTTLE DEPOSIT: 12 CHARGED, 13 CREDITED �wvvi! -6.00v 0819712571 12 5 GAL ICE MOUNTAIN DIRK W/HANDLE 47.88v 3 9 OZ PLASTIC CUP 50C/SLV 9.87✓ BOTTLE DEPOSIT: 12 CHARGED, 13 CREDITED -6.00V Purchase 2/28 0820055168 1 OIL/FUEL SURCHARGE 2.88✓ 84178366 RENT Description / 5 99✓ P.O.# PorF TOTAL G.L.# /D9/� �3509Dy 133.30 / Budoet 54, Line`bescr Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Q,._ I. �Subject to terms on reverse side. 30.80 — 0.00 + rj�6�h62-50- = 133.30 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 WIII 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 first bill on which the he error or problem appeared.You can an telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. - - 1234667890 Your Account Number You do not have to pay the disputed amount while it is being W/00100'00140t00 - investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. D18-ocr o. 2345678 MDN-a3 z9 Watch here for a GENERAL INFORMATION ,B fKC K 7, personalized account TIIE- 1.Payments received after the billing(INVOICE)date will appear on Important p�d,ap,,gte"C.Addtl p,a„R, your next invoice.Pas[due invoices(not paid within 30 days of news and message r6.,E7�b"'�'a"`"spiO"d" billing date)may be assessed a late fee as allowed by law not to offers iiiM�s' exceed$20 per month.Additionally,third party collection/attorney �'sw1e ptppeOD,,,t6„d4a4•tp„ 6"6Lt 1 expenses may be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by_law. mm. ?i>t..- s '�53 `y-rL ” j---� - Pay electronically 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. i `- Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity °'` - - - 3 a✓°" •+ .. amount has been ACTIVITY. since your ACCODNTACTw,T3 " aid in full to 4. Equipment replacement costs will be charged for bottles lost, �- ceie�r�°ia`b1n DO`'121 w+e aa0oo yxxx P last invoice avoid late fees stolen,damaged or not returned. n�8a'""a 5.In accordance with NWNA's Terms and Conditions("T&C"),your u,e9a srm"r,•B.�sa^`9"'"" ,„ 3Haes,u4� s swiD�N• xxxR Equipment Lease and/or Service Agreement account maybe Monthly Oil subject to minimum monthly purchases and/or early cancellation o9"' 31� r�'s'"`""e` ' '" xuz F Surcharge,3,ar6am„ i- Surchar a Fuel fees.(A complete version ofthe current T&C may be viewed on the wn `x'0"7 "'-"' Surcharge or Delivery website listed below)Upon service discontinuation,rent for the r°ru - Fee(see#6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. �•^°'"jp1M` M Information' 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or „�, - Delivery e as described in our T&C. On one of these fees Pa ment stub ACCOUNT surAEAAar c- -_ Nr �' Y Y ,"r--•, .- PAY THIS AMDU will apply to each account. The fee that applies to your account _'"_-' w. +�"^^•"..�w Ems^^•' AccouNT NOAEeEx `'�' w+ is stated on the front of the invoice.For further information please ,z3+s67890 W .ENCLOSED �,ryp,CE NUMBER NWNG DATE visit the website listed below or contact our customer service 12 4 67898 WIMIN center. 7. As a food product, bottled water is subject to the rules and 0,20096307 09262712619 000391099 2aa9 16 Amount due regulations promulgated by the Federal Food and Drug a O, Administration(FDA). �E uN wATER�CO 123 •�°p°°° 8.Your first invoice indicates the products delivered on your first - •°M'�°'aE� °• EA,1�731a Submit your rw cu payment b this delivery,along with any applicable bottle and account deposits, p�.61,4td,a � •,,,.- P Y Y redemption fees,and any dispenser charges.All future invoices �srxwwnm�EwmPAnvmw °nx•�+• 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. Form No.NW 709 08/12 �r`�SServlce.ice mou ntai nwater.co m 0 service.icemountainwater.com • • ®® #215 6661 DIXIE HWY,SUITE 4 02/01/13-02/28/13 03BO120095351 LOUISVILLE KY 40258 ® ® t3 ADDRESS SERVICE REQUESTED MON- MAR 25 0120095351 WED WED- APR 24 THU- MAY 23 MAR 1 1 2013 MON- JUN 24 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA 1411 E 116TH ST -- - - --- Did you forget about us? Kindly pay upon receipt. CARMEL IN 46032-3455 Remember,past due accounts are subject to a late fee. Your prompt payment is appreciated. For your 'll'I'llll'I"IIIII'll"IIII'llll"III��I�I��IIIII'lllll'llllll' convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. INe are`novi proud_to offer NESTEA.prodUcts!for awl imited'tirne;save'"$1.'on n"ew.Nestea�122 oz cans and 1°/2 liter-bottles,V t service Icemountainwater.com or call 1 800-472 9888 to add to your next order! Offer expires r r ... � ... ACCOUNT ACTIVITY For questions or a re ort 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 107.25 2/10 233045 PAYMENT-THANK YOU -58.58 2/22 0818021214 6 5 GAL ICE MOUNTAIN DRK W/HANDLE "' ` JLU, bWd 23.9 4 9 OZ PLASTIC CUP 50C/SLV 16 BOTTLE DEPOSIT: 6 CHARGED, 6 CREDITED .00 0819712605 6 5 GAL ICE MOUNTAIN DIRK W/HANDL%jrchase 23.94 It 4 9 OZ PLASTIC CUP 50C/SLV i �Arrin i n hiA d, . 13.16 BOTTLE DEPOSIT: 6 CHARGED, 6 CREDITEB / .00 2/28 0820041937 1 RENT OIL/FUEL SURCHARGE G P.O. .# ! 25-1—�3- �,3�0�0� 11.984. Pudcet TOTAL Line Descr 137.73 Purchaser Date Approval Date ��- PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 107.25 — 58.58 + )�9<6 = 137.73 \ 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 t-Boo-a7 vss8 OR WRITE us AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 6661 DIXIE HWY.,SUITE 4 If you prefer,you can pay your bill online at service.icemountainwater.com 6661 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of paper.We must hear from you in writing later than thirty(30)days after we SAMPLE INVOICE sent you the first bill on which thhe e error or problem appeared.You can an telephone us,but doing so will not preserve your rights.In your letter, give us the following information: • Your name,address,telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. Describe the error and explain if you can,why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. 1234567890 Your Account Number You do not have to pay the disputed amount while it is being 00/00100-00100/00 investigated.During the investigation,we cannot report your account t .12345678 as delinquent or take any action to collect the amount in question. MoN oa 29 Watch here for a tyro-NOV x1 GENERAL INFORMATION mE.DEc I9 personalized account 1.Payments received after the billing(INVOICE)date will appear on Important ,-80 724999 n,n,an.ncantLl.,nnAAtlL.�,mn"n;ataAn ��,1^^�`�`^"`< message your next invoice.Past due invoices(not paid within 30 days of news and n„REY"Riwu,l^9"`Mpun°�"P` — g billing ate may be assessed a late fee as allowed b law not to o« g ) Y Y offers i�Ma10 n l exceed$20 per month.Additionally,third party collectionlattorney °ry.s`a`< 00020 LAtl,L.A,rOL.AI AI i1.AnrL LLIdA tl _ospenses,mny�be-assessed.at-a-rate.no4to-exceed 100%of the - unpaid balance or the maximum allowed by law. ----�-°"""� rt tm<,a+y+��s' Yr^ °.PSD' Pay electronically 2.Each returned check is subject to a service charge subject to the ,;�RR4Rm93wwrroc �t•'"d""""''^"`n" ' maximum check return charge allowable in your State. `" wRfeA dpefiwRan r, r-s- `t"`!" a Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ,.. '- Yad°• '°°�°'°• ACTIVITY. since our pccouNTpalvlrY °""'"'""""`•"�� M amount has been 4. Equipment replacement costs will be charged for bottles lost, Y kid— 1On^p^<,123Ma1^S ``Y,State ppp00 AaxA paid in full to last invoice stolen,damaged or not returned. P.<r;w,eaw^`° zx.>u avoid late tees Thank YOu 5.In accordance with NWNA's Terms and Conditions("T&C"),your W3 461099 q�;woHam,aisw'^9w°`� •"x" i nl 3178051M44 5 1ceMwnuln SGal Oepont Equipment Lease and/or Service Agreement account may be 3,79es,4++4 5 aMR4"„msw;R<,.r^ xxax - Monthly Oil subject to minimum monthly purchases and/or early cancellation 99m 3','085 ; �w<iwrdur9e ''"° ` )036389„ �", Surcharge,Fuel fees.(A complete version ofthe current T&C may be viewed on the o9n2 '6 j 97 - ' .xxn ' i Surcharge or Delivery website listed below)Upon service discontinuation,rent for the 3 TAL Fee(see#6 under Leased Equipment is charged through the end of the billing cycle ' "General in which service is discontinued. `""° _ <AY.RS M Information") 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or ,RD,oO LAIAR� --,a.>a „ , Delivery Fee as described in your T&C. Only one of these fees Payment stub AGCOUNTSUMMARY o you Y r -o,c e PAY BY PAY THIS AMOUNr will apply to each account. The fee that applies to your account _ •-"-•�-�� ;------- ACCWMNUM50' Rr- is stated on the front of the invoice.For further information please •-- ---R- 1234567090 eiw G o TE T.ENCLoSED NUMBER visit the websi[e listed below or contact our customer service ;NMI Nloo eO,23.,567890 center. 7. As a food product, bottled water is subject to the rules and 0420096307 04282712619 000393049 2014 " Amount due regulations promulgated by the Federal Food and Drug Administration(FDA). ICE MOUNTNN WATER COMPANY 123 Main St ' Submit your��d,,,^ywanNermA^•""•"' 1 8.Your'first invoice indicates the products delivered on your first C;tY,S'.. 00000 Submit DMERSER ECML,2 12-9M delivery,along with any applicable bottle and account deposits, payment by this I.JP.L.d.p4..Jiwlt-.t4La..4.LLLW.n 5°,. redemption fees,and any dispenser charges.All future invoices Nnro6"s9"U,R<we•OO^""""` date will reflect charges for water delivered and dispenser rental,bottle s.0"OPtoRE9EE - 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 h . �;.. ,is 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 3/5113 3130121202766 Drinking water& cooler- MCC $ 54.62 3/5/13 3130120095351 Drinking water& cooler- Maintenance $ 51.96 Total $ 106.58 1 hereby certify that the attached invoice(s), or bill(s) is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20_ Clerk-Treasurer Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 106.58 ON ACCOUNT OF APPROPRIATION FOR 101 General fund / 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 3BO121202766 4350900 $ 54.62 1 hereby certify that the attached invoice(s), or 1125 3BO120095351 4350900 $ 51.96 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-Mar 2013 Signature $ 106.58 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund