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224531 09/25/2013
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $140.44 ' PO BOX 856680 CHECK NUMBER: 224531 LOUISVILLE KY 40285680 CHECK DATE: 9125/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4239099 10 . 32 03HO121776199 1801 4350900 32 . 28 03HO121975593 2200 4239099 21 . 24 03HO120048525 2201 4238900 40 . 33 03I0119252823 2201 4238900 36 . 27 13HO117821082 0 service.icemountainwaler.com �e #215 6661 DIXIE HWY,SUITE 4 08/13/13-09/12/13 0310119252823 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED MON- 07 0119252823 NOV MON- NOV 04 THU- DEC 05 TUE- JAN 07 CITY OF CARMEL STREET DEPARTMENT Customer Service: 1-800-472-9888 BONNIE CALLAHAN Pay your bill online at:service.icemountainwater.com or 3400 W 131ST ST by phone at: 1-800-472-9888.It's free! CARMEL IN 46074-8267 Ill�rl�i�llll�lll�n�ll��ilr��ll�li�lllri��ll���i���rl�l�lll� s s for a lirriited time only, buy twro 1 gallon bottles of Tradewinds�sI brewed Iced Tea and save 20%IXYou cant s also buyone 1 gallon bottlexfor only$4:99:1 Available InSweet, en..D16 Green& Lemon Tea=�lavorsycall, 1�800-47,2-9888�to adcl,to�your next�orcler�!�.Offer�exnires 1ni�1i�� � � � "�� � e ACCOUNT ACTIVITY For uestions or a re ort on water qualit 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 45.91 9/08 396952 PAYMENT-THANK YOU -45.91 9/09 0846403582 8 5 GAL ICE MOUNTAIN DIRK W/HANDLE 27.92 8 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 48.00 2 9 OZ PLASTIC CUP 50C/SLV 5.58 8 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -48.00 9/12 0848921219 1 OIL/FUEL SURCHARGE 2.84 15227621 RENT 3.99 TOTAL 40.33 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 45.91 — 45.91 + 40.33 = 40.33 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY AND INFOWATION, PLEASE payment is due by the HELP US SERVE YOU BETTER CALL 1- 1. Please remember 800-472-9888 OR WRITE US AT: 2. Remember,if by"date noted to ensure the smoothest service. ICE MOUNTAIN gp�G WATER CO. You are renting equipment,your e ui 6216 your first invoice will include a pro-rated fee for the current month,plus the next month's rental. q pment rental is charged one month in advance.That means 6661 DIXIE HWY,SUITE 4 3• Kindly fill in the amount enclose LOUISVILLE,KY 40258 If you prefer,you can a include your account number on online at 4. Never hesitate to call us with ommen s,questions,or concerns. "ater•comr °heck, and do Ifyou think your bill is wrong,or if 2301 Send Cash. a transaction on your bill,write us on a separate sheen of paper.We must hear from you in writing no later than thirty(30)days after we sent you the first bil!on which the error or problem appeared.You can telephone us,but doing inform will not preserve your rights,in your letter,give us the following information: SAMPLE Your name,address,telephone and account numbers. INVOICE The dollar amount of the suspected error. Describe the error and explain if Date range of this invoice an error. You can,why you believe there is 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 investigated.During the investigation,we cannot re i as delinquent or take any action to c port Your account olleci the amount in 3 DoioDioo.00foatoo 1234567890 GENERAL �RM� question, YOur Account Number 1.Payments received aft�[h2 billing TIN 1234s6789e $ Your next invoice.Past due invaes(not Paid 30 days of news and Important oN DIC 2s vrta NW 71 billing ate nE-orc,a Watch here for a g )may month assessed a late fee as allowed by law not to hldmttt gl�uU!h^.nlhl,lpb�dtid a dddn exceed c41,^me XrvKe:,b00�72-9868 Personalized account 20 per month.Additionally,third party collection/attorney offers 123 expenses may be assessed at 123mail sT Ua^ {w usM91<e Mamt+l^P'° _4 rneS3$g¢ unpaid balance or the maximum allowediby,exceed 100%of the q`ys 00000 12kA d I14odGpd6�11 4I1»b+baW,Jyp �i 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 deposits are shown euaVm :tea aR Pay electronically ACTIVITY as CURRENT Activity r 4. Equipment replacement costs will be charged for bottles cost, sinC¢your stolen,damaged or not returned. AccouMACnvrry mw� «.a�a Make sure this S.In accordance with N last jnv°1C¢ + .ra.n,..Am Equipment WNA's Terms and Conditions D,P,,Vry Adam,J^h^Da 125 MailSt'"t C4SIaLl I=D amount has been your 9 pment Lease and/or Service Agreement ac oust may be °raNOUZ8a1a^" rxxx paid in full to subject to minim oen, 461B9e P•rm°^3-TM=^E�^^ xx.xx um monthly purchases and/or earl n, 3naas,4+44 s sGailm,Nat^a1s96^9 ,4' M,w `j4 avoid late fees fees.to complete version of the current T&C may be viewed on " 3'7BBS,4 a s kliM ^urns W 0epo It zx.xx ji wobsite listed below Upon service discontinuation,rent for the avn2 3,0263BB11 w�s^Kn 19^ Monthly O[) Leased Equipment is Charged X13 664097 "°' as5kt f' xxx through the end of the billing cycle I Surcharge, in which service is discontinued. xxxx Fuel 6.YOU will be charged a monthly AL � Surcharge or Delivery Delivery Fee as described in Y Oil Surcharge,Fuel Surcharge or Fee(see#6 under will a 1 Your T&C. poly one of these •" General p y[o each account The fee that a fees Payment stub °ReRO05w.N<L P6TNOO 3 MO N A,ATM — uRRL H 00 is stated on the fr ont of the invo' applies to Your account ACCOUM SUMMARY visit ice.For further' r< Information the website listed below information please °"—"" "° ""``°" ° '"'"--— �" N mation`� --------------- -- ;.,t Or contact o ACCOUNT NUMBER PAY BY PAY THIS AMOUM center, w customer service xxxx `'„i 1234S67890 DD w Olt 7 As a food product, bottled water is subject [o the rules and INVOICEMMIRR BILLING DATE T_ENCLOSED regulations promulgated b 12345676" 0o7DO/o0 Administration(FDA). Y [tee Federal Food and Drug 8.Your first invoice indicates the products delivered on your first 0420096307 04262712619 000391049 2004 16 delivery,along with an Amount due Y applicable bottle and account deposits, ICE MOUNT`XN WA E0.COMPANY 1^hO DD redemption fees,and an oMm awm wk�wm mw a 123WIlSo } y dispenser charges.All future invoices ci"s— DODDD will reflect charges for water delivered and dispenser rental, deposits and credits plus charges for t:aoJ„(»m.;Jb 16,n«6a u bbu'a;a oR<D:TONER SERmcL a 1-coo 729666 Submit your bottle ordered by you. Deliveries are g any additional products �'WHO°TOBFREE""0R115jntpPepu1eO0nPie she ❑ '°`"ryOmn9°O° "� ¢ Payment by this made every three or four weeks,for �. •�• x� a date IL a rota!of 16-17 deliveries per year.You will only receive invoices � � • -� 12 limes 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. Q service.icemountainwater.com r�r� Form No.NW 709 08/12 service.icemountainwater.com SEEN-1 A090 #215 6661 DIXIE HWY,SUITE 4 08/01/13-08/31/13 13HO117821082 LOUISVILLE KY 40258 g B e ADDRESS SERVICE REQUESTED TUE- SET 17 0117821082 WED- OCT 16 WED- NOV 13 MON- DEC 16 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 !t ll,t l!I�Ilt nt lll�llll�t Itill ttt!tl�ltnnlll«<,It�lt�lttllllt n�..m.��� �..�� «��..�,..�. � ���,x¢« �,. �,.� ,-. .:3. ;« ,•. �. .:�1',, ,a �a "mm 'rS - we�.e� .���. �-�^.„eye, For a limited time only; buy two 1 gallon bottles ofTradewinds slow brewed Iced Tea and save.20%! YOU can `also buy one 1 gallon bottle for only$4.99!�Avaiiable in Sweet, Green, Diet Green 8�Lerr►on TeaFtauors Calf - .__ _ ` 1-800-472-9888 to add to�your next order! Qffer exoires 10L31-/1;3 m e,_ __ _ ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemou ntainwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE -8.38 8116 0843450263 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 30.00 3 9 OZ PLASTIC CUP 50C/SLV 8.37 3 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -18.00 8/31 0846793917 1 OIL/FUEL SURCHARGE'• 2.84 H5022264 RENT 3.99 TOTAL 36.27 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT I Subject to terms on reverse side. -8.38 — 0.00 + 44.65 = 36.27 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE_q A REPORT ON WATER QUALITY AND INFORATION, PLEASE WAYS TO HELP US SERVE YOU BETTER CALL 1-800-472-9888 OR W I• Please remember payment is due b WRITE Us AT: 2. Remember,if y the pay by"date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. invoice you are renting equipment, 6661 your first in t will include losecrated fee for the current month,plus the next month's rental.Your equipment rental is charged one month in advance,That means 6661 DIXIE HWY.,SUITE 4 3. Kindly fill in the amount enclose LOUISVILLE,KY40258 Ifyou prefer,you can a include ,your account number on o Pay Your bill online at service.icemountainwater.com Ifyou mink your bill is wron , 4. Never hesitate to cal]us with com Your check, and do not send cash. a transaction g or ifyou need more information about meats,questions,of must hear from you in writing te later that)separate sheet of paper.We concerns. sent you the first bill on which the error or problem a p,days after we telephone us,but doing fo will not preserve your rights.In your letter, ppeared.You can SAMPLE�/� give us me following information: S��PLE • Your name,address,telephone and account numbers. I VUI The dollar amount of the suspected error. Describe th and e error Date range of this invoice an error. explain if you can,why you believe there is You are obligated to pay the parts ofyour bill that are not in question. You do not have to pay the disputed amount while it is being investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount t 00!00!00-OOI00/00 1234567890 GENE nt in question. YourAccount Number GENERAL INFORMATION ' I.Payments received after the billing(INVOICE)date will appear on Important TMR'QC'0° 1234s6)a9 your next invoice.past WN-Oa 2s due invoices(not paid wIaNDV n Watch h billin date within 30 days of news NE.z °a ere for a g )may be assessed a late fee as allowed by law not to and exceed$20 IUa6;tlingUA[tI1rI^d111,61g4^dllptiq.=nddp costume,S.Mc 1-eoo<n.9aaa perSOnaijyed account per month.Additionally,third a offers on^o« expenses may be asses p rlycollection/a[torne 123M 151 —A.."iorusb9iceMOUneMngodum ' mes$age sed at a rate not to exceed 100% e ccy,sr4re 00" ana....k•,. unpaid balance or the maximum allow of the 2.Each returned check is subject to a sere ce law, subject to the maximum check return charge allowable in your State. M """"9` "' �� b 3. All bottle and equipment deposits are shown as CURRENTx.vm�x b CtOdEArt�#uMA 3 z f ACTIVITY. �� C Y Pay electronically, 4. Equipment replacement costs will be charged for bottles lost, l NIs stolen,damaged or not returned. ince your umed ACCOUNT ACTIVITY �n �� •�•� a • Make sure S.In accordance with NWNA last invoice this Equipment s Terms and Conditions("T&C DetM,Addren mnnDOe,1z3Ma 5=e1.cryscme ooudo amount has been Lease and/or Service Agreement j'Your wpm^,Bala^� paid in full to su ject to minimum month! account may be oei3, 46,BSe ry,n.n,-manxvn^ xxxx fee Y purchases and/or earl m 3n88snM4 s scmo�nanscD:anw[,., xxxx avoid late fees ( complete version of ihe current T&C may y cancellation o m m,eesi4wa s ma - xxxx website listed below Ybe viewed on the oYn, Bvees144w s meM^�n anscalBn^N xxxx Upon service discontinuation,rent for the a nz 3,826388„ q^^is^,.na,9e Monthly Oil Leased Equipment is charged 9z1z 664wsz e xxxX g through the end of the billing cycle Surcharge,Fuel in which service is discontinued, xxxx 6.You will be charged a monthly Oil Surcharge, o A Surcharge or Delivery Delivery Fee as described in yourT&C. g Fuel Surcharge or Fee(see#6 under will led to each account. The fee that applies of these fees t — "General is stated on the front of Payment stub — x.xz rvm 8,8 M the invoice.For ACCOUNT SUMMARY +� xxxx "'Sit the website listed urtherinformatio aa,,..-,... -------..____. uM„e^��..d below or contact our nPlease --------,------- ------�----- Information") center, customer service 4�,Nr•b,n,,.,�,e =w, , ------------`----- ACCOUNT N.M.E. FAY BY PAY THIS AMOUNT 7. Asa food product, 1234s6)B90 00 00l0o x fOdnCl, INYOKENUMBEN .,u,NG DATE W.ENCLOSED water is subject to me rules and 23456)b90 00/00100 regulations promulgated by the Federal Food and Drug Administration(FDA). 8,Your first invoice indicates the products delivered on your first 01420096307 01282712619 000191014 2004 18 delivery,along with an Amount due Y applicable bottle and account deposits, ictoaNraNwaTracoMaANr ron^� redemption fees,and any dispenser char es. "°'"""`"'"°^""""'�'"` 113 Mam st acr,stre oa000 will reflect charges for water delivered and dispenser l r ntal bottle your deposits and credits plus charges for an p 1.,Iad,.J.06,ndL p.,t1.,.6ga4nl.,LLLd.n EDN<usroMEa sEmnau ,.eoo,n.se8a Submit ordered b Y additional Products ❑sw"o.08 uE urovAnsy No1•a�l..aone xsla ❑ m<nn,v,on1« _ P43,ment by this a total of 16-17 deliveries sPer yearr..You will three receive envoi es - date two deliveries. 12 times per year,so approximately 5 of those invoices will retices ©2008 ice Mountain Spring Water Company,a Division of Nestfe Waters North America Inc. SerVice.icemountain Water.COm Form No,NW 709 08112 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 - Louisville, KY 40285-6680 $76.60 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 13HO117821082 42-389.00 $36.27 1 hereby certify that the attached invoice(s), or 2201 0310119252823 42-389.00 $40.33 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except • Friday, ept er 20 2013 reet atnrni���� �r 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)) 09/04/13 13HO117821082 $36.27 09/14/13 0310119252823 $40.33 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 5-11-10-1.6 120 Clerk-Treasurer se rvice.icemountainwater.com #215 6661 DIXIE HWY,SUITE 4 ° 08/01/13-08/31/13 03H0121975593 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® B s 11 I I I��'I II 'I �II I f I I I I I I' II III TUE- SET 10 0121975593 WED- OCT 09 WED- NOV 06 MON- DEC 09 CARMEL REDEVELOPMENT COMMISION DON CLEVELAND Customer Service: 1-800-472-9888 30 W MAIN STREET Did you forget about us? Kindly pay upon receipt. SUITE 220 Remember,past due accounts are subject to a late fee. CARMEL IN 46032-1938 Your prompt payment is appreciated. For your 11�1�II��I�Illlil!I�II111�1I��I111��'I'll'I'�"III'�II'I�11�"111 convenience,pay online:service.icemountainwater.com. If payment has been made,we thank you. For a limiter!time only, buy two 1 gallon bottles of Tradewinds slogw brewed Iced 1 ea and save 20°to!You sari alsobuy one 1 gallon bottle for only$4.99! Available in Sweet Green, Diet Green 8r Lemon TeaFla�ors Call, , 1,-800=472-988.8 to add o your neXtorder! Offer expires 1A/31f13 — ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service,icemountainwater.com. Delivery address: CARMEL REDEVELOPMENT COMMISSION,30 W MAIN ST STE 220,CARMEL IN 46032 PREVIOUS BALANCE 87.96 8/11 244111 PAYMENT-THANK YOU -40.52 8/09 0842401481 2 5 GAL ICE MOUNTAIN DIRK W/HANDLE 15.16 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 8/31 0846836682 1 OILIFUEL SURCHARGE"J- - 2.84 H5099908 RENT 10.99 TOTAL 79.72 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 87.96 - 40.52 32.28 = 79.72 BILLING RIGHTS SUMMARY 11 CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE- A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 1• Please remember Payment V s due by the Pay y" SERVE YOU BETTER CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,if you are renting pay eq date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. g equipment,your e9uiPment rental is charged one month in advance.That means #216 your first invoice will include.pro-rated fee for the current month, 6661 DIXIE HWy SUITE 4 3• Kindly fill in the amount LOUISVILLE, enclosed, include Plus the next month's rental. KY 40258 If you prefer,you can pay your bill online at s rvice icemounta nwater.com 4. Never hesitate to call us with comments, on your check, and do not send cash. lfyou transaction think your bill is wrong,or if you need more information about a transaction on your bill,write us on a separate sheet of questions,Or must hear from concerns. YOU in writing no later than thin Paper.We sent you the first bill on which the error or problem a30)days after we telephone us,but doing so will not preserve our appeared.You can give us the following information. Y rights.In Your letter, SAMPLE • G. Your name,address and account numbers. INVOICE The The dollar amount of the suspected error. Date range of this invoice 1 Describe the error and explain ifyou can,why you believe there is an error. You are obligated to pay the parts of your bill You do not have to pay the disputed that are not in question. amount while it is being investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question. • OD'WJO0-0010 m 1234567890 GENERAL,INFORMATION Account Number I.Payments reserved after the b�llAi TION T11R-ocroa 1z34567s9 Your next invoice.Past due invoices g(VOICE)date will appear on important MO`COLT" P tant W O NOV n billing date (not Paid within 30 days of news and TLE-OEC 14 Watch here for a may be assessed a late fee as allowed by law not to till«?ftbl„uN1»ntLii44aftta« Nadp exceed$20 per month.Additionally,third a,mmet sere<e:1�w.4>z-saes Personalized account expenses may be assessed at Party offers°ffers Conn D. a rate Y 1z3Mams< manlrou7wudn9 message -paid not to exceed 100%of ntvstate 00000 ... .na,e.vla•. P balance or the maximum allowed by law. the au.t«a«ab, tt m.at.SC«t«u6u a«u 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 a ui ment de 4 P z �vuAmr,�cz saactyo�sxw�.., °�r�v ACTIVITY Posits are shown as CURRENT " 4 Pay electronically 4. Equipment replacement costs will be charged for bottles lost Activity since your stolen,dams ACCOUNT ACTIVITY ads. ^�^°'°Y�• Make Bed or not returned. sure this 5.In accordance with N last invoice ��^�m� Equip Lease and/oAs Terms and Conditions •D0,gAm•ea::3«nn o^e,123 Mam SI—C,CRYS-A 0X000 amours sub'ecment Service Agreement (T&C")'your Pe„^4sB as xxx paid tit full been 'object minimum month) account may be Da9i .class Pannent-manEre4 ull t0 fees. A co Y Purchases and/or earl m 3neasla4aa s srunen Naw•arsw+•yware. xxxx avoid late fees ( complete version of the current T&C may y viewed n the - , /1l 3178061aN4 S keMWnt Seal Deposit - XXX% website listed below)Upon service discontinuation,rent for the 31 ,N” ' 1a Mn"^+ sc I nn xxxx y be viewed on the D9nx 3lan3een E"e s",<n 9 xxxx Leased Equipment is charged Monthly oil g through the end of the billin 1 Surcharge,Fuel n which service n discontinued. g cycle 6.You will be charged a monthly Oil Surcharge, TOTAL xxxx Surcharge or Delivery Delivery Fee as described in . Fuel Surcharge or FCC(see Surcharge under will a Your T&C. Only one of these apply to each account. The fee fees Payment stub is stated that applies to aE oOSBAUNa_a.«u uwpa t"T HTArn m = on the front of the invoice.F Your account ACCOUNT SUMMARY xxxx xx + xxxx "IS%xxx "Genera) ��G visit the website or further information pie a•a•••_••_=•a_�^_••^—_--^�=_F^°°°°^°°^ -__.___ fisted below or contact our e ass -- -------------------------------------- Information") center. customer seN1Oe V«au6•b mum vnu,w pymem ACCOUNT NUMBER PAT BY PAY THIS AMOUNT 7. As a food product, bottled 173456789D DOWIM xxx regulations promulgated is subject to the rules and INVOICE NUMBER BILLING DATE MT.ENCLOSED p omulgated by the Federal Food and Drug ,234s67e9a 00/X010() Administration(FDA). 8.Your first invoice indicates the products delivered on 0420096307 04262712619 000391049 2004 16 delivery,along with an Your first ` Amount due redem lion Y aPAlrcable bottle and account de III tonnON P fees,and an posits, s0,«�,a"�aP~,«.«"�°^^•^°I�- ILL Mam st Y dispenser charges.All future invoices Cm,state X0000 will reflect charges for water delivered and dispenser rental, deposits and credits plus charges for an Wat4i«4ant..at...aL..4L.t9.;k«4646d.q oa cus.oMeR:eRVUe uLU�eoo../]saea Submit your bottle ❑P mAm payment Ordered b Y additional products No""Pf0""""11p°""5ign1pPttryxi°OnPeN s� <"' � Re$� by this Y you. Deliveries are made every three or four weeks,for f date a total of per yea deliveries per year.You will only receive invoices _ w 12 times per year,so approximately 5 Of those invoices wilt reflect two deliveries. ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Or—service.icemountainwater.com Form No,NW 709 08112 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 De /you l?+& Direl f Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9 —3 03 129�ss9� �•a cr '3 2• Total 32• 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 _ -Tee /'�oun�aIn Dire�� IN SUM OF $ $ 32 ON ACCOUNT OF APPROPRIATION FOR 1 e0 l 1q3jhjj0 Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 1X0 I .03#012nsY13 3S 32.16"" 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 x_20^201(, �atlr e Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com 0 @ e IMMEM #215 6661 DIXIE HWY,SUITE 4 e 08/01/13-08/31!13 03N0121776199 ' LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED ® @ MON- 07 0121776199 NOV MON- NOV 04 THU- DEC 05 TUE- JAN 07 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Pay your bill online at:service.ice mountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 llll��Ill�l�ll�llllulllllllll�llllll�llll�rnl�l��lll�lnllllll L mT N,e�,74 7,e�*�f.�3,.,:. Fora;linitetl time only, buy two 1 gallon bottles of Tradewintls slow b�ewetl Icetly Tea antl saue20%!You can also buynel4gallon bottle et Green Lemon TeaFla�ors Call 1-800-4;72-9888'to add to�your next order! OffereXpires 10%31113 ___-_ 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 7.85 8/23 325003 PAYMENT-THANK YOU -7.85 8/07 0841857469 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED,;1 CREDITED .00 8/31 0846834091 1 OIL/FUEL SURCHARGE" 2.84 H5027575 RENT 3.99 TOTAL 10.32 D . Q a SIE 2 3 2013 By ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side 7.85 — 7.85 + 10.32 = 10.32 ------- ------ -------- -------- -------- -------.. - - ------ .. - - BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR IN ON WATER QUALITY AND INFORMATION, PLEASE I• please remember payment is due by the"Pay by"date CALL I-800472-988e OR WRITE Us AT: 2. Remember,if you are renting equipment,your equipment rental ntatis charged one month in atdvance.That means ICE MOUNTAIN SPRING WATER CO. your first invoice will include a pro-rated fee for the current month,plus the next month's rental. 6661 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send ca 666]DIXIE HWY.,SUITE 4 If you prefer,you can a LOUISVILLE,KY 40258 Pay your bill online at sen°ice.icemountainwater.com 4. Never hesitate to call us with comments, cash. Ifyou think your bill is wrong,or ifyou need more information about mentS a transaction on your bill,write us on a separate sheet of paper.We questions,or Concerns. 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 IV)-phone us,but doing so will not preserve your rights.In your letter, SAMPLE give us the following information: INVOICE Your name,address,telephone and account numbers. • The dollar amount of the suspected error, Date range of this invoice 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 investigated.During the investigation,we cannot report your account as delinquent or take any action to collect the amount in question t oolooloo-oorooloo z3as67s90 Your Account Number GENERAL INFORMATION „R-D 113456789 I.Payments received after the billing(INVOICE)date will appear on Important MoN-oa 2s Your next invoice.Past due invoices not p wEUNOV n Watch here for a NE-DEC t8 billing date)may ( aid within 30 days of news and tFl„ittan«iN9b«I4d.iGw6dnp�H NddA curt rservi<e:l-BOW]Z-9888 personalized account y be assessed a late fee as allowed by law not to exceed$20 per month.Additionall Offers t,I,DOe nanEy°uforusinglt¢MOUnUMpr°6utts message y,third party collection/attorney 3 M6msc a expenses may be assessed at a rate not to exceed cry,scace oo000 unpaid balance or the maximum allowed by law, 100%of the .eat r,nt,.,,n....n:.ar 4n"r.tcttd.0 2.Each returned check is subject to a service charge subject to the maximum check return charge allowable in your State. - we6�Te 3. All bottle and equipment deposits are sh �� "�� pay eleCtronicaily ACTIVITY. own as CURRENT Activity _ Tr ,°° e r+ 4. Equipment replacement costs will be charged for bottles lost, since our Make sure this stolen,damaged or not returned, ACCOUNT ACTIVITY•� "��°,� ^^"^ " 5.In le urned last invoice cordancewithNWNA'sTe Dewerrnaare: °n°Dce.,z3rwmsc�6ec,n,vsca,e00006 amount has been Terms and Conditions("T&C p,er°,,,6°Ixa« paid in full to Equipment Lease and/or )'yOU1 xxxx avoid late fees Service Agreement account may be oBin subject[o minimum monthly purchases and/or earl ' nnees,.a.,4 s Galbn N°r°.zl spa°9w„<r xxxx y cancellation n, 3,]egs,4u «Ma°,a swlD w,l, xx fees.(A complete version ofthe currentT&C may be viewed on the o9n, 6v66s,<44e s rceM°u",=°S Galeemm xxxx website listed below)Upon service discontinuation,rent for the '162eaeen ' E�s°.<n°,9e xxxx Monthly Oil °] Surcharge,Fuel Leased Equipment is charged through the end of the billing cycle Xxx" in which service is discontinued. TOTAL Surcharge or Delivery 6,You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in your T&C, Only Will a I Y one of these fees Payment _>•.ND z OI°„M1"T*<°""` "" = A. o Tnrsxx o9Nr x "General pp y to each account. The fee that a Stub ACCOUNT SUMMARY xxxx _xxxx Information,,) is stated applies to your account _ ________9u°"_"°"""`pAfNee A" on the front of the invoice.For °°°°°^°•°'°°°"°'°`-""°"`°°"`"°°"."�" --' visit the website listed below or contact Our information please — �<F,„-�.�,a,�m�.�rownm� pqy By PAY THIS AMOUNT ACCOUNT NUMBER center. our customer service 12}456]890 W 00100 INVOICE NUMBEB BILLING PATE M,ENCLOSED 7, As a food product, bottled water is subject to the rules and 116667890 wl ju0 redguulations promulgated by the Federal Food and Drug ODn391U49 2DO4 18 AwVinistration(FDA). 0420a96307 ❑4282712619 S.Your first invoice indicates the products delivered on your first Amount due oho Dce delivery,along with any applicable bottle and account deposits, ICE ouNT"AINwATE" oM SAN CIM5-sc redemption fees,and any dispenser charges.All future invoices ocvsca,e 00000 wilt reflect charges for water delivered and dispenser rental,bottle ......dG••tt en„dntdt.ta.0 wgwnDMEBSEam<EUU,boo-+>e-9g66 Submit your deposits and credits plus charges for any additional products °°"'"'" geOn <°•6b< Payment by this ❑ pr° 6EEA�roP4.:geDp4.9°I�4�,6e�n<sa< date 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 Per 5 of those invoices will reflect two deliveries. ©2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Q service.icemountainwater.com ,�,]�_• Form No.NW 709 08/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ PO Box 856680 Louisville, KY 40258 $10.32 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 103HO121776199I 42-390.99 $10.32 f hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, September 23, 2013 l Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 09/04/13 03HO121776199 $10.32 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 0 #215 6661 DIXIE HWY,SUITE 4 08/01/13-08/31/13 03H0120048525 0 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED rRUSSOM119 WINNER,, e MON- 07 0120048525 NOV MON- NOV 04 THU- DEC 05 TUE- JAN 07 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1-800-472-9888 LISA SCOTT OR JUDY STOHLER Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 �1 111111!I�rlllrlllll��lnlllllulll�lnllllll�lrll�llr�llll� e e a=or a iinitetl time only, buy two 1 gallonffibottles�of1'radewinds slow�brewed IcedTea antl save20°l0! �'ou can also buy one 1gallon bottle�foronly�$4�99�Av`atlable in Sweet, Green,,Diet_ Green $ Lemon TeaFlauors Call= � 1�=800�7�2-9888to adtl to your neXt order! OfFer expires iLOL�1.11�3 ��� ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CITY ENGINEERING DEPT,CARMEL IN 46032 PREVIOUS BALANCE 27.82 8/23 325002 PAYMENT-THANK YOU &15 6789;ro -27.82 8/07 0841857410 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE ��' 'jP 13.96 4 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN C��fiQ a .00 8/31 H5036282 RENT SfiP 2013 .tea 3.99 TOTAL C/Ty�2MF� v 21.24 0j £Z Z��Z®'L woo-j ejemu!elunowooraowas 2:L/90 soy MN ON wJo� .Oul eouawy glJoN S�OWM?RSON 10 uo!S!A!Q a '�(uEdwoO ja;eM 6uudS u!elunoW aol 8002 O BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION,PLEASE I• please remember payment is due by the"pay CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,if you are renting equipment,Your by"uipmentttr ntales charged one month in advance.That ICE MOUNTAIN SPRING WATER Co, your first invoice will include a pro-rated fee for the current month,plus the next month's rental. #216 means 6661 DIXIE HWY.,SUITE 4 1 Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. LOUISVILLE,KY 40258 If You prefer,you can pay your bill online at service.icemountainwater.com Ifyou think your bill is wron 4, Never hesitate to call us with comments,questions,or concerns. a transaction on your bill,write us on a separatoe sheeinformation about [ofpaperWe 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 so will not preserve your rights,In your letter, SAMPLE give us the following information: INVOICE Your name,address,telephone and account numbers. The dollar amount of the suspected error, Date range of this invoice 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 investigated,During the investigation,we cannot report your account as delinquent or take an t 00/00/00-00100/00+5 1z34s67a90 Your Account Number y action to collect the amount in question. GENERAL INFORMATION iry ou )23456789 1.Payments received after the billing(INVOICE)date will appear on Important Mo ,iI Your next invoice.Past due invoices(not paid within 30 day wEU"ov n Watch here for a luE DEC le billing dale)may s of news and np„dp„U6,tttI41"dln=6IM6_dtt&.tallaaq Cvs1w"ersemce.1 e00-4n�9888 personalized account y be assessed a late fee as allowed by law not to exceed$20 Per month.Additionall offers IpnnDpe rnankyoutau>tn91«MavnMlnp.eau<u message expenses may be assessed at a rate not party collection/attorney tof the 1z3 Nam s1 apa aernaa. cy s 1e 00000 unpaid balance or the maximum allowed bylaw cdaa a o>~"atw.n. tsa"esrgu4 q 2.Each returned check is subject to a service charge subject to the z a,akua maximum check return charge allowable in your State. , as+nom 1s' ( a Pay electronically ACTIVITY. 3. All bottle and equipment deposits are shown as CURRENT Activity 4. Equipment replacement costs will be charged for bottles lost, since your i M.a<��m^ Make sure this stolen,damaged o AccouNT Amvnv W man " r not returned. last invoice amount has been 5.In accordance with NWNA's Ter Ddl„ery aearess:loon Dce,u3 Nam s otysaa,e 00000 paid in full to Equipment Leas ms and Conditions , ("T&C"),Your Pre"oua ealana xx.xx Least and/or Service Agreement account may be P mina-man4 rw xx subject to minimum month! °&;; 461890 xxxx avoid late fees 317ees14444 s scaimn rvar"ai sunrywa«r xxxx { fees.(A complete version of[he curhent T&and/or may be v ewed olnt[he " "'�51 5 Ica Maps nsG ID pe 09111 317805144M s IceMOUntan5GN8 %X'%x Monthly pit website listed below)Upon service discontinuation,rent for the �" 3'8263ae'1 well na,� 7 ,l 09/]3 6640497 flm! Leased Equipment is charged through the end of the billing cycle 7 Surcharge,Fuel in which service is discontinued _ Surcharge or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Fee(see#6 under Delivery Fee as described in our T �"• "General Y &C. Only one of these fees ,aawa48_PBxMOarlAplo:r.48"T Ta"""'' — "'ISZxix +am04ry _ w r Will apply to each meet stub "`"°" xxrx x I acconnt. The fee that applies to your account Pay b ACCOUNT SUMMARY xx,x ,",�„_•-, ,„... Information") a xx is stated on the front of -.o.,�=,""_��_*•_�•_--_—__—_ ______ the For further information please visit the website listed below or contact our customer service °`�°'6f`� m ' AccouNrnuMBEB Parer PArrNXS%NOUN. center. 1234567B9O 00 00 00 ENCLOSED 123456)8 7. As a food product, bottled water is subject to the rules and INVOICE 679neex BILLING DATE MT.90 00100!00 regulations promulgated by the Federal Food and Drug Administration(FDA), D42D096307 04282712614 000391049 2004 16 8.Your first invoice indicates the products delivered on your first Amount due loon aae delivery,along with any applicable bottle and account deposits, .CEMDUMAIN WATER COMPANY 123 Nam s1 ,waw„M",n6 M,.,;..a,= oly,slale 00000 redemption fees,and any dispenser charges.All future invoices Submit your will reflect charges for water delivered and dispenser rental,bottle t•dad.J•tu^rJ6°d6..a"6a„t,.`Lt�.t'a.;c oecu:TOMeaEmACCUUI-Boo"¢-9680 deposits and credits plus charges for any additional products (]vc"uPi08iPE8auroP""s9""p"`°""°o"e ,a a ❑Pr��,a•xcn••9"one zOe date by this ordered by you. Deliveries are made every three or four weeks,for - date 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. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Ice Mountain Purchase Order No. POB 856680 Terms Louisville, KY 40285-6680 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 9/4/2013 03H water cooler $ 21.24 Total $ 21.24 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6. ,20 Clerk-Treasurer VOUCHER NC WARRANT NO. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF $ Louisville, KY 40285-6680 $ 21.24 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITI- AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 03H 2200-4239099 $ 21.24 or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 9/23/2013 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund