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228037 1/14/2014
CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $186.46 PO BOX 856680 CHECK NUMBER: 228037 LOUISVILLE KY 40285-6680 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 43 . 15 3LO121202766 1125 4350900 54 . 30 3LO120095351 1205 4239099 10 . 32 03LO121776199 1701 4239099 17 . 10 13L7220327048 2200 4239099 24 . 73 03LO12004852S 2201 4238900 36 . 86 13LO117821082 service.icemountainwater.com D g 0 #215 6661 DIXIE HWY,SUITE 4 LOUISVILLE KY 40258 12/01/13- 12/31/13 03L0120095351 ADDRESS SERVICE REQUESTED THU- JAN 23 0120095351 �INIM111110111 Mil flifli H ON MON FEB 24 TUE- MAR 25 n ,{ n,,_� WED- APR 23 p � CARMEL CLAY PARKS AND REC DEPT. JAM 0 9 20114 Customer Service: 1-800-472-9888 AUDREY KOSTRZEWA Pay your bill online at:service.icemountainwater.com or 1411 E 116TH ST CARMEL IN 46032-3455 =-- byphone at: 1-800-472-9888.It's free! IIII'III"IIIII1�11111111'I'I""'IIIIIIIII'III'I"II'IIIIII'I'II �I3If� IM'PORTANTEffective.January 1„2014,(here will�be apriceincrease onselect pr=,oclucts Fordetaifs;please . � v-islteservlcex icemountalnwa r=.eom/price�or callus directly at 1800=472--9888 e, �_ a r ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: P CARMEL CLAY PARKS AND REC DEPT.,1427 E 116TH ST,CARMEL IN 46032 PREVIOUS BALANCE 32.60 12/22 984141 PAYMENT-THANK YOU -32.60 12/20 0862217817 6 9 OZ PLASTIC CUP 50C/SLV 19.74 6 5 GAL ICE MOUNTAIN DIRK W/HANDLE 25.74 BOTTLE DEPOSIT: 6 CHARGED„7 CREDITED -6.00 12/31 0864451752 1 OIL/FUEL SURCHARGE” 2.84 L5698123 RENT 11.98 TOTAL 54.30 DalMKIKci W*Ti-V-- 16-2 T i"; �0 Cow _` -�,� ____— - -- --- --- ------------- - ---- - - --- ACCOUNT SUMMARY PREVIOUS BALANCE_ PAYMENT/ADJUSTMENT CURRENT ACTIVITY—PAY THIS AMOUNT 32.60 32.60 + 54.30 54.30 f Subject to terms on reverse side. BILLING RIGHTS SUMMARY IN cnsE of ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR remember Payment WAYS TOhe HELP US SERVE YOU BETTER A REPORT ON WATER QUALITY AND INFORMATION, PLEASE p y CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,1f you are renting equipment,pay by"date noted[0 ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. your first invoice will include a pro-rated fee forguiptheYour tcurrententntal month,glis ue he ned one st month's rental. That means #216 3. Kindly fill in the amount enclosed,include your account number on your check,and do not send cash.If you 6661 DIXIE HWY,SUITE 4 prefer,you can a LOUISVILLE,KY 40258 pay your bill online at service.icemountainwater.com If you think your bill is wrong, or if you need more 4. Never hesitate to call us with comments,questions,or concerns. information about a transaction on your bill,write us on a separate sheet of paper. We must hear from YOU in writing no later than thirty(30)days after We sent you the first bill on so W llwhichtnot p ese ve Your he error or nrights.In Your leter,give us ad. or teetus,but doing the following ������ ������� Date range of this invoice information: • Your name,address,telephone and account num hers. • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is �'I - an error, t oorom00-0aow0o 1234567890 You are obligated to pay the'parts of your bill that are not in question. - You do not have to aamount R.o o 234567590 investigated.During the investigation,we cannot reporwhit It is being MON-o0- B wEo-NDY 7, Your Account Number as delinquent or take any action to collect the amount in your account mE-Dec,B question. Mi dfi.pR�Ptpla.Hp,LpIL.�BIp,.RpJAtl c„:mm<,xm«.1 600.0-72 9666 GENERAL INFORMATION TM°"xr ,I,InMW P ° 123 M St .ntl,e I.Payments received after the billingImportant ars <00000 Watch here for a esVnot pal date will appear on Out 1"m'"n" 4F�tA�uM['tubun personalized account 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 tooffers ++samu message exceed$20 per month.Additionally,third party collection/attorney rea� �., ws,«,ac xw<gLaAas�v9a6, �. -•c expenses may be assessed at a rate not to exceed 100%of the � ^ unpaid balance or the maximum allowed by law. m Pay electronically 2.Each returned ch AccourrrnrnvlrY eek is subject to a service charge subject to the " maximum check return charge allowable in your State. , o a< A6a,<s lohn Dce,,23 Ma1n 5<re tory Aal<00000 xx 3. All bode and equipment de Activity „ xx Make sure this posits are shown as CURRENT since your amount has been ACTIVITY. osri� s,76es,.+w sc°non Nal°a,so;,ywa x�u ;;;Bes,4u. « u"MMsw,D<P°° xxxx P 4. Equipment replacement costs will be charged for last invoice �On4w. ^'^w'R«0," xxxx aid in full to stolen, g bottles lost, 09„: i,6:6306„ `x,<,w.<na,y< xxxx damaged or not returned. ,�„ <� Lam,` 1 °- [ ,i '_ awed late fees 5.In accordance with NWNA's Terms and Conditions("T&C"),your R Equipment Lease and/or Service Agreement account may be subject to minimum monthly purchases and/or early cancellation Your new N Monthly Oil fees.(A complete version of the c M 0 _ MYTM„^Ma^ Surcharge,Fuel current T&C may be viewed on the + B xxxx xx.>a .aE.,Ou,aauuN•_..YANM�^PlOn.,< website listed below) Upon service delivery ACCOUNiSUMMANY xxxx xxxx P ee discontinuation,rent for the y Surcharge Leased Equipment ^w-- -- -- Fq pment is charged through the end of the billing cycle calendaG ”"°'°`"°'°---°° - ® rg �, Y e or Delivery in which service is discontinued. My Deliveries A<wuNSNUMe aoo 'k Fee(see#6 under 6.You will be c D in i_ charged a monthly Oil Surcharge,Fuel a Scheduled °" "General Deliver F g Surcharge or Information") Y Fee as described in your T&C. Onl on o will a Y e of these fees delivery apply to each account. The fee that applies to ° is stated on the front of PP Your account the invoice.For further information please visit the website listed below �o„ or contact our customer service center. o 0 Payment stub 7. Asa °,an: v� moon „„v„mp �•=•a= food product, bottled water is subject to (he rules and >.na,.,e rb„ ttzarp u promulgated b ------------- regulationsy the Federal Food and Drug ---------- Administration(FDA). oevn W,w6•°°�<°+'^'"b`1°'"P"'"<^• A<COUM NUMBE0. PAT BY PAY THIS AMOUNr 8.Your on your CI first invoice indicates the products delivered u3+567690 oolooroo x*''-” Amount due iSI INVOKE NUMBER BIWNO DATE A NCLOSEO delivery,along with any applicable bottle and account deposits, 123+567690 oolooloo redemption fees,and any dispenser charges.All future invoices will reflect charges for water delivered and dispenser rental, bottle 09eo0963a7 ❑9262712619 000391049 eoovavm6 Submit your deposits and credits plus charges for any, additional products ordered b ,cEMouNrAIN w6rERoMPANv M°,°„`sl Payment by y you. Deliveries are made every three or four weeks,for a w•� M a s,ac<00000 this date a total of 16-17 deliveries per year.You will only receive invoices 12 times per year,so approximate) t,„tp�t;,!»tp,....h:.�t.u..t.n.�..wu.6�G•U wa<usroMLR sERwce uEu-coo.>x-seBe two deliveries. Y'S of those invoices will reflect ❑vcO UPsonvREEAutoMnsg"uP 8<°w,<4 a,P<.<„45,64. ❑”,^."'"c"°""`°""`"""s'°< ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North America Inc. service,icemountainwater.com Form No.NW 708 08112 �ss service.icemountainwater.com ' 0 #215 6661 DIXIE HWY,SUITE 4 LOUISVILLE KY 40258 12/01/13- 12/31/13 03L0121202766 ® ® 0 ADDRESS SERVICE REQUESTED �I����� I�I���III HIM M1H IB �I� THU JAN 23 0121202766 MON- FEB 24 _ TUE- MAR 25 WED- APR 23 CITY OF CARMEL PARKS DEPARTMENT 20111 Customer Service: 1-800-472-9888 MANDY SPADY Pay your bill online at:service.icemou ntainwater.com or 1411 E 116TH ST - =-_.-- _ phone at: 1-800-472-9888.It's free! CARMEL IN 46032-3455 I��"II�IIIIII'1�1��I�IIII"II'II�'llllllllll'�IIIII"�I"'I�I��I `IMPORTANT Effective January1,2014 there will bea prlceincrease on�selectproducts For:detalls please suislt eserwlce iycemotantatnwater.com(prlce�or call ous directly at 1�800 472-9888:r � �'°~ _m. t e G m ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472.9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL PARKS DEPT/MONON CENTER,1235 CENTRAL PARK DR EAST,CARMEL IN 46032 PREVIOUS BALANCE 60.93 12/22 984142 PAYMENT-THANK YOU -60.93 12/20 0862217858• 8 5 GAL ICE MOUNTAIN DIRK W/HANDLE 34.32 BOTTLE DEPOSIT: 8 CHARGED""8 CREDITED .00 12/31 0864474028 1 OIL/FUEL SURCHARGE' 2.84 L5784460 RENT 5.99 TOTAL 43.15 DRINK,!NCS ATFL BICC, l OG( --43ecn oD ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 60.93 — 60.93 '¢' 43.15 = 43.15 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WgTER QUALITY AND INFORMATION, PLEASE HELP y" SERVE YOU BETTER CALL 1-800-472-9888 OR WRITE US AT: I Please remember Payment IS due b the" 2. Remember,if y pay by"date noted to ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. you are renting equipment,your to rental is charged one month in advance.That means X216 your first in will include a ro-rated fee for the current month, 6661 DIXIE IlWy 3. Kindly fill in the amount enclosed include SUITE 4 plus the next month's rental. LOUISVILLE,KY 40258 prefer,you can pay your bill online at servi eelCemouuur t8ifiwaer On Your check,and do not send cash.If you If you think 4. Never hesitate to call us with co your bill is wrong, or if you need comments,questions,or concerns. information about a transaction on your bill,write us on a separate sheet of paper. We must hear from yott 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,give us the following SAMPLE INVOICE information: Date range of this invoice • Your name,address,telephone and account numbers. The dollar amount of the suspected error. • Describe the error and explain if you can, error: why you believe there is _ D You are obligated to pay the parts of your bill that are not in question. a 00100roo-001001N • 178a167890 You do not have to pay the disputed amount while it is being invest) iTH -o N )2N56)890 gated.During the investigation,we cannot report our "«r 39 as delinquent or take an n Y account w o-No°" Your Account Number y action at collect the amount rt nE-occ.e GENERAL INFO question, nab;,nt�m.mat;.tm�.tnt.�a�a.�.u.tm INFORMATION �� fUe Cuvuma Smice:i-800.1)1.9888 1.Payments ■>urlATION i i Main s, rn,"E rw a°,°an N.Mw,um poem yments received after the billing INV Important ory,su,e Your next.invoice.Past due inv°igces no0iIC6)date wtl(a Lan,b.?.W»•.:tt•„tbi.n¢p..asyl�we•u Watch here for a appear on news and _ personalized account billing date)masessedy e paid within 30 days of - exceed$20 perm nth Add't onally third party of ee as allowed b ion/altornev offers message ( Tepsiugef x/aum vry,bnedeyw,aNC,RRPti`iW” �sP.rouuwehAtert expenses may �m,°a•cz"m"``°"`>M `'°`""`°°"`°d'"`"° rW`°e�°u.'9 y be assessed at a rate not to exceed 100%of the a�"kwaa u9m9wc p�Rmza a unpaid balance or the maximum allowed by law, 2-Each returned check is subject to a service charge subject to the A[COnNT ACT3VT' M,�.°R Pay electronically maximum check return charge allowable in your State, VA ~ 3, All bottle and equipment Activity DllNe,y AEdress 31n O°e,]3 Maln Svrel Ory,B,ate 00000 �� q pment deposits are shown ,R uM ACTIVITY. CURRENT since your 9R,) Make sure this as C .aie9e Parm.m-Tlu"xrou xxxx 4. Equipment replacement 09r„ n)een.aaa s sr»u""N..•„�s�n9wau, xxxx amount has p cement costs will last invoice 18R'"" s """° f1n5G10" .. xxx been stolen,damaged or not returned. be charged for bottles lost, paid in full to avoid late fees 5.In accordance with NWNgs Terms and Conditions("T&C"),your n: Manua„ m a,9c Equipment Lease and/or Service Agreement account may be TrnnE F xr" subject to minimum monthly purchases and/or early cancellation Your new fees.(A complete version of the current T&C may be viewed on the ���»• Monthly Oil website listed below)Upon service discontinuation,rent for the delivery ACCOUNTsuMMARv ""'a0P' + — Surcharge,Fuel Leased Equipment is charged through the end of the ------------------------------- In >o<xx •ar. xx.KK Cal ».M.,. - au"'"` e -- seas n which service is discontinued. billing c ----------------- «R 3 g ycle My Delivenes "aM w,e° ^•a Surcharge or p eliver 6,You will be charged a monthly Oil Surcharge,Fuel Surcharge or D indicates FCC(see#6 under Deliver Fee as a Scheduled 'General Y described in your T&C. O Information") w'll aPPIY to each account Th my one of these fees delivery ,o is stat e fee[hat ed an the from f applies to your account o the in3'oice.For further information please visit the website listed »na,. nn" ffi center, belOn'or contact our customer service c' 7. As a food ;m�.t.l.�, ;,o�S;,L product, bottled water i Payment Stub mman regulations s subject to the rules and mns ,n„ mvA•A ,�.�. promulgated b • >e �...,,.. -�.•-m --- Administration(FDA), } the Federal Food and Drug ----------------------- - 8.Your first invoice indicates the °"i0'""`"°'""" '»""•'°" ' ACCOUNT NOMBER PAy ar PAY TNIS AMOUNT Amount du delivery,along with an products delivered on your first �NvoicE NUMBER BIWNG DATE A NCE08En e redemption fees,and any dispenser ch bottlargese and account deposits, will ,1s.5me90 oo/ro/oo reflect charges for water delivered and dispenser rental, bottle tIV2009630T aV282T12619 OOa391aV9 200VOT038 deposits and credits plus charges for any additional r Submit ordered b °n"o« }'our y you. Deliveries are made ever Products KE�M°""r,�",w�"TE",�oMA"` payment by a total of 16.17 deliveries vi three or four weeks,for oasw,P 00000 12 times Per Per year.You will only receive invoices this date P year,so approximately 5 of those invoices will reflect L»W,e„t•to�M�flMdL.,a..bn"t+N�.b,�,u u,mw>T9eee two deliveries. �sroMER sERv»:E u ❑sK,»uP.oP.RE[.uroPansnuoa.9W,.eo"a•.a�,•sba. (]s �H.u.�o"r..•,.sa.. ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North Amer servige.icemountainwater.con Ica Inc. Form No.NW 706 08/12 0 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 1/4/14 3LO121202766 Drinking water& cooler- MCC $ 43.15 1/14/14 31-0120095351 Drinking water & cooler- Maintenance $ 54.30 Total $ 97.45 I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20— Clerk-Treasurer Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285-6680 In Sum of$ $ 97.45 ON ACCOUNT OF APPROPRIATION FOR 101 General fund/ 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 31-0121202766 4350900 $ 43.15 1 hereby certify that the attached invoice(s), or 1125 31-0120095351 4350900 $ 54.30 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-Jan 2014 Signature $ 97.45 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com 8 D #215 6661 DIXIE HWY,SUITE 4 12/01/13- 12/31/13 13LO117821082 LOUISVILLE KY 40258 6� ROOM e B ADDRESS SERVICE REQUESTED THU- JAN 16 II �IIIIII �I III ���II ���� III ��� TUE- FEB 18 0117821082 WED- MAR 19 THU- APR 17 Customer Service: 1-800-472-9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at:service.icemountainwater.com or 3400 W 131 ST ST CARMEL IN 46074-8267 by phone at: 1-800-472-9888.It's free! I�IMI'ORTAN®T��Effectiue January 1:,2014;there�nrillbe a price increase on�select�productsFordetails�please,� Vislt"eserurceaeemotuntalnwater,.comlprice'gr ca Ius directly at 1 800 472=98x8 e ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1.800.472-9888 or visit service.icemountainwater.com. Emil Delivery address: CITY OF CARMEL STREET DEPARTMENT,3400 W 131TH ST,CARMEL IN 46074 PREVIOUS BALANCE 83.09 12/06 886536 PAYMENT-THANK YOU -36.90 12/22 984143 PAYMENT-THANK YOU -46.19 12116 0861129021 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE: 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 30.00 2 9 OZ PLASTIC CUP 50C/SLV 6.58 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -24.00 12/31 0864446968 1 OIL/FUEL SURCHARGE 2.84 L5669026 RENT 3.99 TOTAL 36.86 F; e ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT S Subject to terms on reverse side. 83.09 — 83.09 + 36.86 = 36.86 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR EIEC,OR FOR YOUR INVOICE-4 WAYS T A REPORT ON WATER QUALITY AND INFORMATION, PLEASE O HELP US SERVE YOU BETTER CALL 1-800-472.9888 OR W I• Please remember payment is due b the" WRITE os AT; 2, Remember,if you are ren ng Y pay by"date noted to ensure the s ICE MOUNTAIN SPRING WATER CO. g e9uipment, our e smoothest service, #216 Your first invoice will include a pro-rated fee for the current month,plus the next month's rental. Y equipment rental is charged one month in advance.That means 6661 DIXIE ,Ky"SUITE 4 3. Kindly fill in the amount enclosed,inc(ade your account number on LOUISVILLE,KY 40258 prefer,you can pay your bill online in lode our account Dumber on Y 4. Never hesitate to call us with comments, Your check,and do not send cash.If you If you Think your bill is wrong, or if you need more information about a transaction on QUCStiOr1S,Or CODCernS, sheet of paper. We Your bill,write us on a separate writing no later than thirty(30) hr from days after we sent you the first bill on You n Which the error or problem appeared.You can telephone us,but doing SAMPLE' so will not preserve your rights.in your letter,give us the following INVOICE information: Date range of this invoice • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. .• e 00/00/00-00(00/00 723/567890 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.Darin the love iHR-oaw 1239567890 During investigation,we cannot report w°N0C1'� as delinquent or take an g amount Your account ANO°z1 Your y action to collect rhea roE-oec,B Account Number GENE mount in question. trtr:�,nrwauma�++s�si�am��,ua,at 1.Payments INFORMATION ayments received after the billing(INVOICE) 123M mn ^r^°rw°��^9�••M^°^w^a � Important " 0°°°° Watch here for a your next invoicz.Past due invoices not date will appear on t Wi«hln.,af,.«fl,«tF.,4a„1 f,IJ,F.d«q billing ( paid within 30 news and _ d g date)may be assessed a late fee as allowed by law not o exceed$20 Per month. Additionally,third offers `" a account Personalized s � � Message expenses may be assessed a[a rate not to exceed 100%to the r � � sw Party colleotion/attorney v � unpaid balance or the maximum allowed bylaw. 2.Each returned check is subject to a service charge subject to the �amw z pay electronically maximum check return charge allowable in your State. AccouNrAarvrrr ...w-N.�N«wk^^^�^W"^°^ 3. All bottle and equipment de ocr+ery aaarcn:wn" .,z3 mom sues,.ansNlQ BoaoB posits are Activity "��°•�°"^`° xx"" � Make sure this ACTIVITY, shown as CURRENT slnee your 90-m^, d^m Deni ,gave xxx 4. Equipment replacement 3,7aesau s s�ml°^H.,°alsBn^9w , xxzz amount has be costs will be last invoice °�51 1eMv nb"3G 1p 0° been stolen,damaged or not returned. charged for bottles lost, xxzz paid in full to 5.In accordance with N .IQ 3�azc3ee„ weis,,,rnar9< e V✓NA's Terms and Conditions("T&C", z 6618197 �^ avoid late fees Equipment Lease and/or Service Agreement ) yO°r xx.xx subject to g ement account 1 minimum monthly purchases and/or early cancellation Y fees.(A complete version ofthe currentT&C may he viewed on the Monthly Oil website listed below Our new Leased Equipment ) Upon service discontinuation, delivery •x — k " " °"" "" = Surcharge,F rent for he ACCOUM SUMMARY xxx +` 'zx.xx is charged through the Calendar. ", • K.«W.,«. --------- -V--_^---- Surcharge� uel m which service is discontinued, g e end of the billing cycle _______ _____ _ _ _ ,„�., or Delivery 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or Indicates My Deliveries >3.:e,Bm c `" -, e(se6 under Delivery Fee as described in a scheduled "General will app/ to your T&C. Only one of these fees de►ive Information") y each account. The tee that a delivery is stated on the front of i PPI"es to Your account visit the he invoice.For further information please website listed below v.�,» '+^"•m" center. or contact our customer service 7. As a food product, bo �om�>;�� •;,w;; '•' ""» toed water is s Payment stub wo"°"" n°bpHn =m�.1.�• LOam regulations promulgated b abject to the rules and Administration(FDA). Y the Federal Food and Drug ------------------------------------------------------ 8. `n - b 8.Your first invoice indicates the products delivered on ��>b rt°m '� ACCOUNT NUMBER BnV OY BAY THIS AMWM N567B9B ao,aaroo Amount delivery,along with any applicable bottle and accountyder first ,N CE NUMBER BiW1-n A NecozEo due redernption fees,and annser posits, 67890 oolooroo reflect charges for watery deliveredha and dspenll serCerental�boula deposits and credits ❑420096307 042A2732619 000391049 too4o7o3e ordered b Plus charges for any additional t°n° Submit your Y you. Deliveries are made ever Products _ co— Iz3 M.m s, a total of 16-17 deliveries Per Y three or four weeks,for o,r,s*a,e 00000 Payment by I2 times er P Year.You will only receive invoices this date P Yet,so approximate) .oecvs.oe+rRSERmcEw.,aoaoz-9Me two deliveries. Y5 ofthose invoices will reflect os.eEe Bu<w�n sv"„°,4,W,.,a,�.«,,.s0-.. ❑.,w Mru«v.+o"�rae. ❑e»x+Re. ©2008 Ice Mountain Spring Water Company,a Division of Nestle North America Inc. service.icemountainwa er.Com Form No.NW 708 08/12 0- VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF $ P. O. Box 856680 Louisville, KY 40285-6680 $36.86 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 113LO117821082 I 42-389.001 $36.86 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 rid 2014 00 '" Str(F&EM05otss6imi mer 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)) 01/10/14 13LO117821082 $36.86 1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer service.icemountainwater.com A 0 #215 6661 DIXIE HWY,SUITE 4 12/01/13- 12/31/13 03LO120048525 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTEDTUE- JAN® e II 'II1I1�I1II 1I I1I all oil THU- FEB 06 0120048525 MON- MAR 10 TUE- APR 08 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 -1M'PORTA►NT Effective Janua®ry1,2014,there will bea price increase onselectproducts For details; "PI please ��vislt�eserviceicem untainwater�com/price or cal drectlq at1 00-472 888.� �;, 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 49.46 12/06 886539 PAYMENT-THANK YOU -24.73 12/22 984146 PAYMENT-THANK YOU G.7 8 9 70 -24.73 12/05 0859703746 5 5 GAL ICE MOUNTAIN DIRK W/HANDLE r�3 '1j 17.45 5 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC CUP 50C/SLV3.29 4 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 12/31 L5682069 RENTM JAN 2014 w 3.99 TOTAL N CgnM V 24.73 CID � CINENv`l �cbv ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 49.46 49.46 + 24.73 - 24.73 BILLING RIGHTS SUMMARY IN case of ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please YOUR INVOICEu4WA due bOrH"Pay HELP S SERVE YOU BETTER he A REPORT ON WATER QUALITY AND INFORMATION, PLEASE payment to CALL 1-800-472-9888 OR WRITE US AT: 2. Remember,if you are renting equipment,your quipment"date d rental Charged One month in nsure the smoothest service. That means ICE MOUNTAIN SPRING WATER CO, your first invoice will include a pro-rated fee for the current month,plus the next on rental. 6661 3. Kindly fill in the amount enclosed include your account number on your check,and do not send cash.if you 6661 DIXIE HWY,SUITE 4 LOUISVILLE,KY 40258 prefer,you can pay your bill online at service"cemountainwater.com 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 an fter we sent you the first bill on SA MP `, which the error or problem appeared,You can telephone us,but doing LE IN r OICE SO will not preserve your rights.In your letter,give us the following Date range of this invoice information: • Your name,address,telephone and account numbers. • The dollar amount of the suspected error. • Describe the error and explain if you can,why you believe there is an error. r �/DOJp0.0ffiff 12345678% You are obligated to pay the parts of your bill that are not in question. V You do not have to pay p TRR-oaw 123,0567890 a the disputed amount while it is being MON«r 79 investigated.During the investigation,we cannot report your account Your ACCOurtt N as delinquent or take any action to collect the amount inquestion. mE-Dec,B umber GENERAL quest on. iat;acsa:mnLam,lmG6sla»Il;ubm Customer8ry el-800 U2-9880 INFO b �.n4Yo M,uil 9keMw".,"P�» RMATION 23M""` ^""" Watch here for a 1.Payments received after the billingImportant c'rys"" °p°o0 (INVOICE)date will appear on °t"t"rt"n Icrr aa+uwax u personalized account Your next invoice.Past due invoices(not paid within 30 days of clews and - billing date)may be assessed a Tate fee as allowed b offers message exceed$20 per month.Additionally,third party collet oln/attorney � expenses may n "'• s 4 y be assessed at a rate not to exceed 100%of the unpaid balance or the maximum allowed by law ` ma P npY 2 Pay electronically 2.Each returned check is subject to a service charge subject to the AccouNrAcrn9Tv P.,,,'.RONa»•,..k•, w.»,».m maximum check return charge allowable inD li ryAEdress'.bhn DD.1J3 Main Sb 4 CIry, ate 00008 xx 3. All bottle and your State. Activity Pm P B mMe Make sure this equipment deposits are shown as sawxa"mma"xvw xx xX ACTIVITY. CURRENT since your ; ;;mss, wioywate, amount has been "swi onm ; 4. Equipment replacement costs will be charged for bottles lost, last invoice paid in full to C9i,1 3i78881iW ke MoununS WiPetum KX XX stolen,damaged or not returned. 0912 ;'8,6,88° n.oi w�,9e r n avoid late fees 5,In accordance with N mnt eua97 11 I `°"` r' WNA's Terms and Conditions("T&C"),your xxxx Equipment Lease and/or Service Agreement account may be rnAs„'" subject to minimum monthly purchases and/or early cancellation Your new Monthly Olt fees.(A complete version of the current T&C may be viewed on the "T'""'' — '"""Bi"x°°"r Surcharge,Fuel eeEvwvs eauNee_.•r..eN*,.Brvarme,rt t w•`�".xx3a website listed below Upon delivery ACCWMIUMMARY KX.xx xxxx Surcharge O p service discontinuation,rent for the °,_- ^'^ - Leased Equipment is charged through the end of the billing cycle calendar. °°"""" •" - ® '� __ �;,,,,, r Delivery in which service is discontinued. My Del veries uwMN aPP "" Fee(see#6 under "D"indicates 6.You will be charged a month( - "General y Oil Surcharge,Fuel Surcharge es a scheduled Information") Delivery Fee as described in will a Your T&C. Only one of these tees delivery a»° apply to each account. The fee that applies to ""° is stated on thepp Your account front of the invoice.For further information please I:;n visit the website listed below or con center, tact our customer service 7. As a food product, bottled waterPayment stab is subject to the rules and » " " regulationspromulgated �.,--_xxxx _-- (FDA) by the Federal Food Administration(FDA). and Drug '---�8�„wb»,B,.b,m,wb,x»P� ACCOUNT NUMBER DAY eV PAY TN6 AMOUNT S.Your first invoice indicates the ,z3a6>R9B O/Ww Amount due Products delivered on your first INVOKE NUMBER Bwrvc oArE A Nnosro delivery,along with any applicable bottle and account deposits, 1 4567"0 BB/W1. on and any spenser reflectredempchargess for wat atdeliveredcharges. dispenser re talc ottlees will 0120096307 09262712619 000391019 200907016 Submit your deposits and credits plus charges for any additional products ton" ordered b ICEMOUNiA41`�VATEROMPPM' ,7}MainSt payment by Y you, Deliveries are made every three or four weeks,for "'�' ask cy,5tate 00066 this date a total of 16-17 deliveries per year.You will only receive invoices NAI CUSroMER:ERVKE uru.b0oA7=-9868 t z times per year,so approximately 5 or those invoices wilt resect ®µ�N..�A.a«tA.d�61Jb,R.9 °"",aMe6..gaamRa.Maesa.. two deliveries. ❑sw„w,a,BEeam�e.^vv^UP"�'"•'°^"""'"s'"` � ©2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. service.icemountainwater.com Form No.NW 708 08/12 Sr 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 1/3/2014 03L water cooler $ 24.73 Totall $ 24.73 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 NC WARRANT NO. Ice Mountain ALLOWED 20 POB 856680 IN SUM OF$ Louisville, KY 40285-6680 $ 24.73 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 03L 2200-4239099 $ 24.73 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 G 1/13/2014 Si nature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund service.ice mountainwater.com #215 6661 DIXIE HWY,SUITE 4 ` o LOUISVILLE KY 40258 12/01/13- 12/31/13 03L0121776199 • 9 sun ADDRESS SERVICE REQUESTED 11 ll I0 I1I1 I II91111 11 I I I IillIl )2�5 TUE- JAN 07 0121776199 THU- FEB 06 MON- MAR 10 TUE- APR 08 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1-800-472-9888 JIM SPELLBRING Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 II1�1�1�1111��1�1���1IIII�III��III����'ll'I'll�l�l'�'�"I'�I�IIII �IMPORTANT� Effectl�e January 1,2014;there will be a price increase on select products. For detail"s;please r, visa-eservlce icemounfainwater.com/price or callus directly at 1 800-4729888., ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, HUMAN RESOURCE DEPT,CARMEL IN 46032 PREVIOUS BALANCE 20.72 12/06 886537 PAYMENT-THANK YOU -10.36 12/22 984144 PAYMENT-THANK YOU -10.36 12/05 0859703787 1 5 GAL ICE MOUNTAIN DIRK W/HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED�',1 CRED ED .00 Submitted To 12/31 0864497623 1 OIL/FUEL SURCHARGE.' 2.84 L5673995 RENT 3.99 TOTAL JAN 13 2014 10.32 Clerk Treasurer ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CU RENT ACTIVI Y PAY THIS AMOUNT Subject to terms on reverse side. 20.72 — 20.72 +" 10.32 = 10.32 ------ ----------------- ------- ._.. -- My DeliverieS ACCOUNT NUMBER:0121776199 ustomer Service: 1 2 9888 service.icemountainwaternwater.com q,,.',`,^.,..c..,...ra,_- Kc,R�.: .a of a� e: �.s��''" gR ✓ , <.a?`'. 3xr cep' �.� January 2014 February 2014 March 2014 April 2014 May 2014 June 2014 1 2 3 4 1 1 1 2 3 4 5 1 2 3 1 2 3 4 5 0 7 5 6 0 8 9 10 11 2 3 4 5 7 8 2 3 4 5 6 7 8 6 7 0 9 1011 12 4 5 6 8 9 10 8 9 10 11 1213 14 12 13 14 15 16 17 18 9 10 11 12131415 9 011 12 13 14 15 13 14 15 16 17 18 19 11 12 13 14 15 16 17 15 16 17 18 19 20 21 19202122232425 16 1718 192021 22 16 17 18 192021 22 20 21 22 23 24 25 26 18 192021 22 2324 22 23 24 25 26 27 28 26 27 28 29 30 31 23 24 25 26 27 28 2324 25 26 27 28 29 27 28 29 30 25 26 27 28 29 30 31 2930 30 31 July 2014 August 2014 September 2014 October 2014 November 2014 December 2014 1 2 3 4 5 1 2 1 2 3 4 0 6 1 2 3 4 1 1 2 3 5 6 6 7 0 9 10 11 12 3 4 5 0 7 8 9 7 8 9 10 11 12 13 5 (D 7 8 910 11 2 (D 4 5 6 7 8 7 8 9 10 11 1213 13 14 15 16 17 18 19 10 11 12 13 14 15 16 14 15 16 17 18 19 20 12 13 14 15 16 17 18 9 1011 12 13 14 15 14 15 16 17 18 19 20 2021 22 23 24 25 26 17 18 19 20 21 2223 21 22 23 24 25 26 27 19 20 21 22 23 24 25 16 17 18 19 20 21 22 21 22 23 24 25 26 27 27 28 29 30 31 24 25 26 27 28 29 30 2829 30 26 27 28 29 30 31 2324 25 26 27 28 29 28 29 30 31 1110-1 31 30 e^ 01 ;,a BILLING RIGHTS SUMMARY YOUR INVOICE-4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL,OR FOR 1. Please remember payment is due by the"pay by"date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember,if you are renting equipment,your equipment rental is charged one month in advance.That means CALL 1-800-472-9888 OR WRITE US AT: your first invoice will include a pro-rated fee for the current month,plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed,include your account number on your check,and do not send cash.If you #216 prefer,you can pay your bill online at service.icemountainwater.com 6661 DIXIE HWY.,SUITE 4 LOUISVILLE,KY 40258 4. Never hesitate to call us with comments,questions,or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill,write us on a separate SAMPLE INVOICE sheet of paper. We must hear from you in writing no later than thirty(30)days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing Date range of this invoice so will not preserve your rights.In your letter,give us the following information: • Your name,address,telephone and account numbers. • The dollar amount of the suspected error, f 1z3+s67890 W100,00-00�00�00 • Describe the error and explain if you can,why you believe there is ` an 87707. T -DCT w 1234567890 MON-Dcr 29 Your Account Number You are obligated to pay the parts of your bill that are not in question. wBoNw 2+ You do not have to pay the disputed amount while it is being 10E M 10 investigated.During the investigation,we cannot report your account Ism;,pbgtaa:a®f.Aa�A!®-!!•�as�Fn cmr sewNe.1 800.7='vse0 for usl,g M in prnauN Th Y Watch here for a as delinquent or take any action to collect the amount in question. 1023 M11 St a s 00°°° Important personalized account atYR�dlk14J..Id�uA^fl i GENERAL INFORMATION P t mA!•u•-�� ., £ message 1.Payments received after the billing(INVOICE)date will appear on news and your next invoice.Past due invoices(not paid within 30 days of offers billing date)may be assessed a late fee as allowed by law not to exceed S20 per month.Additionally,third party collection/attomey ** „,ate•.,.,,,, w.+ Pay electronically expenses may be assessed at a rate not to exceed 100%of the ��-n w�,,,�„.....8• ^�'"^'"`°'^• unpaid balance or the maximum allowed by law. ACCOUNT AarvrtY ' '"" , '23 Ma10 s+,=n.onsN1e ao90u >%x.xx Make sure this o•nwery AaarK::�^� 2.Each returned check is subject to a service charge subject to the amount has been maximum check return charge allowable in your State. Activity ° rna^I,va, xxxx O0r3+ SGalonNaaraSOan9water ! aid in full to 3. All bottle and equipment deposits are shown as CURRENT since your wm 3ve�asi4+`aa s IaMaa^u^scalD•w1 . "Y� exxx ! P avoid late fees ACTIVITY. last invoice .11 1110" 4a w•Iw.19 t fs 4. Equipment replacement costs will be charged for bottles lost, stolen,damaged or not returned. roTAt �" ria ,m ' g Monthly Oil 5.In accordance with NWNA's Terms and Conditions("T&C"),your Surcharge,Fuel Equipment Lease and/or Service Agreement account may be subject to minimum monthly purchases and/or early cancellation Your new .aaM Ma^"r xxxx� „�•„ _. ' Surcharge or Delivery fees. A complete version of the current T&C may be viewed on the ACCOUNT SUMMARY xxxx a ,,;, �,°�` '° Fee(see#6 under ( p y delivery °• "" i website listed below)Upon service discontinuation,rent for the Calendar. _^„ 311 p90 ® "General My Delrvenes ucw4 ..�° ; Leased Equipment is charged through the end of the billing cycle "D"indicates ' Information") in which service is discontinued. � �._ al9aa1� 6.You will be charged a monthly Oil Surcharge,Fuel Surcharge or a Scheduled Delivery Fee as described in your T&C. Only one of these fees delivery „n °. `" "wID,Aa9 =_•a-^-n" will apply to each account. The fee that applies to your account is stated on the front of the invoice.For further information please visit the website listed below or contact our customer service center. Payment stub --- p °AY THIS AMOUNT 7. As a food product, bottled water is subject to the rules and ----- ,a--- ..1.Y AccouNrNUm.ER w xx.xx Amount due regulations promulgated by the Federal Food and Drug 1234567990 WwNc DATE A NCEOSEO INVOICE NUMBER Administration(FDA). w/wim 1234567890 .i 8.Your first invoice indicates the products delivered on your first delivery,along with any applicable bottle and account deposits, 0420096307 04282112619 000391049 200407018 Submit your redemption fees,and any dispenser charges.All future invoices will 10110 0« j payment by reflect charges for water delivered and dispenser rental, bottleaysrn=.s0 this date deposits and credits plus charges for any additional products ME95EIrvIGE uuI-goo-1179898 ordered by you. Deliveries are made every three or four weeks,forpq,„t„ta�wr>idlnldtd».I.uaauA. ❑�ae^� `°”""""'"` a total of 16-17 deliveries per year.You will only receive invoices 5K„wwereN^"f0°^"s""°oe°0n"`""u510e 12 times per year,so approximately 5 of those invoices will reflect --- two deliveries. ©2008 Ice Mountain Spring Water Company,a Division of Nestl6 Waters North America Inc. Form No.NW 708 08112 service.icemountainwater.com r a o =-0 D N ° < m e r d ° p o m n p Cte ,� '+ f �/11 0 ° < < o N O < N O 7 O1 O C 7 ° `_ v., +�, >A�. .�.: ° O O fD e`O�k M � n � 3 < � nmQA0gW O° ° 2 r- 8CL s (p � tO Fns �'lD °o.a m f `t < o rn .O. w �ti �yD m x � - m m e�' ° m o ° e r 10 rrro tD c ° 33 Amo � o m N �<� <�� a' ° CL 6. rn ooi -� < eo —• 0 m c o o _ m ° m g0 V) Y!1< 9 O �•A .y. tp N N tDCD 7 t7 Zr 'c N > to �. 7 •< fD x i9 c 0 m a rt.0 D m e n m a m A n PQ to o O p m 1b — O ° � o < 0 3 c< < to c O pr = c —C CL c a O 9; A "t CD E Cb c E CL t7� Z c° ta to .� m < � 4: r.- '0 o A n 3 ma a� � m �' n04 » o o m < y; m� °eQ M < o, 7 (D � c m A C y a) CD m m co' 01<: •- c � 0 0 0 -o do M 7. D� c N an o � m m 2 w c °� ° tea to ` , 'D 0 > > 0 3 c °' � a; ?2 3E Dv mt�i » c c mem N 'c �v �::cc o ? o c ,0, o < C (D i, - C nm .m va >> w. �c m 3f wAao3 d O tQ �ooi co•c ?o � O� � (p f �. w c n• m 3 g o °a c�i �O ° c w o — `D m o 0 m 3 � fD � m 7c � c c c y CS m �,n � y c � 01 �O �' 0 (D t? 0 m C Pf ° m F pt elm =o c 3. m m g w ?; 0 3 3 is o A '� 3 load ': i F(D _ a ° 'O a � c ° o I¢ 0 m o o m a 3 m 'r Q), V m c m a m n A a n 0 306 mak m ;.� N a b m m 0 9 Q O�' 3am .>� �i `c' o C ° A v o '� N c ,� V) O O N O 7 O m m r' .moi N , V j •� N 3 �C., 0 C l 0 �o 0 11 tD F D m rn a°1i f .* m v m m "0 o n m ° �: rri o w •< o '.,'Q,•'. v - o m oc a 9 N n to t;'� a rD N �o 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 f 03LO121776199 I 42-390.99 I $10.32 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, J nuary 13, 2014 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)) 01/03/14 03LO121776199 $10.32 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 ' service.icemountainwater.com NEW9 @ #215 6661 DIXIE HWY,SUITE 4 12/01/13- 12/31/13 131-7220327048 LOUISVILLE KY 40258 ® ® 0 ADDRESS SERVICE REQUESTED TUE- JAN 07��I� I519 11 I I B I I 119 oil THU- FEB 06 7220327048 MON- MAR 10 TUE- APR 08 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1-800-472-9888 ANN DAVIS Pay your bill online at:service.icemountainwater.com or 1 CIVIC SQ by phone at: 1-800-472-9888.It's free! CARMEL IN 46032-2584 IIIIIIIII'lllllllll'll"II'll'I'llllllllll�l�lll��l�l�llll'111111 " IMPORT'AN�T�- Effective January 1,2014 there will be a price�increa�se onselproducts. dor detai'1s, please vstt�eseruice�"cemou�ntainw�ater.com/pnce,�o call�us�directly at*1 800 472 9888.E tt ACCOUNT ACTIVITY For questions or a report on water quality and information,call 1-800-472-9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL,1 CIVIC SQ, CLERK TREASURER OFFICE,CARMEL IN 46032 PREVIOUS BALANCE 30.79 12/06 886538 PAYMENT-THANK YOU -13.65 12/22 984147 PAYMENT-THANK YOU -17.14 12/05 0859703993 2 5 GAL ICE MOUNTAIN DRK W/HANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 9 OZ PLASTIC CUP 50C/SLV 3.29 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN .00 12/31 0864520101 1 OIL/FUEL SURCHARGE. 2.84 1-5712363 RENT 3.99 TOTAL 17.10 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 30.79 — 30.79 + 17.10 = 17.10 BILLING RIGHTS SUMMARY IN CASE OF ERRORS OR QUESTIONS AgpUTypUR BILL,OR FOR YOUR INVOICE-4 WAYS TO A REPORT ON WATER QUALITY AND INFORMATION, PLEAS@ HELP US SERVE YOU BETTER CALL 1-800_472- I. Please remember payment is due by the"pay b 9888 OR WRITE US AT: 2. Remember,if you are renting Y"date noted t0 ensure the smoothest service. ICE MOUNTAIN SPRING WATER CO. g equipment,your equipment rental is charged o #216 your first invoice will include a pro-rated fee for the current month, I g One month in advance.That means 6661 DIXIE HWy. SUITE 4 3. Kindly fill in the amount enclosed include LOUISVILLE,KY 40258 refer,y pus the next month's rental. Your account number on your check,and do not send cash.Ifyou ou can pay your bill online at Your If YOU think 4. Never hesitate to call as your bill is wrong, or if you need With comments, information about a transaction more questions,or concerns. sheet of on your bill,write us on a separate paper. We must hear from whiting e tater than thirty(30)days after we sent you the firs[bill on You in ^1 which the erroror problem appeared.You can telephone us,but doing SAMPLE INVOICE in will not preserve your rights.In your letter,give us the following reformation: Date range of this invoice Your name,address,telephone and account numbers, The dollar amount of the suspected error. • Describe the error and explain an error, ifyou can,why you believe there is You are obligated to pay the parts of your bill that are not in question, t 00/00/00-00100/00 1234567890 You do not have to pay the disputed amount white it is being investigated.During the investigation,we �Nnoa o< 3234567e90 g cannot report your account oN.oa x9 as delinquent or take any action to collect the am W ONOV 3, Your Account Nu " p 1e tuber GENE oust in question. itaM ac;as,.maa•amd,trrtr,„ate»t&.u�at Costumer Semce 180D�JL9008 RAL INFORMATION h �e Thmk°u for u•M91a Mw ulnp°dum I.Payments received after the billingI 133 M in 5 .,a,erYla3 INVOICE Important Watch here for a your next invoice.Past due invoices(not paiddwith within da i«,lat«t.fa it„;,u„ara.tbd ti�,t.a n appear on news and billing date)may be assessed a late fee as allowed by law not oof - - ed account exceed$20 per month.Additionally,third party collection/attorney offers message ersonatiz �, ° r .� `+u .` sage expenses +n+rskaF "m 5 ” Pe may be assessed at a rale not unpaid balance or the to exceed 100%of the maximum allowed by taw 2.Each returned check is subject to a service charge subject to the -ewe•<,.r aww ,+09, ^M« maximum check return charge allowable;n your State. AaouNrnrnvrrr ..y,a.�9wa<n Pay electronieally 3. All bottle and Activity Damen weress:�^^WC 333 Mzm snee,.ansrnfear000 xxxx equipment deposits are shown as CU ➢'" a xx Make he this ACTIVITY. CURRENT since your OB 31 e,e9e P°rmem ^k Ya 5 Gall°n Nalunl0pnn9 XX XX 4. Equipment replacement costs will be amountas been last invoice neas,u Ma M^swi apw stolen,damaged charged for bottles lost, 9wn 3n80s,NM s aeM°"^u"sw enU paid in g or not returned. °9n3 31ezb3een , ➢"e ar�,rye x full t0 5.In accordance with N avoid late fees WNA's Terms and Conditions("T&C"),your Equipment Lease and/or Service Agreement account may be _ mA subject to minimum mon thl fees.(A complete version ofthe current ies a d/Or early be viewed lllationn the • Monthly Your new y Oil website listed below)Upon service discontinuation, — Surcharge,Fuel delivery A[CDUNT BUMMARY Kx.% XX.sXM n t cues N fM _., or the Leased Equipment is char in through the end of the billing cycle calendar, ^°° ---------- " -- in which service is discontinued. ® �� Y _ ° � �9, 98� Surcharge or Del fiver 6.You will be charged a month l "D"indicates My Deliveries c NUM sa e9° _ "" Fee(see#6 under Y it Surcharge,Fuel Surcharge or ""`m `General Delivery Fee as described in a scheduled """"'"` will aPpt to each Your T&C. Only one of these fees delivery G • '• °°" : Information") Y account. The fee that y counte® 1 is stated on[he applies to our ac a=lso ^m„U„' ”" ;;mall front of the invoice.Forfurther visit the website listed informationplease 3114 below,or contact aur customer service M 'o; center. 7. As a food c ''"°' S, n •;i Product, bottled water Payment stub turn regulations is subject to the rules and Promulgated b the F � vl, ,•.. Administration(FDA), Y ederal Food and Drug ---_----------------------------- S. --- Your first invoice Indicates the products delivered On ��� .",m.mm ysn pe,"e•' nttouf.r fVUMBE ➢AT BY `PAr THIS AMOUM 23456)890 00109/00 xX.%X Amount delivery,along with an Your first t due Y dispenser bottle and account deposits, wvoice NUMec6 Blwrvc ogre A Naosco redemption fees,and any dispenser charges.All future invoices will 3sbva99 00199/00 reflect charges for wafer delivered and dispenser rental, deposits and credits plus charges for any additional products 0V20096309 04262912619 000393049 20o4o9oie bottle Submit your ordered by you. Deliveries are made every three or four weeks,for K°E°M��^',M"w""„”",`oM'�A- ��^^DOe 33Me�^b, Payment by a total of 16-17 deliveries per year.You will only receive invoices 12 times ccysr4fe 00000 per year,so approximately 5 of those invoices will w.cvsroMaess➢mccc,,eU,-eoo..,,.9aee this d• two deliveries. t",tq*,a.ia•Mra:..e�..na�na.•tM.w..4 date reflect ❑M�,UP.o•refexurU�.n=g•U,➢<,"�.<ao<•<.<,usb<. ❑w,<S,m<N.°9<• <».,<:<<. ©2008 Ice Mountain Spring Water Company,a Division of Nestle Waters North - service.icemountainwater.com America Inc. Form No.NW 708 08/12 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) C cd Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ $ ON ACCOUNT OF APPROPRIATION FOR Board Members PO# INVOICE NO. ACCT#!TITLE AMOUNT DEPT..# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 20 Signature i � Cost distribution ledger classification if Title 'i claim paid motor vehicle highway fund