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Home My WebLink About228895 2/11/2014 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1 ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $612.69 CARMEL, INDIANA 46032 PO BOX 6293 CAROL STREAM IL 60197-6293 CHECK NUMBER: 228895 CHECK DATE: 2/11/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231400 35663481 612 . 69 0453-00-794629-6 FLEET SERVICES INVOICE/STATEMENT INVOICE NUMBER: 35663481 ACCOUNT NAME: CARMEL FIRE DEPARTMENT PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0453-00-794629-6 8100.00 31 01-31-2014 02-26-2014 612.69 pqF >:::::::::::::::::: ACTIVITY DESCRIPTION Cji RGESDEOTS PAYMENTS/CREDITS 01 21.20:14PAYMENT RECEIVED-THANK YOU 563.19 0.1 31-2Q 4 . RETAIL FUEL PURCHASES .. 6$ MONTHLY CARD CHG20 Q ....................................... ................................. ............. .......... ... ...... ............ YOUR SAVINGS FROM DISCOUNTS THIS PERIOD=$2.09 REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT PORTION OF THE REMITTANCE STUB. XX .. PURCHASES,-RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT.APPEAR UNTIL THE NEXT INVOICE/STATEMENT PREVIOUS BALANCE PAYMENTS (+)PURCHASES (+)DEBITS CREDITS +LATE FEE =NEW BALANCE 563.19 563.19 590.69 22.00 0.00 0.00 612.69 $39.00 MINIMUM LATE FEE PAY ONLINE AT:www.wexonline.com CALL CUSTOMER SERVICE TO PAY BY PHONE The Late Fee is determined by Which is an ANNUAL To the Balance subject to late FEDERAL TAX ID: 84-1425616 applying a monthly periodic rate of PERCENTAGE RATE of fee for this period which is 2.249% 26.99 % 0.00 SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS. TO ENSURE PROPER CREDIT,TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYMENT_ --- --- -- — — --- --- — Balance Subject to Late Fee Payment Options The late fee will be calculated by determining the total balance Mail due on the date your account becomes delinquent,as follows: Be sure to include bottom portion of invoice with your payment. adding the total amount due on your Account on the payment due Write your account number or invoice number on the check to help date together with any purchases posted to your Account from avoid delays in payment processing if the check and remit stub the end of the last billing cycle through the payment due date,and become separated. subtracting from that amount of any payments and/or credits entered during that period.The total balance due will then be multiplied Allow 10 business days prior to the due date for mailing to help by the applicable periodic rate to determine your late fee.If your avoid late fees. payment is not received and posted by the invoice payment due date,you may be charged a late fee or other fees in accordance Online with the terms in your Business Charge Card Account Agreement. Authorized users can elect to receive email notification when an p invoice is ready for online viewing and payment.Log in or register to How to Dispute Your Invoice set up an online account at www.wexonline.com. Charges must be disputed in writing no later than sixty(60) Online payments scheduled by 3:00 PM ET(on business days) days from the billing date or they will be considered final are credited to your account on the same day.There is no fee for and binding. online payments. Phone Card Issuer Call Customer Service and select the menu option for Billing The card is issued and payable to WEX Bank under a Business Inquiries. In addition to scheduling a payment,you can also Charge Account Agreement with the cardholder named on the check your balance. reverse. Payments scheduled by 3:00 PM ET(on business days) are credited to your account on the same day. Customer Service Be prepared with your fleet card account number and a sample For account inquiries and correspondence regarding account check to enter your bank account number and routing number. service or billing: There is no fee for phone payments. • Call 1-888-387-5665, or Automated Clearing House(ACH) To make a one-time electronic payment go to: • Fax to 1-800-395-0809,or http://www.e-fleet.com • Mail to P.O.Box 639, Portland, ME 04104 ACH payments scheduled by 2:30 PM ET(on business days)are credited to your account on the same day.There is a fee for each Be sure to include your account number on all correspondence. ACH payment. • I ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 01-31-2014 FLEET SERVICES ACCOUNT NO: 0453-00-794629-6 DELIVER TO: DENISE SNYDER CARMEL FIRE DEPARTMENT 2 CIVIC SQ CARMEL IN 46032-2584 Tax Summary TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE FEDERAL 356000972 -7.00 0.00 FEDERAL DIESEL 28.800 112.28 0.24300 -28.68 0.00 FEDERAL E85 156.640 482.93 0.18300 -4.18 0.00 . FEDERAL GASOLINE 22.860 76.56 018300 FEDERAL TOTALS 39.1:88 0.09 208; 44 B3i,33.. IN 356000972 0.00 4.61 STATE EXCISE DIESEL 28.800 112.28 0.16000 0.00 25.06 STATE EXCISE E85 156.640 482.93 0.16000 . 0.00 4.11 STATE EXCISE GASOLINE 22.860 76.56 0.18000 -6.59 0.00 STATE SALES DIESEL 28.800 112.28 0.07000 -28.07 0.00 STATE SALES E85 156.640 482.93 0.07000 -4.470.00 STATE SALES GASOLINE 22.860 76.56 0.07000 .. IN STATE TOTALS 39:13 >j 33.78 ACCOUNT TOTALS -78.99 33.78 owl%Z (c)WEX INC.2014 PAGE 1 FLEET SERVICES STANDARD REPORT INVOICE NUMBER: 35663481 ACCOUNT NAME: CARMEL FIRE DEPARTMENT PAGE 1 OF 2 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD I BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0453-00-794629-0 8,100.00 31 01-31-2014 02-26-2014 612.69 CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ DISCOUNT ITEM TOTAL NO. NO. UNIT TOTAL AMOUNT 0004 MH 001 074 01-03-2014 20:26 HABOUSH,DAVE 37,328 E85 18.940 3.089 -0.19 58.50 58.50 MH 001 074 01-10-2014 08:31 HABOUSH,DAVE 35,579 E85 21.750 3.089 -0.22 67.18 67.18 MH 001 074 01-16-2014 21:15 HABOUSH,DAVE 37,824 E85 25.070 3.089 -0.25 77.44 77.44 MH 001 074 01-23-2014 19:43 HABOUSH,DAVE 38,035 UNL 22.860 3.339 -0.23 76.33 76.33 CARD SUBTOTALS 88.620 -0.89 279.45 0006 MH 001 074 01-07-2014 16:32 BC 23,652 DS+ 28.800 3.889 -0.29 111.99 111.99 CARD SUBTOTALS 28.800 -0.29 111.99 0007 MH 001 074 01-04-2014 16:29 SMITH,KEITH 27,344 E85 20.690 3.089 -0.21 63.91 63.91 MH 001 095 01-11-2014 15:09 SMITH,KEITH 27,586 E85 24.190 3.088 -0.24 74.71 74.71 MH 001 095 01-18-2014 15:11 SMITH,KEITH 27,820 E85 24.600 2.988 -0.25 73.51 73.51 MH 001 074 01-26-2014 15:41 SMITH,KEITH 27,990 E85 21.400 3.089 -0.21 66.11 66.11 CARD SUBTOTALS 90.880 -0.91 278.24 TOTAL PURCHASES 208.300 -2.09 669.68 Y-T-D PURCHASES 208.300 -2.09 669.68 SITES USED THIS MONTH NO.PURCHASES TOTAL AMOUNT Location No. Brand Street City State Zip MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 7 521.46 MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 2 148.22 PRODUCTS: DS+=PREM DSL E85=ETHANL85 UNL=UNLEADED FLEET SERVICES This page is intentionally left blank. VOUCHER NO. WARRANT NO. ALLOWED 20 Wex Bank IN SUM OF $ P.O. Box 6293 Carol Stream, IL 60197 $612.69 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1120 I 35663481 I 42-314.00 I $612.69 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 � - \\ - N-,-x Fire Chief 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)) 35663481 $612.69 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 5-11-10-1.6 120 Clerk-Treasurer