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229733 3/5/2014
CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1 ONE CIVIC SQUARE WEX BANK CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $196.48 CAROL STREAM IL 60197-6293 CHECK NUMBER: 229733 CHECK DATE: 3/5/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231400 35947601 196 . 48 0496-00-138012-0 190 I nvoi©e Statement INVOICE NUMBER: 35947601 ACCOUNT NAME: City of Carmel Fire PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 049fr00138012-0 9,550 28 FEB-28-20 MAR-26 2014 196.48 DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS FEB-18-2014 PAYMENT-THANK YOU 362.39 FEB-28-2014 FUEL PURCHASES 196.48 REMINDER REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH PAYMENT, MAIL TO THE ADDRESS SHOWN IN THE RIGHT PORTION OF THE REMITTANCE STUB. PURCHASE$RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT. PREVIOUS BALANCE PAYMENTS (,)PURCHASES (,)DEBITS CREDITS + LATE FE = NEW BALANCE 362.39 362.39 196.48 0.00 0.00 0.00 196.48 CALL CUSTOMER SERVICE TO PAY BY PHONE FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an EFFECTIVE ANNUAL To the balance subject to late applying a monthly rate of RATE of fee for this period which is 2.249 % 26.99 % 0.00 SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS _TO ENSURE PROPER CREDIT-TEAR AT PERFORATION AND I NCLUDE_BOTTCM_PORTIQN WITH YOUR PAYM ENT. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms PO ox Date Due C , Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 48 03/03/14 35947601 ne Fire Dept $436.71 Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. , 20- Clerk-Treasurer 20Clerk-Treasurer VOUCHER NO. WARRANT NO. 03/03/14 ALLOWED 20 WEX BANK (Circle K Fleet) IN SUM OF $ PO Box 6293 1rC11 VI Sll CAl l lIL vv I:J 1--vL.Jv - $ $436.71 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund Board Members PO#or 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 12o5 19q 457 314 $240.23 received except 1120 35947601' 314 48 20 1 n r " � Cost distribution ledger classification if Title claim paid motor vehicle highway fund