230224 03/18/14 `Coq
1y _...,,Mf CITY OF CARMEL, INDIANA VENDOR: 366015
® ''r ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $*******745.48*
CARMEL, INDIANA 46032 PO Box 6293 CHECK NUMBER: 230224
�.y,roN. ;r CAROL STREAM IL 60197-6293 CHECK DATE: 03/18/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 35965547 745.48 0453-00-794629-6
FET SERVICES INVOICE/STATEMENT
INVOICE NUMBER: 35965547
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMITDAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453-00-794629-6 8100.00 28 02-28-2014 03-26-2014 745.48
........................
i)AFE::>'::«s:>::>:: ACTIVITY DESCRIPTION CfiAFG£S/L7E$f7:S: PAYMENTS/CREDITS
PAYM NT REC IV
E E ED THANK YOU 612.69
3 48
RETAIL FUEL PURCHASES > ><< > .......
MONTHLY CARD CHG #7d
YOUR SAVINGS FROM DISCOUNTS THIS PERIOD= 2.60
REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE NCE STUB WITH
PAYMENT.EN MAIL TO THE ADDRESS SHOWN IN THE RIGHT
PORTION OF THE REMITTANCE STUB.
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
612.69 612.69 , 723.48 22.00 0.00 0.00 745.48
$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 an email notification when an
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)
• Fax to 1-800-395-0809,or To make a one-time electronic payment go to:
http:/twww.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.
ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 02-28-2014
FLEET S E RV I( _�\E S 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 -40.34 0.00 FEDERAL E85 220.440 672.94 0.18300
8.40 0.00 FEDERAL L GASOLINE 45.880 148.31 0.18300
FED RA4*TOTALS >>. -4s 74 Q Qa : >::; `:::: 2GS;3a0 .8 1 as
IN 356000972 0.00 35.25 STATE EXCISE E85 220.440 672.94 0.16000
0.00 7.02 STATE EXCISE GASOLINE 38.980 126.65 0.18000
-39.07 0.00 STATE SALES E85 220.440 672.94 0.07000
-7.36 0.00 STATE SALES GASOLINE 38.980 126.65 0.07000
..................... S -aSa3. 2T.
ACCOUNT TOTALS -95.17 42.27
(c)WEX INC.2014 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 35965547
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE I PAYMENT DUE DATE AMOUNT DUE
0453-00-794629-0 8,100.00 28 02-28-2014 03-26-2014 745.48
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ DISCOUNT ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0004 MH 001 074 01-30-2014 19:16 HABOUSH,DAVE 38,234 UNL 17.640 3.179 -0.18 56.08 56.08
MH 001 074 02-04-2014 16:31 HABOUSH,DAVE 38,541 UNL 21.340 3.289 -0.21 70.18 70.18
MH 001 074 02-09-2014 19:41 HABOUSH,DAVE 38,850 E85 23.320 3.089 -0.23 72.04 72.04
MH 001 074 02-13-2014 16:47 HABOUSH,DAVE 39,113 E85 24.570 3.089 -0.25 75.89 75.89
MH 001 074 02-16-2014 23:22 HABOUSH,DAVE 39,218 E85 11.010 2.990 -0.11 32.92 32.92
MH 001 074 02-20-2014 07:34 HABOUSH,DAVE 39,452 E85 20.140 2.989 -0.20 60.19 60.19
MH 001 078 02-21-2014 20:23 HABOUSH,DAVE 39,719 E85 22.150 2.989 -0.22 66.20 66.20
CARD SUBTOTALS 140.170 -1.40 433.50
0007 MH 001 095 02-01-2014 13:27 SMITH,KEITH 28,211 E85 23.780 2.989 -0.24 71.07 71.07
MH 001 074 02-06-2014 17:08 SMITH,KEITH 28,445 E85 23.030 3.089 -0.23 71.14 71.14
MH 001 154 02-11-2014 15:29 SMITH,KEITH 28,700 E85 24.830 3.089 -0.25 76.70 76.70
MH 001 074 02-17-2014 13:12 SMITH,KEITH 28,950 E85 24.850 2.989 -0.25 74.28 74.28
MH 001 074 02-24-2014 17:25 SMITH,KEITH 29,182 E85 22.760 3.089 -0.23 70.30 70.30
CARD SUBTOTALS 119.250 -1.20 363.49
4551 IP 100680 02-14-2014 11:42 VANVOORST,BOB 9,999 UNL 6.900 3.139 21.66 21.66
CARD SUBTOTALS 6.900 21.66
TOTAL PURCHASES 266.320 -2.60 818.65
Y-T-D PURCHASES 445.820 -4.40 1,376.34
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 9 583.02
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 1 76.70
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 1 71.07
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 1 66.20
IP 100 680 SHELL 501 S AIRPORT DR SANDSTON VA 23150 1 21.66
PRODUCTS: E85=ETHANL85 UNL=UNLEADED r/y
FLEET SERVICES
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Wex Bank
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197
$745.48
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 35965547 I 42-314.00 I $745.48 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
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))
35965547 $745.48
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