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233160 06/04/14
CITY OF CARMEL, INDIANA VENDOR: 366015 ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $*******305.22* CARMEL, INDIANA 46032 PO Box 6293 CHECK NUMBER: 233160 CAROL STREAM IL 60197-6293 CHECK DATE: 06/04/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4231400 36936756 305.22 0496-00-138002-1 I nvoi©e Statement INVOICE NUMBER: 36936756 ACCOUNT NAME: City of Carmel Admin. PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0496-00-138002-1 1550.00 31 MAY-31-2014 JUN-26-2014 305.22 DATE '` ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS MAY-09-2014 PAYMENT-THANK YOU 243.15 MAY-3072014 FUEL PURCHASES 305.22 REMINDER REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT PORTION OF THE REMITTANCE STUB. PURCHASES RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEM ENT. PREVIOUS BALANCE PAYMENTS +PURCHA (+)DEBITS CREDITS + LATE FE =NEW BALANCE 243.15 243.15 /"'�305.221 0.00 0.00 0.00 305.22 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 monthiv rate of RATE of fee for this periDd which is 2.249 % 26.99 % 0.00 SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS. _TO ENSURE PROPER CBEPIT-TEAR AT PEI�FOBATIOIV AND INCLI_DE BOTJOM PORJIQN Y111T}H-YQVR PAYMENT. 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 WEX RANK (Cirde K Fleet) Purchase Order No. PO Box 6293 Terms Date Due Carol IL Holy/ fi2q3 Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/3i 36936756 ne -Admin Dept $305.22 $305.22 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. 03/037-14 WEX BANK (Circle K Fleet) ALLOWED 20 IN SUM OF $ PO Box 6293 i i Garol Stream, IL 60197-6293 $ $305.22 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 1205 36936756 314 $305.22 received except I f l' i 20 r, i j Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund