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234469 07/08/14 (9, ) CITY OF CARMEL, INDIANA VENDOR: 366015 ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $*******228.89* CARMEL, INDIANA 46032 PO Box 6293 CHECK NUMBER: 234469 CAROL STREAM IL 60197-6293 CHECK DATE: 07/08/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4231400 37279803 228.89 0496-00-138002-1 1110 4231400 37284771 345.98 0496-00-138007-0 1120 4231400 37284771 -345.98 0496-00-138007-0 nvoi©e Statement I NVOI CE NUMBER: 37279803 ® ACCOUNT NAME: City of Carmel Admin. PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PER107 BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 049600-138002-1 1550.00 30 JUN-30-2014 JUL-25-2014 228.89 DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS JUN-11=2014 PAYMENT-THANK YOU 305.22 JUN-30-2014 FUEL PURCHASES 228.89 - REMINDER REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT PORTION OF THE REMITTANCE STUB. Submitted To JUL 072014 Clerk Treasurer PURCHASES,RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEM ENT. PREVIOUS BALANCE PAYMENTS +PURCHASES + DEBITS CREDITS (,)LATE FE (=)NEW BALANCE 305.22 305.22 228.89 0.00 0.00 0.00 228.89 CALL CUSTOMER SERVICE TO PAY BY PHONE FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an EFFECTIVE ANNUAL To the balance subject to late applying a monthly rate of RATE of fee for this Period which is 2.249 % 26.99 % 0.00 SEE REVERSE SI DE FOR I M PORTANT I NFORMATI ON AND TERM S ---------TQENSURE_PR9P�R CREDIT,TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION MT}iYQV9-QAYM ENT. VOUCHER NO. WARRANT NO. .�� ALLOWED 20 r, l t)( q� IN SUM OF$ POBox6293 Carol Stream, IL 60197-6293 $228.89 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 I 37279803 I 42-314.00 I $228.89 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 onday, July A7, 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)) 06/30/14 37279803 $228.89 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