239668 12/01/14 4i�.�,q,,F� CITY OF CARMEL, INDIANA VENDOR: 366015
ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $ 994.50
:9, _� CARMEL, INDIANA 46032 PO BOX 6293 CHECK NUMBER: 239668
M��iori.-. CAROL STREAM IL 60197-6293 CHECK DATE: 12/01/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 3896390 994.50 0496-00-138012-0
No nvoi ce Statement
I NVOI CE NUMBER: 38986390
ACCOUNT NAME: City of Carmel Fire
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMITDAYS THIS PERIOD BILL CLOSING DATE I PAYMENT DUE DATE AMOUNT DUE
0496.00-138012-0 9,550.00
550.00 30 NOV-30-2014 DEC-22-2014 994.50
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
NOV-07-2014 PAYMENT-THANK YOU 613.09
NOV-28-2014 FUEL PURCHASES 994.50.
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 INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS + PURCHASES (+)DEBITS CREDITS (+)LATE FE (=)NEW BALANCE
613.09 613.09 994.50 0.00 0.00 0.00 994.50
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX I D: 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 period which is
2.249 % 26.99 % 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
TA FIVRI IRF PRCAPFR rRFTNT TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYMENT.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wex Bank
IN SUM OF$
P.O. Box 6293
Carol Stream, IL 60197
$1,306.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 38958551 42-314.00 $312.27 1 hereby certify that the attached invoice(s), or
1120 38986390 42-314.00 $994.50 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
DEC 2914
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))
38958551 $312.27
38986390 $994.50
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