240576 01/06/15 CITY OF CARMEL, INDIANA VENDOR: 366015
CHECK AMOUNT: $*******122.18*
j 6 ONE CIVIC SQUARE WEX BANK
s. =q CARMEL, INDIANA 46032 PO BOX 6293 CHECK NUMBER: 240576
CAROL STREAM IL 60197-6293 CHECK DATE: 01/06/15
tON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4231400 39323525 122.18 0496-00-138002-1
nvoi cue Statement
INVOICE NUM BER: 39323525
NO ACCOUNT NAME: City of Carmel Admin.
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00-138002-1 1550.00 31 DEC�1-2014 JAN-22-2015 122.18
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
DEC-12-2014 PAYMENT-THANK YOU 140.62
DEC-31-2014 FUEL PURCHASES 122.18
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
Submitted ToAN 0 52014
Clerk Treasurer
PURCHASES,RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
PREVIOUS BALANCE PAYMENTS (+)PURCHASES (+)DEBITS CREDITS + LATE FE = NEW BALANCE
140.62 140.62 122.18 0.00 0.00 0.00 122.18
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616 The Late Fee Is determined by Whlch is an EFFECTIVE ANNUAL To the balance subject to late
applying a monthiv rate of RATE of fee for this period which is
2.249 % 26.99 % 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS
_____TO E�V$URE PPOP€R CREDIT-TEAR AT PEf- BAIQN AICD INCLUDE BOT_Q PORTIQN WITI YOUR PAYMENT.
VOUCHER NO. WARRANT NO.
ALLOWED 20
W EX BANK
IN SUM OF$
PO Box 6293
Carol Steam, IL 60197-6293
$122.18
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members -
priol-Year1 hereby certify that the attached invoice(s), or
1205 I 39323525 I 42-314.00 I $122.18
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
Monday, January 05, 2015
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))
12/31/20 39323525 $122.18
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