240575 01/06/15 ?,% cam" CITY OF CARMEL, INDIANA VENDOR: 366015
® ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: S""''"328.33•
9: ,=a CARMEL, INDIANA 46032 Po Box 6293 CHECK NUMBER: 240575
.y,��oN�, CAROL STREAM IL 60197-6293, CHECK DATE: 01/06/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 39272699 328.33 0453-00-794629.6
FLEET SERVICES INVOICE/STATEMENT
INVOICE NUMBER: 39272699
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 31 12-31-2014 01-22-2015 328.33
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
12-05-2014 PAYMENT RECEIVED-THANK YOU 312.27
12-31-2014 RETAIL FUEL PURCHASES 306.33
12-31-2014 MONTHLY CARD CHG 22.00
YOUR SAV I NGS FROM DI SCOUNTS TH 18 PERI OD= $1.52
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 PAYMENTSMADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT
PREVIOUS BALANCE PAYMENTS (+)PURCHASES (+)DEBITS CREDITS + LATE FE = NEW BALANCE
312.27 312.27 306.33 22.00 0.00 0.00 328.33
$39.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonlinexom
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 I D: 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.
---------TQ EIVSUIRE PR9PEI3 CREDIT-TEAR AT PERFORAI19N AND I IVCLIZDE BOTTOM PORJIQN WITH YQUR PAYMENT
1 -
i i
VOUCHER NO. WARRANT NO.
i
ALLOWED 20
Wex Bank
IN SUM OF $
r
P.O. Box 6293
Carol Stream, IL 60197
CF $797.82
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members
1120 39324625 42-314.00 $469.49 1 hereby certify that the attached invoice(s), or
1120 39272699 42-314.00 $328.33 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
.iAN - 5 2015
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
f,
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-
hom, 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))
39324625 $469.49
39272699 $328.33
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