242169 02/17/15 +er Coq*
;•: CITY OF CARMEL, INDIANA VENDOR: 00351794
6 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $ .....293 26'
_.
CARMEL, INDIANA 46032 PO BOX 183019 CHECK NUMBER: 242169
+M.__... , COLUMBUS OH 43218-3019 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65129116502 293.26 065129116
Account Statement
Commercial Account
G Customer Service: CARMEL POLICE DEPARTMENT
V shellfleetcard acoountonline.com
Shell Fleet Plus Card Account Inquiries: Account Number:. 065 129 116
:. 1-800-377-5150 Fax 1-866-533-5302 Invoice Number: 0000000065129116502
Summary of Account Activity Payment Information
Previous Balance $255.12 Current Due $293.26
Payments -$255.12 Past Due Amount �^ + $0.00
Credits -$28.89 Minimum Payment Due _ $293.26
Purchases � +$322.15
Debits _ +$0.00 Payment Due Date 02/28/15
Late Fees _ +$0.00 Credit Line $4,250
New Balance $293.26 -
Credit Available $3,906
Total Transactions 10 Closing Date _ 02/03/15
Send Notice of Billing Errors and Customer Service Inquiries to: Next Closing Date 03/06/15
SHELL
P.O.Box 6406,Sioux Falls,SD 57117-6406
_ I
TRANSACTIONS
Trans Trans Trans Msg Prod
Date Time ID Location/Description Quantity Code Code Exempt Tax Amount
.0 PAYMENTS,CREDITS,FEES AND ADJUSTMENTS
01/23 I I I PAYMENT-THANK YOU j I I I I $255.12-
0- PURCHASES AND DEBITS
CARD NUMBER 0035 _
01/16 10:07 0272195 1 1201 S HOLT RD INDIANAPOLIS IN --� 12.190^8 SUP $2.23 $25.60
I 12.190 GAL SUPER $25.60 I
CARD NUMBER 0035 TOTAL I 12.190 �� _ S2.23 S25.60
CARD NUMBER 0036
01/14 17:19 0942383 6416 E STATE ROAD 334 WHITESTOWN IN _T 13.405 I 8 UNL $2.45 $25.31
13.405 GAL UNLEADED $25.31 I
CARD NUMBER 0036 TOTAL 13.405 ^�-I 52.45 $25.31
CARD NUMBER 0037
01/11 17:55 0299578 1821 E 151ST ST CARMEL IN --F-18-000 88 UNL T $3.29 $36.00
18.000 GAL UNLEADED $36.00
01/20 11:50 0307066 1230 S RANGELINE RD CARMEL IN 18.436 i 8 I UNL $3.37 $35.01
18.436 GAL UNLEADED $35.01
01/22 14:12 0655803 4624 LAFAYETTE RD INDIANAPOLIS IN 17.285 8 UNL $3.16 $38.01
17.285 GAL UNLEADED $38.01 I
CARD NUMBER 0037 TOTAL L 53.721 ` ' S9.82 S109.02
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 4 This Account is Issued by Citibank,N.A.
_______________ y Please detach and return lower portion with Zour [hent to insure proper credit. R_tain„user ort on for your_[ecords. J
Information About Your Account Payment Other Than By Mall.
When Your Payment Will Be Credited.If we receive your payment in Phone.Call the phone number on Page 1 of your statement to make
proper form at our processing facility by 5 p.m.local time there,it will a payment.We may process your payment electronically after we
be credited as of that day.A payment received there in proper form verify your identity.You will be charged$14.95 to use this service.
after that time will be credited as of the next day.Allow 5 to 7 days for The payment cutoff time for Phone Payments is midnight Eastern
payments by regular mail to reach us.There may be a delay of up to time.This means that we will credit your account as of the calendar
5 days in crediting a payment we receive that is not in proper form or day,based on Eastern time,that we receive your payment request.
is not sent to the correct address.The correct address for regular mail If you send an eligible check with this payment coupon,you authorize
is the address on the front of the payment coupon. us to complete your payment by electronic debit.If we do,the checking
Proper Form.For a payment sent by mail or courier to be in proper account will be debited In the amount on the check.We may do this as
form,you must: soon as the day we receive the check.Also,the check will be destroyed.
Enclose a valid check or money order.No cash,gift cards, Report a Lost or Stolen Card Immediately.You may call Customer
or foreign currency please. Service 24 hours a day,7 days a week.
Include your name and the last four digits of your account number.
..o
I'
0
T04563-H2-9366-8015-0001-OOL--0---04/01/91-287-60-P--O-N--0-0-0-SHFLEET2---03/31/10-SH33-January 6,2015----
PLOCOMM OCT13
_ I
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))
02/10/15 65129116502 gasoline- SID $293.26
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
Processing Center IN SUM OF $
P.O. Box 183019
Columbus, OH 43218-3019
$293.26
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 65129116502 I 42-314.00 I $293.26 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
Tuesday, Fe ruary 10, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
a