245367 05/18/15 CITY OF CARMEL, INDIANA VENDOR: 00351794
® I ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $**t 518.90R
CARMEL, INDIANA 46032 PO BOX 183019 CHECK NUMBER: 245367
COLUMBUS OH 43218-3019 CHECK DATE: 05/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193505 518.90 065-127-193
Account Statement
Customer Service: Commercial Account
GICustomer POLICE DEPARTMENT
shellfleetcard accountonline.com
Shell Fleet Plus Card Account Inquiries: Account Number':-_",' . .065127 193
1-800-377-5150 Fax 1-866-533-5302 Invoice Number '.000000606M271'93505
Summary of Account Activity Payment Information
Previous Balance _$484.10 Current Due $518.90
Pyments — -$484.10 Past Due Amount + $0.00
Credits -$42.73 Minimum Payment Due = $518.90
Purchases +$561.63
Debits �i +$0.00 Payment Due Date 05/31/15
Late Fees +$0.00 Credit Line $3,700
New Balance $518.90 —
Total Transactions 15 Credit Available $3,181
Closing Date 05/06/15
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Notice of Billing Errors and Customer Service Inquiries to: Next Closing Date 06/05/15
LBox 6406,Sioux Falls,SD 57117-6406
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TRANSACTIONS
Trans Trans Trans Msg Prod
Date Time ID Locatlon/Description Quantity Code Code Exempt Tax Amount
PAYMENTS,CREDITS,FEES AND ADJUSTMENTS
04/22 1 , l PAYMENT-THANK YOU I l l $484.10- .
PURCHASES AND DEBITS
CARD NUMBER 0015
04109 1 09:58 0260430 11230 S RANGELINE RD CARMEL IN r 16.721 1 8 UNL _ ;$3;06F $39.78
Information About Your Account Payment Other Than By Mail.
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
orforeign currency,please. Service 24 hours a day,7 days a week.
• Include your name and the last four digits of your account number.
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T04563-H2-9366-8015-0001-00L--0---04/01/91-290-56-P--0-N--0-0-0-SHFLEET2--03!31/10-SH33-April 5,2015----
PLOCOMM OCT13
Account: **** **** **** 7193
TRANSACTIONS (cont.)
Trans Trans Trans Meg Prod
Date Time ID Location/Description Quantity Code Code Exempt Tax Amount
16.721 GAL UNLEADED $39.78
04/30 06:36 0476747 8924 E 116TH ST FISHERS IN 16.700 8 UNL $3.06 $43.42
16.700 GAL UNLEADED $43.42
CARD NUMBER 0015 TOTAL 33.421 $6.12 $83.20
CARD NUMBER 0018 _
04/06 08:47 0189852 6402 W 10TH INDIANAPOLIS IN 7.042 8 UNL $1.29 $15.00
7.042 GAL UNLEADED $15.00
04/18 08:37 0563536 9510 E 126TH ST FISHERS"IN 6.612 8 UNL $1.21 $15.54
6.612 GAL UNLEADED $15.54
05/03 15:41 0547836 15587 M-60 TEKONSHA MI 14.121 8 UNL $2.58 $34.16
14.121 GAL UNLEADED $34.16
CARD NUMBER 0018 TOTAL 27.775 $5.08 $64.70
CARD NUMBER 0021
04/29 13:25 0407395 901 MAMMOTH CAVE STREET CAVE CITY KY 23.993 8 UNL $4.39 $59.00
23.993 GAL UNLEADED
$59.00
CARD NUMBER 0021 TOTAL 23.993 $4.39 $59.00,
CARD NUMBER'0022
04/13 18:16 0646190 545 S RANGE LINE RD CARMEL IN 21.286 8 UNL $3.90 $48.30
21.286 GAL UNLEADED $48.30
05/01 09:55 0373415 1230 S RANGELINE RD CARMEL IN 21.050 8 UNL $3.85 $54.52
_j 21.050 GAL UNLEADED $54.52 -
L-i CARD NUMBER 0022 TOTAL 42.336 $7.75 $102.82
W - CARD NUMBER 0023
O 04/11 23:35 0322685 9609 OLIO RD MCCORDSVILLE IN 15.902 8 UNL $2.91 $35.94
ru 15.902 GAL UNLEADED $35.94
CARD NUMBER 0023 TOTAL 15.902 $2.91 $35.94
CARD NUMBER 0025
04/18 21:00 0379016 9609 OLIO RD MCCORDSVILLE IN 16.414 8 UNL $3.00 $37.08
16.414 GAL UNLEADED $37.08
04/20 23:19 0087106 14126 BERGEN BLVD NOBLESVILLE IN 15.850 8 SUP $2.90 $38.04
15.850 GAL SUPER $38.04
04/23 00:03 0487231 7788 E 96TH ST FISHERS IN 15.894 8 UNL $2.91 $41.31
15.894 GAL UNLEADED $41.31
04/30 14:01 0789016 14000 W STATE ROAD 28 GASTON IN 14.250 8 UNL $2.61 $33.63
14.250 GAL UNLEADED $33.63
_ CARD NUMBER 0025 TOTAL 62.408 $11.42 $150.06
CARD NUMBER 0026
04/2511:5 0 1005 N RILEY HIGHWAY SHELBYVILLE IN 10.853 8 UNL $1.99 $27.33
10.853 GAL.UNLEADED $27.33
CARD NUMBER 0026 TOTAL 10.853 $1.99 $27.33
CARD NUMBER 0038
04/19. 10:56 0575043 9510 E 126TH ST FISHERS IN 16781 8 UNL I $3.07 $38:58, '
i Ir `CARD NUMBER 0038 TOTAL 16.781 I $3.07 $38.58
GRAND TOTAL I 233.469 I $42.73 I $561.63
Message Codes:_ 1- Electronic Sale with Authorization 4-Electronic Sale without Authorization 8-Electronic Sale at Pump
- � 2- Keyed"Sale with Authorization w� 5 Keyed Sale without Authorization 9-Manual Sale
YEAR-TO-DATE SUMMARY
Total Gallons Purchased this Statement 233.469
Total Gallons Purchased in 2015 1,392.419
TAX EXEMPTION SUMMARY
Description Amount
FEDERAL-EXCISE TAX
233.4 GALLONS GASOLINE ��✓ �LL-$42.73
Page 3 of 4 1-800-377-5150 shellfleetcard.accountonline.com
"
Account: **** **** **** 7193
SAVE MONEY Financial Benefits: =
AND AGE ■ Lower your fuel costs with the Shell Fleet Plus Rebate Program
■ No monthly,annual,,or per card fees
YOUR FLEET y
Convenience"'and Card Control
PROGRAM ■ Purchase restrictions and driver prompts help eliminate
� unauthorized card usage
ORE ■ Concise monthly reports by driver,vehicle or department enables you to;
stays-R control of your drivers activities without ever leaving your desk
EFFICIENTLY
■ 24/7 online account management
with the Shell Fleet Plus Card! ■ Limit the'number of transactions per card, per day
956
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Page 4 of 4 1-800-377-5150 shellfleetcard.accountonline.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
IN SUM OF$
Processing Center
P.O. Box 183019
Columbus, OH 43218-3019
$518.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1110 I 65127193505 I 42-314.00 I $518.90 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
/Friday, May 15, 2015
Chief of Police
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))
05/14/15 65127193505 gasoline $518.90
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