246171 06/1 7/1 5 � ,44g3R
CITY OF CARMEL, INDIANA VENDOR: 00351794
.��; ® ' ONE CIVIC SQUARE SHELL CREDIT CARD CENTER
CHECK AMOUNT: $*******853.89*
s. ,, CARMEL, INDIANA 46032 PO BOX 183019 CHECK NUMBER: 246171
vM, COLUMBUS OH 43218-3019 CHECK DATE: 06/17/15
[TON GO'
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193506 853.89 065-127-193
Account Statement
Commercial Account
Customer Service: CARMEL POLICE DEPARTMENT
V shelMeetcarcl acoountonline com
Shell Fleet Plus Card Account Inquiries: Account Number: " 065127.-193
1-800-377-5150 Fax 1-866-533-5302 Invoice Number: `0000000065127193506,
Summary of Account Activity Payment Information
Previous Balance $518.90 Current Due $853.89
moments -$518.90 Past.Due Amount + $0.00.
Credits 474.07 Minimum Payment Due $853,89
Purchases _ _ +$927.96 - -
Debits _ +$0.00 Payment Due Date 06/30/15
Late Fees +$0.00 Credit Line _ $3,700
New Balance $853.89 - -
Total Transactions 24 Credit Available $2,846
_Closing Date _ 06/05/15
Send Notice of Billing Errors and Customer Service Inquiries to: Next Closing Date 07/06/15
SHELL
P:O.Box 6406,Sioux Falls,SD 57117-6406
Attention: New Pump Authorization Requirement
(ACTION REQUIRED)
_B Help prevent credit card fraud. For added security and protection, you and your employees may be asked to enter the business
W
E3five-digit Billing ZIP Code when making a purchase at the pump. Please provide all employees with the Billing ZIP Code and
make sure they are aware of this change. Thank you for your cooperation and see you at a Shell Station soon.
Beginning June 2015 and throughout 2015 Z0p in bi ZIP out
TRANSACTIONS
Trans Trans Trans Mag Prod
Date Time ID Location/Description Quantity Code Code Exempt Tax Amount
PAYMENTS,CREDITS,FEES AND ADJUSTMENTS
05/20 PAYMENT- 518.90-
06/05 I +DISCOUNT THANK YOU I I I f $$10:43-
PURCHASES AND DEBITS
- .. NOTICE.SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 6 Thls Account Is-issued by Citibank,N.A.
y Please detach and return lower portion with your payment to Insure proper credit. Retain upper portion for your records. +
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$14.95 to use this service.
after that time will be credited as of the next day.Allow5 to 7 days for The payment cutoff time for Phone Payments is midnight Eastern
payments by regular mail to reach us.There may be a delay of up to time..This means that we will credit your account as of the calendar
5 days in crediting a payment we receive that is not in proper form or day,based on Eastern time,that we receive-your payment request.
is not sent to the correct address.The•correct address for regular mail If you send an eligible check with this payment coupon,you authorize
is the address on the front of the payment coupon. us to complete your payment by electronic debit.if we do,the checking
Proper Form.For a payment sent by mail or courier to be in proper account will be debited in the amount on the.check.We may do this as
form,you must: soon as the day we receive the check.Also,the check will be destroyed.
• Enclose a valid check or money order.No cash,gift cards, Report a Lost or Stolen Card Immediately.You may call Customer
or foreign currency please. Service 24 hours a day,7 days a week.
• Include your name and the last four digits of your account number.
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T04563-H2-9366-8015-0001-OOL-0-04/01/91-291-56-P--0-N--0-0-0-SHFLEET2--03/31/10-SH33-May 6,2015---
PLOCOMM OCT13
Pana 9 of R —
VOUCHER NO. WARRANT NO.
Shell Fleet Plus ALLOWED 20
Processing Center IN SUM OF$
P.O. Box 183019
Columbus, OH 43218-3019
$853.89 I
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACcT#/-rITLEF AMOUNT Board Members
1110 I 65127193506 I 42-314.00 I $853.89 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
Monday, June 15, 2015
----------- V--�a3�tt'2
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))
06/15/15 65127193506 gasoline $853.89
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