249158 09/09/15 `% p'". CITY OF CARMEL, INDIANA VENDOR: 366015
`'0 CHECK AMOUNT: S*""*"*326.05*
.� ® °.�• ONE CIVIC SQUARE WEX BANK
,. ?a CARMEL, INDIANA 46032 PO BOX 6293 CHECK NUMBER: 249158
1y,TON„�� CAROL STREAM IL 60197-6293 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 42113947 326.05 0496-00-138007-0
I nvoi oe Statement
INVOICE NUM BER: 42113947
NO ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMITDAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-M138007-0 20 000.00 31 AUG-31-2015 SEP-22-2015 326.05
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
AUG-17-2015'• PAYMENT-THANK YOU 134.06
AUG-31-2015 FUEL PURCHASES 326.05
REMINDER
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 PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISFATEMENT.
PREVIOUS BALANCE I QPAYMENTS (+)PURCHASES (+)DEBITS CREDITS +LATE FE =NEW BALANCE
134.06 134.06 326.05 0.00 0.00 0.00 326.05
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616 The Late Fee is determined by To the balance subject to late
applying a monthly rate of fee for this period which is
2.249 % 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
VOUCHER NO. WARRANT NO.
ALLOWED 20
W EX Bank
� IN SUM OF$
I
P.O. Box 6293
Carol Stream, IL 60197-6293
$326.05
ON ACCOUNT OF APPROPRIATION FOR
I
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
.1110 I 42113947 I 42-314.00 I $326.05 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
Wednesday, S ptember 02, 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))
08/31/15 42113947 gasoline $326.05
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