250100 1 0/07/1 5 0", CITY OF CARMEL, INDIANA VENDOR: 366015
ONE CIVIC SQUAREWEX BANK CHECK AMOUNT: S'******179.52*
CARMEL, INDIANA 46032 PO BOX 6293 CHECK NUMBER: 250100
CAROL STREAM IL 60197-6293 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 42475642 179.52 0496-00-138007-0
I twice Statement
INVOICE NUMBER: 42475642
® ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00-138007-0 20 000.00 30 SEP-30.2015 OCT-22-2015 179.52
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
SEP-14-2015 ' ' PAYMENT-THANK YOU - 326.05
SEP-30=2015 . FUEL PURCHASES 179.52
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 RETURNS AND PAYMENTS MADE JUSF PRIOR TO BI LLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/SFATEM ENT.
PREVIOUS BALANCE -PAYMENTS (+)PURCHASES (+)DEBITS -CREDITS (+)LATE FE (=)NEW BALANCE
326.05 326.05 179.52 0.00 0.00 0.00 179.52
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX I D: 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.
_TO ENSURE PROPER CREDIT—TEAf-AT PERFORATION AND I NCLUDE_BOTTOM PORTIQN WITI I YOI�R eAYM ENT.
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
W EX Bank
IN SUM OF$
P.O. Box 6293
Carol Stream, IL 60197-6293
$239.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 42501275 42-314.00 $59.56 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1110 42475642 42-314.00 $179.52
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, ct er 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))
09/30/15 42501275 gasoline $59.56
09/30/15 42475642 gasoline $179.52
i
I
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