250097 10/07/15 ���.4.iq*Fi
CITY OF CARMEL, INDIANA VENDOR: 366015
ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $********60.93•
4, 4�
'' ® PO BOX 6293 CHECK NUMBER: 250097
s.. _ CARMEL, INDIANA 46032
�''�iraN c°� CAROL STREAM IL 60197.6293 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO_NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 42443512 60.93 0453-00-794629-6
FLEET SERVICES INVOICE/STATEMENT
INVOICE NUMBER: 42443512
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
045300-794629-6 8100.00 30 09.30.2015 10-22-2015 60.93
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
09-14-2015 PAYMENT RECEIVED-THANK YOU 328_.48
09-30-2015 RETAIL FUEL PURCHASES 38.93
09-30-2015 MONTHLY CARD CHG 22.00
YOUR SlkVINGSFROM DISCOUNTSTHISPERIOD= $0.20
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 PAYMENTSMADE JUST PRIOR TO BILLING DATE MAY NOTAPPEAR UNTIL THE NEXT INVOICE/STATEMENT
PREVIOUS BALANCE PAYMENTS (,)PURCHASES (+)DEBITS I OCREDITS + LATE FE = NEW BALANCE
328.48 328.48 38.93 22.00 0.00 0.00 60.93
PAY ONLINE AT:www.wexonlinexom
CALL CUSTOMER SERVICE TO PAY BY PHONE The Late Fee is determined by To the Balance subject to late
FEDERAL TAX ID:84-1425616 applying a monthly periodic rate of fee for this period which is
2.249 % 0.00
SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS.
_TO ENSUR-R-PROP€13 CREDI TAT AI�AT PERFORA�19NAND!NCLUDE BQTT_Q_PORTI QN WI LKYOUR PAYM ENT
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wex Bank
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197
$421.41
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 42474245 42-314.00 $360.48 1 hereby certify that the attached invoice(s), or
1120 42443512 42-314.00 $60.93 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
OCT 5 2015
qV
i
Fire Chief
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))
42474245 $360.48
42443512 $60.93
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
120
Clerk-Treasurer