250556 10/21/15 ♦e+.C�ggl
CITY OF CARMEL, INDIANA VENDOR: 00351794
/ 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $*******762.49*
9� �� CARMEL, INDIANA 46032 PO BOX 183019 CHECK NUMBER: 250556
M,iloN�` COLUMBUS OH 43218-3019 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193510 762.49 GASOLINE
Account. Statement-
Customer.Service: Commercial Account
6/�►� CARMEL POLICE DEPARTMENT
shelliteetcardaccountonlinacom
Shell Fleet Plus Card Account Inquiries: Account Number 065`i"27193.
1-800-377-5150 Fax 1-866-533-5302 Invoice Number. "'00000000651271.93510
Summary of Account ActivityPayment Information
Previous Ballance $902.16 Current Due $762.49
Payments -$902.16 Past Due Amount + $0.00
Credits -$78.18 Minimum.Payment Due _ $762.49
Purchases +$840,67 - --
Debits` _ +$0.00_ Payment Due Date 10/31/15
Late.Fees +$0,00 Credit Line $3,700
New'Balance $762.49 — --
Total Transactions 25 Credit Available _ $2,887
Closing Date 10/06/115 .
end Notice of Billing Errors and Customer Service Inquiries to:
HELL, Next Closing Date 11/05/1.5
P.O.Box 6406,Sioux Falls,SD 57:117-6406
Attention: New Pump Authorization Requirement
(ACTION REQUIRED)
Help prevent credit card fraud. For added security and protection, you and your employees may be asked to enter the business
.C3 five-digit Billing ZIP Code when making a purchase at the pump. Please provide all employees with the Billing ZlP 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. ZIP.=► ZIP �
TRANSACTIONS .
Trans Trans_ Trans. Msg Prod
Date Time -ID Location/Description Quantity Code. Code Exempt-Tax Amount
PAYMENTS,CREDITS,FEES AND ADJUSTMENTS9/25 1
10/06 f DISCOUNT NT THANK YOU $$101.01-
PURCHASES AND DEBITS III
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 6 This Account is Issued by Citibank,N.A.
--lit:-'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$14.95 to use this service.
after that time will be credited as of the next day.Allow 5 to 7 days for The payment cutoff time for Phone Payments is midnight Eastern'
payments by regular mail to reach us.There may be a delay of up to time.This means that we will credit your account as of the calendar
5 days in crediting a payment we receive that is not in proper form or day,based on Eastern time,that we receive your payment request.
is not sent to.the correct address.The correct address for regular mail If you send an eligible check with this payment coupon,you authorize
is the address on the front of the payment coupon. us to complete your payment by electronic debit.If we do,the checking
Proper Form.For a payment sent by mail or courier to be in proper account will be debited in the amount on the check.We may do this as
form,you must: soon as the day we receive the check..Also,the check will be destroyed.
• Enclose a valid check or money order.No cash,gift cards, Report a Lost or Stolen Card Immediately.You may call Customer
or foreign currency please. Service 24 hours a day,7 days a week.
• Include your name and the last four digits of your account number.
_n
U.1
C3
T04563-H2-9366-8015-0001-00L--0---04/01/91-295.56-P--0-N--0-0.0-SHFLEET2...03/31/10-SH33-September 4,2015----
PLOCOMM OCT13
VOUCHER NO. WARRANT NO.
Shell Fleet Plus ALLOWED 20
Processing Center IN SUM OF$
P.O. Box 183019
Columbus, OH 43218-3019
$762.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1110 1)0000065127193j 42-314.00 I $762.49 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
Wednesd y, October 14, 2015
4Z,� I
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))
10/14/15 000000651271935 gasoline $762.49
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
- --