256205 03/15/16 0J/ CITY OF CARMEL, INDIANA VENDOR: 00351794
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $*******253.95*
=a CARMEL, INDIANA 46032 PO BOX 9001015 CHECK NUMBER: 256205
.yiioN,�, LOUISVILLE KY 40290-1015 CHECK DATE: 03/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65129116603 253.95 065129116
VOUCHER NO. WARRANT NO.
ALLOWED 20
SHELL CREDIT CARD CENTER
PO BOX 9001015 IN SUM OF$
LOUISVILLE, KY 40290-1015
$253.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police
PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Member;
65129116603 I 42-314.00 I $253.95 1 hereby certify that the attached invoice(s), or
1110 101
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
y which charge is made were ordered and
\ received except
✓ a
Friday, March 11, 2016
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 Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
03/11/16 65129116603 SID gasoline $253.95
1110 101
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
Account Statement
Commercial Account
//��►►�� Customer Service: CARMEL POLICE DEPARTMENT
V shell8eetcard.accountonlinecom
Shell Fleet Plus Card Account Inquiries: Account Number: 065129116
1-800-377-5150 Fax 1-866-533-5302 Invoice Number: 0000000065129116603
Summary of Account Activity Payment Information
Previous Balance $237.38 Current Due $253.95
Paym __
ents -$0.00 Past Due Amount _ + $237.38"
Credits -$32.26 Minimum Payment Due - _ _ $491.33'
Purchases -^^ -+$286.21
Debits i _ T+$0.00 Payment Due Date 0.3/31/16 .
Late Fees +$0.00 _Credit Line__ _ $4,250
New Balance $491.33 Credit Available $3,758
Total Transactions 11 Closing Date V _ 03/06/16 -LSendotice of Billing Errors and Customer service Inquiries to: Next Closing Date 04/05/16ox 6406,Sioux Falls,SD 57117-6406
Please note that if we received your pay by phone or online payment between 5 p.m.ET and midnight ET on the last day of your billing period,your
payment will not be reflected until your next statement.
TRANSACTIONS
Trans Trans Trans Msg Prod
Date Time ID Location/Description Quantity Code Code Exempt Tax Amount
L✓ PURCHASES AND DEBITS
Er L✓ CARD NUMBER 0035
.l7 02/11 22:06 ! 0252205 3748 N HIGH SCHOOL RD INDIANAPOLIS IN IT 14.171 8 j BLE - $2.59 $22.66
14.171 GAL BLENDED $22.66
02/15 19:18 0996314 7788 E 96TH ST FISHERS IN } 15.826 8 BLE ; $2.90 $24.04
t 15.826 GAL BLENDED $24.04
i } {
02/18 ± 15:57 i 0946426' 8190 ALLISONVILLE RD INDIANAPOLIS IN 11.173 8 BLE $2.04 ( $20.00
I + 11.173 GAL BLENDED ; I
$20.00
CARD NUMBER 0035 TOTAL i 41.170 $7.53 $66.70
CARD NUMBER 0036
02/22 1 2258 1 0776203 22224 N 600 WEST GREENFIELD IN 24.828 8 1' BF_ $4,54 $39.70
24.828 GAL BLENDED $39.70
03/01 16:13 i 0088203 } 1230 S RANGELINE RD CARMEL IN 10.295 8 BLE $1.88 i' $19.54
s
i + 10.295 GAL BLENDED $19.54 1
__ `� CARD NUMBER 0036 TOTAL _ 35.123_ # - $6.42V(_- $59.24
CARD NUMBER 0037__ _
02/04~; 18:07 0833616 545 S RANGE LINE RD CARMEL IN ; 17.691 8 UNL V $3.24 i $27.05
I 17.691 GAL UNLEADED $27.05 i p
02/14 18:24 ; 0899823 1 545 S RANGE LINE RD CARMEL IN 18.439 i 8 i UNL $3.37 - $26.35
_ _ N(�T�EE-SEEEIEVF�3SES1Dl<EQNJMP�lQN7 J�IEORMAT.IQN - =Pae®_l�ot-4
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Information About Your Account Payment Other Than By Mall.
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 Ih,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.
L✓
o,
0
ki
T04563-H2-9366-8015-0001-OOL--O-D--04/01/91.300.60-P--0-N-1-100.0-SHFLEET2---0381/10-S H33-February 4,2016----
PLOCOMM OCT13
Account: **** **** **** 9116
TRANSACTIONS.(cont.)
Trans Trans Trans Msg Prod
Date" Time ID Location/Description _ _ Quantity Code Code Exempt Tax Amount
f _—p 18.439 GAL UNLEADED $26.35
i
02/17 12:42 0917088 €545 S RANGE LINE RD CARMEL IN S 19.455 i 8 UNL € $3.56 i $35.00
`. 19.455 GAL UNLEADED $35.00 f 6 €
yy CARD NUMBER 0037 TOTAL 55.585 ` $10.17 $88.40
CARD NUMBER 0038 _
02/16 07:43 t 0248195 s 6955 S EMERSON INDIANAPOLIS IN - 14.583 8 i BLE $2.67 i x$21.86
I 14.583 GAL BLENDED $21.86
i CARD NUMBER 0.038 TOTAL 14.583 ( } M$2.67 $21.86
CARD NUMBER 0040
02/07 14:14 t 0 7069 81(1230 S RANGELINE RD CARMEL IN V i 15.100 # 8 BLE ��— $2.76 $21.88
15.100 GAL BLENDED $21.88
03/01" i 17:15 0813956 2224 N 600 WEST GREENFIELD IN # 14.813 8 I BLE $2.71 i $28.13
I 14.813 GAL BLENDED $28.13. ( {
CARD NUMBER 0040 TOTAL 29.913 $5.47 y $50.01
GRAND TOTAL 176.374 $32.26 f $286.21
Message Codes: 1- Electronic Sale with Authorization 4-Electronic Sale without Authorization 8-Electronic Sale at Pump..
2- Keyed Sale with Authorization 5 KeyedSale without.Authorization 9-Manual Sale
L✓'
Ir
YEAR-TO-DATE SUMMARY
C3 Total Gallons Purchased this Statement 176.374
ru -- --- _
Total Gallons Purchased in 2016 409.356
TAX EXEMPTION SUMMARY .
Description Amount .
FEDERAL EXCISE TAX _
55.5 GALLONS GASOLINE -$10.17
120.7 GALLONS GASOHOL -$22.09
Page 3 of 4 1-800-377-5150 shellfleetcard:accountonline.com