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303803 10/06/16
44q"; CITY OF CARMEL, INDIANA VENDOR: 366015 ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $********49 82* s ,_� CARMEL, INDIANA 46032 Po BOX 6293 CHECK NUMBER: 303803 9.y�TON�, CAROL STREAM IL 60197-6293 CHECK DATE: 10/06/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 47097434 49.82 7560001122480 VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) WEX BANK ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 6293 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CAROL STREAM, IL 60197-6293 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $209.33 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Police Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 47097434 42-314.00 $49.82 1 hereby certify that the attached invoice(s),or 9/30/16 47097434 Marathon gasoline $49.82 1110 101 1110 101 47 2817 14.0 15 bills)is(are)true and correct and that the 9/30/16 47072817 Circle K gasoline $159.51 11 101 materials or services itemized thereon for 1110 101 which charge is made were ordered and received except �Wednesday, October 05,2016 Tim Green Chief of Police 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer nvoi©e Statement INVOICE NUMBER: 47097434 ACCOUNT NAME: CARMEL POLICE DEPT PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 7560-00-112248-0 2,000.00 000.00 30 SEP-30-2016 OCT-21-2016 49.82 DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS SEP-12-2016 PAYMENT-THANK YOU 164.24 SEP-30-2016 FUEL PURCHASES 49.82 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 JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT. PREVIOUS BALANCE PAYMENTS + PURCHASES I (+)DEBITS CREDITS (+)LATE FE (=)NEW BALANCE 164.24 164.24 49.82 0.00 0.00 0.00 49.82 CALL CUSTOMER SERVICE TO PAY BY PHONE FEDERAL TAX ID: 841425616 The Late Fee is determined by To the balance subject to late a plying a monthly rate of fee for this period which is 2.990 % 0.00 SEE REVERSE SIDE FOR I M PORTANT INFORMATION AND TERMS. ————————_TO ENSUE—PROPER CREDI T_TFARA_T PERFOBATIQN AND I NCLIJ _BOTT4h4_P0R2TI WMEFLYWR PAYM ENT.