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331882 11/07/18
i pl-Cgg3 ! t CITY OF CARMEL, INDIANA VENDOR: 366015 ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $*******103.17 CARMEL, INDIANA 46032 Po Box 6293 CHECK NUMBER: 331882 9y��oN CAROL STREAM IL 60197-6293 CHECK DATE: 11/07/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4231400 56446814 103.17 GASOLINE VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 366015 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER WEX BANK IN SUM OF$ CITY OF CARMEL PO BOX 6293 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. CAROL STREAM, IL 60197-6293 Payee $103.17 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# General Administration 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 10.31.18 42-314.00 $103.17 1 hereby certify that the attached invoice(s),or 10/31/18 10.31.18 Gasoline $103.17 1205 101 1205 101 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 Tuesday, November 6,2018 Crider,James Administration 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: 56446814 ACCOUNT NAME: City of Carmel Admin. PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0496-00-136002-1 1,550.00 31 OCT-31-2018 NOV-21-2018 241.99 DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS OCT-15-2018' ` Payment-Thank You - 18.72 OCT-31-2018;'' Fuel Purchases 28.17 'OCT-31=2018Other Adjustments this Period 75.00 BALANCE INCLUDES PAST DUE AMOUNT IF PAYMENT HAS BEEN MADE,PLEASE DISREGARD THIS NOTICE. PAST DUE ACCOUNTS ARE SUBJECT TO SERVICE INTERRUPTION NOV 0 6 2018 Clerk "Treasurer PURCHASES.RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT I NVOICEISrATEMENT. CURRENT PERIOD I ONE BILLING P=TWO BILLING PERIOD PAST DUE THREE+BILLING PERIODS PAST DUE TOTAL DUE 103.171 138.821 0.001 0.001 241.99 PREVIOUS BALANCE -PAYMENTS (,)ACTIVITY THIS P -SAVINGS THIS PERIOD = NEW BALANCE 157.54 18.72 r 103.17 0.00 241.99 CALL CUSTOMER SERVICE TO PAY BY PHONE FEDERAL TAX ID: 841425616 SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.