182219 02/16/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES
CARMEL, INDIANA 46032 0453 -00- 7946296 CHECK AMOUNT: $709.75
PO BOX 6293 CHECK NUMBER: 182219
°N CAROL STREAM IL 60197
CHECK DATE: 2/1612010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 709.75 0453007946296
F LEET SERVIC INVOICE /STATEMENT
INVOICE NUMBER: 21970836
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00 794629 -6 6000.00 31 01 -31 -2010 02-26-20 10 709.75
DATE rt ACTIVITY DESCRIPTION CHARGES %pEBITS PAYMENTS]CREDITS
01 =19 201�Jm,' PAYMENT RECEIVED THANK YOU 753.57
1; -29 -2010 x RETAIL FUEL PURCHASES 69 5
01 29 -2010 MONTHLY CARD CHG 19.00
m REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH
PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT
PORTION OF THE REMITTANCE STUB.
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t
NEW FAY -BY -PHONE OP7j0N! y
x CALL CUSTOMER SERVICE AND SELECT BILLING INQUIRIES.
SEE DETAILS ON BACK OR GO TO WWW.FSOLNEWS.COM /PHONEPA g
'J 35 zK f tai
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PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE /STATEMENT
PREVIOUS BALANCE )PAYMENTS +►PURCHASES (-+-)DEBITS (-►CREDITS I (+)LATE FE =►NEW BALANCE
753.57 753.57 695.75 14.00 0.00 0.01 709.75
$1 0.00 MIM M U MI'LATE FEE
PAY ONLINE AT:wwwmexonline.com
FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an ANNUAL To the Balance subject to late
applyi a monthly periodic rate of PERCENTAGE RATE of fee for this period which is
_2.0_0_ 24.00 0.00
SEE REVERSE SWE FOR MORE INFORMATION AND TERMS.'
TO ENSURE PROPER CREDlT, TEAR AT PERFORATION AND 1NCLUDE BOTTOM PORTION WITH YOUR PAYMENT
Balance Subject to Late Fee Payment Options
The late fee will be calculated by determining the total balance Mail
due on the date your account becomes delinquent, as follows: Be sure to include bottom portion of invoice with your payment.
adding the total amount due on your Account on the payment due Write your account number or invoice number on the check to help
date together with any purchases posted to your Account from avoid delays in payment, processing if the check and remit stub
the end of the last billing cycle through the payment due date and become separated.
subtracting from that amount any payments and/or credits entered
during that period. The total balance due will then be multiplied Allow 10 business days prior to the due date for mailing to help
by the applicable periodic rate to determine your late fee. In the avoid late fees. Mail payments to:
event that the calculated late fee is less than ten dollars ($10.00), Fleet Services
a minimum late fee of ten dollars ($10.00) will be charged. PO Box 6293
Your Account will be delinquent if you do not pay it in full within Carol Stream, IL 60197 -6293
26 calendar days of the billing date appearing on your invoice. Online
Certain customers, based upon our credit review, may be required Authorized users can elect to receive an email notification when an
to make payment in less than 26 calendar days on a cycle that we invoice is ready for online viewing and payment. Log in or register to
may establish for you. In addition, certain customers may elect a set up an online account at www.wexonline.com.
shorter billing or payment cycle as offered by us.
Online payments scheduled by 3:00 PM ET (on business days)
If your payment due date falls on a non business day, payment is are credited to your account on the same day- There is no fee for
due on the business day before the payment due date. Delinquent online oavments.
Accounts will be subject to late fees, suspension, or termination
of credit privileges, without notice. All charges must be paid in Phone
full regardless of disputes. Charges must be disputed in writing Call Customer Service at 1- 888 387.5665 and select the menu
no later than sixty (60) days from the billing date or they will be option for Billing Inquiries. In addtion to scheduling a payment, you
considered final and binding. can also check your balance.
Card Issuer Payments scheduled by 3:00 PM ET (on business days)
The Fleet Services Card is issued by, and all card transactions are credited to your account on the same day
are funded by and payable to, Wright Express Financial Services Be prepared with your fleet card account number and a sample
Corporation, under Business Charge Account Agreement with check to enter your bank account number and routing number.
the cardholder named d on the reverse. There is no fee for phone payments.
Customer Service
Automated Clearing House (ACH)
For account Inquiries and correspondence in regard to account To make a one -time electronic payment go to:
service or billing: htt tw.efleet.com
Call 1- 888 -387 -5665, or ACH payments scheduled by 2:30 PM ET (on business days) are
credited to your account on the same day. There is a fee for each
Fax to 1 -000 -395 -0809, or ACH payment.
Mail to P.O. Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 01 -31 -2010
ACCOUNT NO: 0453 -00- 7;1 6
4629-
F L E E T SERVICE0
DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SO
CARMEL IN 46032 -2584
Tax Summary
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAK TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
FEDERAL 355000972 -49.23 0.00 FEDERAL E85 268.960 645.13 0.18300
-12.20 0.00 FEDERAL GASOLINE 66.655 159.91 0.18300
FEDERAL.T,OTALS 400 3 815 .'80504
IN 356000972 0.00 11.99 STATE EXCISE GASOLINE 66.655 159.91 0.18000
-38.99 0.00 STATE :SALES E85 268.960 645.13 0.07000
-8.87 0.00 STATE SALES GASOLINE 66.655 159.91 0.07000
IN STATE TOTALS -47.86
ACCOUNT TOTALS 'i0R29 11.99
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(c) WRIGHT EXPRESS CORPORATION 2010 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 21970836
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00- 794629 -6 6 31 01 -31 -2010 02-26-2 709.75
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 078 01 -02 -2010 14:32 SMITH, KEITH 14,500 E85 9.710 2.458 2387 23.87
MH 001 078 01 -05 -2010 07:52 SMITH, KEITH 14,500 E85 20.910 2399 50.16 50 -16
MH 001 078 01 -07 -2010 08:10 SMITH, KEITH 14,500 E85 13.450 2399 3226 32.26
MH 001 078 01 -09 -2010 13:56 SMITH, KEITH 14,500 E85 14.490 2399 34.76 34.76
MH 001 078 01 -18 -2010 09:27 SMIT-1. KEITH 14,500 E85 19.580 2399 46.98 46.98
CARD SUBTOTALS 78.140 188.03
0002 MH 001 078 12 -31 -2009 12:40 HULETT, MARK 60,057 E85 12.180 2.459 29.95 29.95
MH 001 078 01 -05 -2010 14:45 HULETT, MARK 60,236 E85 12 -760 2.398 30 -W 30.60
MH 001 074 01 -08 -2010 13:31 HULETT. MARK 60,391 E85 9 -300 2399 2231 22.31
MH 001 076 '01 -10 2010 14:45 HULETT, MARK 60,501 E85 6.540 2401 15.70 15.70
R4i 100 1 079 01-132010 15:33 HULETT, MARK 60,703 E85 12.840 2399 30.80 30.80
MIA 001 076 01- 16-2010 02:53 HULETT, MARK 60,883 E85 10 -360 2399 24.86 24.85
MH 001 074 01 -21 -2010 10:17 HULEI f, MARK 61,106 E85 13.030 2.398 31.25 31.25
MH 001 074 01 -25 -2010 10:09 HULETT. MARK 61,277 E85 11.250 2360 26.55 26.55
CARD SUBTOTALS 88.260 21201
0003 GI 001 065 01 -06 -2010 07:18 STEELE, JEFF 9,451 SUP 22.180 2.399 53.21 53.21
G1001 065 01 -19 -2010 07:13 STEELE, JEFF 9,598 SUP 23.288 2.399 55.87 55.87
GI 001 065 01 -28 -2010 07:07 STEELE, JEFF 9,767 SUP 21.187 2.399 50.83 50.83
CARD SUBTOTALS 66.655 159.91
0004 MH 001 074 01 -12 -2010 20:28 HABOUSH, DAVE 21,708 E85 21020 2.399 50.43 50.43
MH 001 074 01 -20 -2010 08:08 HABOUSH, DAVE 21,939 E85 23.930 2399 57.40 57.40
CARD SUBTOTALS 44.950 10723
.17 MH nn' 1 .5 01- 1 1 ?0:5r_: 5.�ii}1 KEDTII R3.0<7 E85 20:840 2.399 50.00 5000
MH 001 154 01 -13 -2010 17:29 SMITH, KEITH 133,219 EB5 13.390 2398 32.11 32.11
MH 001 154 01 -24 -2010 20:06 SMITH, KEITH 84,193 E85 23.380 2.359 55.15 55.15
CARD SUBTOTALS 57.610 13726
TOTAL PURCHASES 335.615 805.04
Y -T -D PURCHASES 335.615 805.04
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street CRY Slate Zip
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 10 319.93
MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 5 187.94
61 001 065 CRYSTAL FLAS 545 SOUTH RANGELINE CARMEL IN 46032 3 159.91
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 3 137-26
PRODUCTS: E85 =ETHANL85 SUP =SUPER UN
FLEET SERVICES
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CYCLE /04 SEa /00024 FILE /WEX_HP-WEX_4 LOTL EXP
4
ATTN DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SQ
CARMEL IN 46032 -2584
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$709.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1120 21970836 42- 314.00 $709.75 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
FEB 15 2010
�V-
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))
21970836 $709.75
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
2D
Clerk- Treasurer