183121 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH PETROLEUM
CARMEL, INDIANA 46032 PO BOX 105080 CHECK AMOUNT: $86.48
ATLANTA GA 30348 -5080
CHECK NUMBER: 183121
CHECK DATE: 3/16/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 BG1298219 86.48 BG1298219
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CF7YSTAL7=LAS14 Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
Account BG1298219
Please reference account on all payments
111 1EI 111111 lip 69 STATEMENT NP23741181
DATE 03101/2010
CITY OF CARMEL ITILITIES DUE DATE 03/3112010
1 CIVIC SQ TOTAL BALANCE DUE $86.48
CARMEL IN 46032 -2584
PAYMENT TERMS Net 30 MN
TI "For online siatements an[i simple; al forna�ed payrrierii 5eiup, coniaci customer 3ervi'ce at cardservices@fleetcor:coM
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 2/28/2010
Date Description Gallons Amount Due
02/19/2010 PAYMENT: Lockbox Payment Thank You $133.00 CR
03/01/2010 Fleet 1315591 Name: CITY OF CARMEL- UTILITIES 33.366 $86.48
Current Activity
Previous
Statement Payments and
Date Prior Balance Adjustments Gallons Charges Total Balance Due
02/01/2010 $133.00 $133.00 CR 33.366 $86.48 $86.48
FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
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PO BOX 105080 FLEET MANAGEMENT REPORT
ATLANTA, GA 30348 -5080 Account BG1298219
FLEET 1315591
Provided By: Name: CITY OF CARMEL- UTILITIES
Crystal Flash Petroleum PL
(800) 903 -9368 MATCHING STATEMENT NP23741181
Page: 1 of 1
CITY OF CARMEL ITILITIES
1 C{VIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 211/2010 2/28/2010
SUMR4A! QF T RANSAC ?!0NS THIS REPORTING- PERIO C FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 33,366 $69.08 $6.20 $11.20 $0.00 $86.48
sw 33 366 s� $li9 08= y $6 20 $11 20 0 00a
m1. ,S. _ray., ,_,,.u5�«, »w.:.te.'' s >�s,�_.a. °'`�2, .�'���..�_a- u��'.,, .u.ro,'$s.$
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 891
1 a
Transaction Detat for ustomer °C NO 1315591 CITY OF CARMEL lTILITIES 21112010' 2128/2010 e k�
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE
y -a I �F 3 {rvr.� s•+r a k s{ 'a x N z ''S i
5 &7171 2007 FORD F25D 24��r x
y: s ma r e� "n'� a
02/15 07:43 885419 DRIVER 1 30861 27.8 UNL 32.058 2.06780 0.52126 $83.00
Miles: 891 27.8 32.058 $83.00
J .N "TP,
..,.3 i E..<.- 1 LiC
Aga
0210E 18:04 885419 DRIVER 1 65041 0.0 UNL 1.308 2.13300 0.52881 $3.48
M i les: 1.308 $3.48
SITE LEGEND
SITE# SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
VOUCHER 105022 WARRANT ALLOWED
69001 IN SUM OF
CRYSTAL FLASH
PETROLEUM CORPORATION
PO BOX 684
INDIANAPOLIS, IN 46206
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
>c I
PO INV ACCT AMOUNT Audit Trail Cade
022810 01- 7500 -08 $86.48
4
Voucher Total $86.48
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
69001
CRYSTAL FLASH Purchase Order No.
PETROLEUM CORPORATION Terms
PO BOX 684 Due Date 3!512010
INDIANAPOLIS, IN 46206
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount.
3/5/2010 022810 $86.48
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
Date Officer