185108 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES
CARMEL, INDIANA 46032 0453 -00 7946296 CHECK AMOUNT: $530.02
PO BOX 6293
CHECK NUMBER: 185108
CAROL STREAM IL 60197
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 530.02 0453 -00- 794629 -6
FLEET SERVICES INVOICE/STATEMENT
INVOICE NUMBER: 22745743
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 6 000.00 30 04-30 -2010 05 -26 2010 530.02
DATE° ACTIVITY DESCRIPTION CHARGESIDEBITS PAYMENTSICHEDITS
Q416 2010 PAYMENT RECEIVED THANK YOU s -t!s< 481.17
U4 30 2Q1Q; RETAIL FUEL PURCHASES 51fi 02
<04302010? MONTHLY CARD CHG 1400
ti
dy'` k
REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH
r a' PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT
PORTION OF THE REMITTANCE STUB.
tM
NEW PAY -BY -PHONE OPTION!
4 CALL CUSTOMER SERVICE AND SELECT BILLING INQUIRIES.
SEE DETAILS ON BACK OR GO TO WWW.FSOLN EWS.COWPHON EPA)
ON
t
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO.BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVO;CEISTATEMENT
PREVIOUS BALANCE )PAYMENTS +)PURCHASES +)DEBITS (-)CREDITS +)LATE FE I =)NEW BALANCE
481.17 481.17 516.02 14.00 0.00 0.00 530.02
$16.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonlinexom
CALL CUSTOMER SERVICE TO PAY BY PHONE The fate Fee is determined by Which is an ANNUAL To the Balance subject to late
FEDERAL TAX ID: 84-1425616 applying a monthly riodic rate of PERCENTAGE RATE of fee for this Period which is
2.00 24.00 0.00
SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS.
TO ENSURE PROPER CREDIT TEAR AT PERFORATION AND BOTTOM PORTION VIITH YOl1R: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 payments.
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 a Business Charge Account Agreement with check to enter your bank account number and routing number,
the cardholder named 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: http://wwvv_e-fleat.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 -800 -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: 04-30 -2010
T SERVICES ACCOUNT NO: 0453 00-794629-6
DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SO
I CARMEL IN 46032-2584
Tax Summary
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
FEDERAL 356000972 -3374 000 FEDERAL EBS 184.310 427.24 018300
FEDERAL TOTALS r 4_ 42724
IN 356000972 -25.75 0.00 STATE SALES E85 184.310 427.24 0,0700C
IN "STATETOTALS,..o
ACCOUNT TOTALS -M49 moo
(cl WRIGHT EXPRESS CORPORATION 2010 PAGE 1
1.
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 22745743
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD SILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00- 794629 -6 6,000J 30 04 -30 -2010 05-26- 2010 530.02
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO, UNIT TOTAL AMOUNT
0001 MH 001 078 04- 142010 08:35 SMITH, KEITH 14,500 185 15 -370 2299 35.33 35.33
CARD SUBTOTALS 15.370 35.33
0002 MH 001 078 03 -30 -2010 18:57 HULETT, MARK 64,510 E86 12.930 2359 30-50 3050
MH 001 078 04 -03 -2010 1817 HULETT, MARK 64,735 E85 12.500 2360 29.50 29.50
MH 001 078 04 -11 -2010 13:00 HULETT, MARK 65,202 E85 13.210 2358 31-15 31.15
MH 001 074 04 -14 -2010 10:48 HULETT, MARK 65,400 E85 11.160 2298 25.65 25.65
MH 001 074 04 -19 -2010 13:41 HULETT. MARK 65,601 E85 12.240 2298 28.13 28.13
MH 001 078 04 -25 -2010 15:22 HULETT, MARK 65,897 E85 13.050 2299 30.00 30.00
MH 001 074 04-282010 10:013 HULETT, MARK 66;076 E85 10. 880 2.298 25.00 25.00
CARD SUBTOTALS 85.970 199.93
0003 GI 001 065 04 -14 -2010 08:13 STEELE, JEFF 11,236 FUL 21.195 2359 50.00 50.00
G1001 065 04 -21 -2010 15:55 STEELE, JEFF 11,434 FUL 20.462 2359 48.27 48 -27
GI 001 065 04 -29 -2010 07:18 STEELE, JEFF 11,695 FUL 21.195 2359 50.00 50.00
CARD SUBTOTALS 62.852 14827
0004 MH 001 074 04 -16 -2010 15:12 HABOUSH, DAVE 24,291 E85 22.010 2.299 50.61 50.61
MH 001 074 04 -22 -2010 21:41 HABOUSH, DAVE 24,509 E85 18.860 2299 43.34 43.34
MH 001 075 04 -28 -2010 12:15 HABOUSH, DAVE 24,774 EB5 21.750 2299 50.00 50.00
CARD SUBTOTALS 62.610 143.95
0007 -MH 001 154. 04 -11 -2010 15:56 SMITH, KEITH 8.','.996 E85 20.360 2359 48.03 48.03
CARD SUBTOTALS 20.380 48.03
TOTAL PURCHASES 247.162 57551
Y -T -D PURCHASES 1,155.940 2,73788
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street City State Zip
MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 5 172.73
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 5 156.48
GI 001 065 CRYSTAL FLAS 545 SOUTH RANGELINE CARMEL IN 46032 3 148.27
MH 001 075 MEIJER 11349 E WASHINGTON INDIANAPOLIS IN 46229 1 50.00
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 1 48.03
PRODUCTS: EB5= ETHANL85 FUL FUL OTH
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$530.02
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1120 22745743 42- 314.00 $530.02 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
MAY 10 2040
r r$
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))
22745743 $530.02
1 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