186166 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $576.85
CARMEL, INDIANA 46032 0453 -00 7946296
PO BOX 6293 CHECK NUMBER: 186166
CAROL STREAM IL 60197
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 23028929 576.85 0453 -00- 794629 -6
FLEET S INVOICE/STATEMENT
INVOICE NUMBER: 23028929
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 31 05 -31 -2010 06 -25 -2010 576.85
PATE a ACTIVITY DESCRIPTION CHARGES /DEBITS, PAYMENTSICREDITS
,`05 142010: PAYMENT RECEIVED THANK YOU 530.02
0531 2010 RETAIL FUEL PURCHASES 562:85
45-31 2010 MONTHLY CARD CHG 14_00
ng REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH
E PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT
'F PORTION OF THE REMITTANCE STUB.
y
3
a
Y
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE /STATEMENT
PREVIOUS BALANCE I )PAYMENTS I (+)PURCHASES I (+)DEBITS I )CREDITS I (+)LATE EE =)NEW BALANCE
530.02 530.02 56245 1440 1 0.00 0.00 576.85
$10.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonlinexom
CALL CUSTOMER SERVICE TO PAY BY PHONE The Late Fee is determined by Which is an ANNUAL To the Balance subject to late
FEDERAL TAX ID: 841425616 applying a month) ri rate of PERCENTAGE RATE of fee for this Deriod which is
2.00 24.00% 0.00
SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS.,
TO ENSURE PROPER CREDIT, TEAR AT PERFORATION 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.wexoniine.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 addition 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:ltwww.e -fleet .corn
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: 05- 31-2010
ACCOUNT NO: 0453- 00-794629 -6
FLEE ERIC S DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SO
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 355000972 -35.82 0,00 FEDERAL E85 195,750 450.00 0.18300
-609 0.00, FEDERAL GASOLINE 33,250 8511 018300
FEDERAL TOTALS_..
22300013611
IN 356000972 0,00 5.98 STATE EXCISE GASOLINE 33.250 85.11 0.18000
-2709 0.00 STATE SALES E85 195.750 450,00 0.07000
-4.78 0.00 STATE SALES GASOLINE 33.250 85.11 0.07000
=11187 598`
w: r
114' ST..
ACCOUNT TOTALS 7378 rs98
IG WRIGHT EXPRESS CORPORATION 2010 PAGE t
FLEET RVICES STANDARD REPORT
INVOICE NUMBER: 23020929
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD I BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00- 794629 -6 600000 31 05 -31 -2010 06 -25- 2010 576.85
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO, UNIT TOTAL AMOUNT
0001 MH 001 078 05 -01 -2010 20:35 SMITH, KEITH 14,500 E85 15.570 2299 35.79 35.79
MH 001 078 05 -09 -2010 11:35 SMITH, KEITH 14,500 E85 9.260 2298 21.28 21.28
CARD SUBTOTALS 24.830 57.07
0002 MH 001 078 05 -01 -2010 01:08 HULETT, MARK 66,279 E86 12.400 2.298 2&50 28.50
MH 001 078 05 -06 -2010 14:49 HULETT, MARK 66,493 E85 12.830 2.299 29.50 29.50
MH 001 078 05 -13 -2010 15:41 HULETT, MARK 66,711 L85 13.440 2299 30.90 30.90
MH 001 078 05 -17 -2010 11:44 HULETT, MARK 66,874 E85 9.200 2299 21.15 21.15
MH 001 078 05 -20 -2010 15:51 HULETT, MARK 67,390 E85 13.920 2.300 3201 32.01
MH 001 078 05 -24 -2010 21:26 HULETT, MARK 67,711 E85 12.070 2299 2775 27.75
MH 001 078 05 -27 -2010 15:45 HULETT, MARK 67,830 E85 14.180 2299 3260 32.60
CARD SUBTOTALS 88.040 202.41
0003 61 001 065 05 -07 -2010 07:15 STEELE, JEFF 11,851 FUL 20.843 2359 49.17 49.17
GI 001 065 05 -16 -2010 15:02 STEELS, JEFF 12,087 UNL 3.801 2649 10.07 10.07
GI 001 065 05 -18 -2010 07:24 STEELS, JEFF 12,113 FUL 21.748 2299 50.0D 50.00
GI 001 065 05 -18 -2010 07:26 STEELE, JEFF 12,113 FUL 1.022 2299 235 2.35
GI 001 065 05 -23 -2010 12:02 STEELE, JEFF 92925 UNL 6.899 2609 18.00 18.00
CARD SUBTOTALS 54.313 129.59
0004 MH 001 074 05 -02 -2010 20:16 HABOUSH, DAVE 25.014 E85 20.540 2298 47.21 47.21
MH 001 074 05 -07 -2010 15:14 HABOUSH. DAVE 25,290 E85 23.580 2299 54.21 5421
MH 001 074 05 -10 -2010 16:48 HABOUSH, DAVE 25,510 E85 18.260 2299 41.98 41.98
MH 001 074 05 -14 -2010 21:45 HABOUSH. DAVE 25,718 E85 20.500 2299 47.12 47.12
MH 001 074 05- 26-2010 08:45 HABOUSH, DAVE 26,208 UNL 22.550 2529 57.04 57.04
CARD SUBTOTALS 105.430 24756
TOTAL PURCHASES 272.613 636.63
Y -T -D PURCHASES 1,271.223 3,00204
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No- Brand Street City State Zip
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 9 259.48
MH 001 074 MEIJER 1426 W CARMEL OR CARMEL IN 46032 5 247.56
GI 001 065 CRYSTAL FLAS 545 SOUTH RANGELINE CARMEL IN 46032 5 129.59
PRODUCTS: E85= ETHANL85 FUL =FUL OTH UNL UNLEADED
FLEET SERVICES
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CYCLE /04 SEQ /00683 FILE /WEX_HP-WEX_4 LOTI.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
0
P.O. J33ox 6293
Carol Stream, IL 60197
$576.85
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members
1120 23028929 42- 314.00 $576.85 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
JUN -8 2010
r r
r
s
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))
23028929 $576.85
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
Clerk- Treasurer