188693 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
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ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $733.40
CARMEL, INDIANA 46032 0453 -00. 7946296
PO BOX 6293 CHECK NUMBER: 188693
CAROL STREAM IL 60197
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 23540589 733.40 GASOLINE
FLEET SERVIC INVOICE/STATEMENT
INVOICE NUMBER: 23540589
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 07 -31 -2010 08 -26- 2010 733.40
DATE ACTIVITY DESCRIPTION CHA PAYMENTS /CREDITS
Ew
07 =26 2010", PAYMENT RECEIVED -THANK YOU 756.41
A702010' RETAIL FUEL PURCHASES 71940,
07 =30 2010 rz;' MONTHLY CARD CHG 1
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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PURCHASES. RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE /STATEMENT
PREVIOUS BALANCE )PAYMENTS +)PURCHASES +IDEBITS (-►CREDITS I +)LATE FE I =)NEW RALANCE
756.41 756.41 719.40 14.00 0.00 0.00 733.40
$10.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonline.com
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 applyinu a monthly riodic rate of PERCENTAGE RATE of fee for this period which is
2.0 24.00 0.00
SEE REVERSE SIDE. FOR ■Q4E.:!N' OR.MA TION;4ND- TEIIMS
TO ENSURE PROPER CREDIT TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYllENT
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: hftp: /Avww.e- fleet.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 -095 -0809, or ACH payment.
Mail to PO_ Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 07 -31 -2010
ACCOUNT NO: 0453 -00- 74629-6
FLEET S osk ERVICES DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SQ
CARMEL IN 46032-2584
Tax Summary
TAX JURISDICTION !D EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
FEDERAL 356000972 -65.24 0.00 FEDERAL E85 356.460 783.79 0.18300
-3.61 0.00 FEDERAL GASOLINE 19.710 54.57 0.18300
EDERALT,OTALS >'�9885
F a
2 �pp.b 976.1701 839,x.
I
IN 355000972 0.00 3.55 STATE EXCISE GASOLINE 19.710 54.57 0.16000
-47.01 0.00 STATE SALES E85 355.460 783.79 0.07000
-3.10 0,00 STATE SALES GASOLINE 19.710 54.57 0.07000
'IN, S7ATE.TOTALS 3Q1i
ACCOUNT TOTALS -418.96 356
I
(6 WRIGHT EXPRESS CORPORATION 2010 PAGE i
FLEET RVI C STANDARD REPORT
INVOICE NUMBER: 23540589
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT I DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00- 794629 -6 6000.00 31 07- 31- 2010 08 -26 -2010 73340
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
•0001 MH 001 078 07 -01 -2010 20:50 SMITH, KEITH 14,500 E85 10.210 2199 22.45 22.45
MH 001 078 07 -11 -2010 20:43 SMITH, KEITH 14,500 E85 19.020 2198 41.81 41.81
MH 001 078 07 -19 -2010 15:06 SMITH, KEITH 14,500 E85 23.560 2199 51.82 51.82
CARD SUBTOTALS 52790 116.08
0002 MH 001 078 06 -29 -2010 15:37 HULEIT, MARK 70.096 E85 12.600 2.198 27.70 27.70
MH 001 078 07 -05 -2010 23:46 HULEIT, MARK 70,337 E85 14.510 2198 31.90 31.90
MH 001 078 07 -10 -2010 13:30 HULETT. MARK 70,523 E85 11.830 2199 26.01 26.01
MH 001 078 07- 122010 15:04 HULEIT, MARK 70,710 E85 11.120 2199 24.45 24.45
MH 001 078 07 -15 -2010 15:51 HULEIT, MARK 70.921 1785 13.940 2.199 30.65 30.66
MH 001 078 07 -19 -2010 15:51 HULEIT, MARK 71,107 L85 11 -870 2199 26.10 26.10
MH 001 078 07 -28 -2010 23:53 HULEIT, MARK 71,723 E85 11.460 2199 25.20 25.20
CARD SUBTOTALS 87.330 19201
0003 MH 001 074 07 -02 -2010 17:35 STEELE, JEFF 13,949 UNL 19.710 2769 54.57 54.57
MH 001 154 07 -07 -2010 11:56 STEELE, JEFF 14,237 E85 20.360 24199 44 -77 44.77
MH 001 095 07 -14 -2010 18:16 STEELE, JEFF 14,502 E85 23.360 2199 51.36 51.36
MH 001 074 07 -22 -2010 14 :46 STEELE, JEFF 14,751 L85 24.080 2.199 5294 52.94
MH 001 095 07 -26 -2010 14:12 STEELE, JEFF 15,003 E85 21.120 2.199 4644 46.44
CARD SUBTOTALS 108.630 250.08
0004 MH 001 074 06 -29 -2010 18:44 HABOUSH, DAVE 27,505 E85 23.970 2.199 5271 52.71
MH 001 074 07 -05 -2010 09:21 HABOUSH, DAVE 27,756 185 21.270 2199 46.77 46.77
MH 001 074 07 -13 -2010 22 :10 HABOUSH, DAVE 27,945 E85 21.620 2,199 47.54 47.54
MH 001 074 07 -19 -2010 07 :43 HABOUSH, DAVE 28,208 E85 21.410 2199 4708 47.08
MH 001 074 07 -24 -2010 17:31 HABOUSH, DAVE 28,471 E85 27100 2.199 59.60 59.60
MH 001 074 07 -27 -2010 08:09 HABOUSH, DAVE 28,611 E85 12.050 2198 2643 26.49
CARD SUBTOTALS 127.420 280.19
TOTAL PURCHASES 376.170 838.36
Y -T -D PURCHASES 1,967.963 4,554.96
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 8 387.70
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 10 30B.09
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 2 97.80
MH 001 154 MEIJER 1.7000 MERGANTILEMD NOBLESVILLE- IN 46060 1 44.77
PRODUCTS: E85 =ETHAN L85 UNL= UNLEADED
FLEET SERVICES
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CYCLE /04 SEQ /00457 FILE /YEX HP -YEX 4_LOM EXP
4
ATTN DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SQ
CARMEL IN 46032 -2584
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$733.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1 120 23540589 42- 314.00 $733.40 f 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
AUG 16 2096
e
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
fnvoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
23540589 $733.40
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