190159 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $1,396.34
0 CARMEL INDIANA 46032
PO BOX 183019
COLUMBUS OH 43218 -3019 CHECK NUMBER: 190159
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065127193009 850.07 GASOLINE
1110 4231400 065129116009 546.27 GASOLINE
www.shellfle accountonli
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO
065 =129 116 15 065129116009 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09- 05.20'10 09 -30 -2010 30 TELEPHONE: 1. 8003773150
FAX: 1 -515- 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
586.58 I .00 819.53 859.84 CR .00 546.27
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 09 -30 -2010
CARD A TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DAl'E TIME ID CD CD TAX AMOUNT
09 -03 PAYMENT THANK YOU 819.53 CR
0003 09 -04 21:32 015967.1 5690 NJ4TIr1NAL RD EAST R!0WAC- In IN 670'. 8 UNL 1.23 18.10
I
6.701 GAL UNLEADED $18.10
TOTAL CARD 0003 6.701 1.23 18.10
0006 08 -19 16:45 0403808 12'30 S RANGELINE RD CARMEL IN 20.076 8 UNL 3.67 52.1B✓
18.06 GAL UNLEADED 552.18
0006 08 -28 13:37 0124081 9599 N MERIDIAN ST INDIANAPOLIS IN 15.163 B UNL 2.77 40.79
15.163 GAL UNLEADED $40.79
0006 08-31 12:58 0492215 1230 S RANGELINE RD CARMEL IN 21.633 8 UNL 3.96 58.39 t!
21.633 GAL UNLEADED $58.39
TOTAL CARD 0006 56.872 10.40 151.36
0007 08 -17 14:14 0387688 1230 S RANGELINE RD CARMEL IN 15.983 B UNL 2.92 43.14✓
15.983 GAL UNLEADED $43.14
0007 08 -21 0534 0415505 1230 S RANGELINE RD CARMEL IN 11.111 8 UNL 2.03 30.00
11.111 GAL UNLEADED $30.00
0007 08 -30 12:03 1403161 1 -69 AND SR 22 GAS CITY IN 10.883 8 UNL 1.99 29.06
10.883 GAL UNLEADED S29.06
0007 09 -02 12:17 1407576 1.65 AND SR 22 GAS CITY IN 13.761 8 UNL 2.52 36.33'
13.761 GAL UNLEADED $36.33
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
SCHEDULE OF LATE FEE
PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE
(MONTHLY) PERCE14TAGE RATE SEE REVERSE SIDE
0.000% 0.00% 0.00 .00
6057 0018, GUG 1 7 2 100905 9366 8015 SH26 5161
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0005161 ,'aye 1 of 2 FLET2GUG
Information About Your Account 1
Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7
days 'a week.'
Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we
do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as
of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a
payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by
regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by
express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement.
Proper Form. For a payment sent by mail or courier to be in proper form, you must:
Enclose a valid check or money order. No cash or foreign currency please.
Include your name and account number on the front of your check or money order.
If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If
we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive
the check. Also, the check will be destroyed.
Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged
$14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time,
your payment will be credited as of the next day. We may process your payment electronically after we verify your identity.
Note: Your account is owned and serviced by Citibank (South Dakota), N.A.
PLOCOMM Rev 06/08
www.shellfleetca d. accountonfine.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 T29 116 15 065129116009 P.O. BO CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -05 -2010 09 -30 -2010 30 TELEPHONE: 1. 800477 -5150
FAX: 1- 515- 226 -4045
CARD TRANS CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0007 51.738 9.46 138.53
0008 08 -29 11'54 0477034 1230 S RANGELINE RD CARMEL IN 20.122 8 UNL 3.68 54.31
20.122 GAL UNLEADED S54.31
0008 06 -30 11'13 0483883 1230 S RANGELINE RD CARMEL IN 4.180 8 UNL 0.76 11.30
4.180 GAL UNLEADED $11.30
TOTAL CARD 0008 24.302 4.44 65.61
0009 08 -25 1140 0454397 8924 E 116TH ST FISHERS IN 10.160 8 UNL 1.86 26.02
10.160 GAL UNLEADED S26.02
TOTAL CARD 0009 10.160 1.86 26.02
0010 08 -17 19:35 0389965 1230 S RANGELINE RD CARMEL IN 18.981 8 UNL 3.47 51.25✓
18.981 GAL UNLEADED $51.25
0010 08 -19 11.45 0448746 1230 WEST SR 32 LEBANON IN 17.995 i 8 UNL 3.29 46.05 r/
17.995 GAL UNLEADED $46.05
0010 08 -28 10:24 0733725 1821 E 151ST ST CARMEL IN 11.071 8 UNL 2.03 29.66 V
11.071 GAL UNLEADED S29.66
0010 08 -30 12:13 0758847 1821 E 151 ST ST CARMEL IN 22.564 8 UNL 4.13 60.00
22.564 GAL UNLEADED $60.00
TOTAL CARD 0010 70.611 12.92 186.96
GRAND TOTAL 220.384 40.31 586.58
FEDERAL EXCISE TAX
220.3 GALLONS GASOLINE 40.31 CR
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
6057 0018 GUG 1 7 2 100905 9366 8015 SH26 5161
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0005161 Page 2 of 2 FLET2GUG
www. shelitleetcard .accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 -127 -193 23 065127193009 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09- 05-2010 09-30 -2010 30 TELEPHONE: 1- 800377 -5150
FAX: 1.515- 2264045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
913.37 .00 668.49 731.79 CR .00 850.07
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 09 -30 -2010
CARD TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE I TIME ID CD CD TAX AMOUNT
09 -03 PAYMENT THANK YOU 668.49 CR
0002 oa -14 17:54 0564995 1521 E 151ST ST CARMEL iN 13. i 71 0 UNL 2.41 34.10
13.171 GAL UNLEADED $34.10
0002 08 -18 18:14 0629196 1821 E 151 ST ST CARMEL IN 14.291 8 UNL 2.62 36.00
14.291 GAL UNLEADED 536.00
0002 08 -26 11:22 0685156 15150 W COMMERCE RD. DALE VILLE IN 13.721 8 UNL 2.51 35.80
13.721 GAL UNLEADED $35.80
0002 08 -31 17:14 0772947 1821 E 151 ST ST CARMEL IN 15.214 8 UNL 2.78 40.00
15.214 GAL UNLEADED $40.00
TOTAL CARD 0002 56.397 10.32 145.90 xw
0004 08 -23 1234 0430637 1230 S RANGELINE RD CARMEL IN 3.051 8 UNL 0.56 8.25
3.051 GAL UNLEADED $8.25
TOTAL CARD 0004 3.051 0.56 8.25
0005 08.07 15:56 0355172 1230 WEST SR 32 LEBANON IN 22.880 8 UNL 4.19 62.92
22.880 GAL UNLEADED 562.92
0005 06 -14 11:06 0531228 9510 E 126TH ST FISHERS IN 21.785 8 UNL 3.99 56.62
21.785 GAL UNLEADED $56.62
0005 08 -20 17:18 0476069 9611 ALLISONVILLE RD INDIANAPOLIS IN 22.101 8 UNL 4.04 59.43
22.101 GAL UNLEADED $59.43
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
SCHEDULE OF LATE FEE
PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE
(MONTHLY) PERCENTAGE RATE SEE REVERSE SIDE
0.000% 0.00% 0.00 .00
6057 0018 GUG 1 7 2 100905 9366 8015 SH26 7802
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007802 Page i ot3 FLET2GUG
i
www. shelifleetcard .accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
066- 127 -193 23 0651 27193009 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -05 -2010 09-30-2010 30 TELEPHONE: 1. 8003773150
FAX: 1 -515- 226 -4045
CARD TRANSACTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0005 66.766 12.22 178.97 x•
0006 08 -11 16:23 0346536 1230 S RANGELINE RD CARMEL IN 15.010 8 UNL 2.75 42.03
15.010 CAL UNLEADED $42.03
TOTAL CARD 0006 15.010 2.75 42.03 x•
0007 08 -16 20:02 0383141 1230 S RANGELINE RD CARMEL IN 12.592 8 UNL 2.30 34.00✓
12.592 GAL UNLEADED 534.00
TOTAL CARD 0007 12.592 2.30 34.00 xx
0016 08 -11 17:51 0318766 7788 E 96TH ST FISHERS IN 16.140 8 UNL 2.95 43.58
0016 08 -22 11.45 0399105 7788 96TH GAL
T FISHERS DEN 543.58 13.964 8 UNL 2.56 35.75✓
13.964 GAL UNLEADED $35.75
0016 08 -29 i ,47 0712776 9510 E 1262 H Sr ESHER:: IN '.5.334 8 UNL 2.80 41.04%/
15.324 GAL UNLEADED $41.04
0016 09 -02 10:37 0506618 1230 S RANGELINE RD CARMEL IN 16.010 8 UNL 2.93 44.19 V
16.010 GAL UNLEADED $44.19
TOTAL CARD 2016 61.438 11.24 164.56 xx
0022 08 -19 22:15 0416420 8924 E 116TH ST FISHERS IN 17.720 8 UNL 324 43.77
17.720 GAL UNLEADED $43.77
TOTAL CARD 0022 17.720 3.24 43.77
0024 08 -23 17:29 0269977 1110 BELL ROAD ANTIOCH TN 13.440 8 UNL 2.46 33.60
13.440 GAL UNLEADED $33.60
0024 08 -24 1146 0350587 2678 WINDY HILL RD SE MARIETTA GA 11.441 8 UNL 2.09 29.29
11.441 GAL UNLEADED $29.29
0024 08 -24 16:10 0292748 329 MAMMOT11 CAVE PARKWAY PARK CITY KY 12.162 8 UNL 2.23 30.77
12.162 GAL UNLEADED $30.77
TOTAL CARD 0024 37.043 6.78 93.66 xx
0028 08 -06 14:10 0484923 1821 E 151ST ST CARMEL IN 16.583 8 UNL 3.03 45.44
16 -583 GAL UNLEADED 545.44
0028 08 -21 09:42 0658393 1821 E 151 ST ST CARMEL IN 16.412 8 UNL 3.00 44.15
16.412 GAL UNLEADED 544.15
0028 08 -24 19:03 0613448 721 E81STAVE MERRILLVILLE IN 11.312 8 UNL 2.07 29.39
11.312 GAL UNLEADED $29.39
0028 08 -28 17:12 0127183 9599 N MERIDIAN S r INDIANAPOLIS IN 16.513 8 UNL 3.02 44.42
16.513 GAL UNLEADED $44.42
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
6057 0018 GUG 1 7 2 100905 9366 8015 SH26 7802
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PL EASE K THIS PORTION FOR YOUR RECORDS
0007802 Page 2 of 3 FLET2GUG
www. shellfleetcard .accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 -'127 -193 23 065127193009 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -05 -2010 09 -30 -2010 30 TELEPHONE: 1- 800377 -5150
FAX: 1 -515- 226 -4045
CARD CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
0028 08 -31 15:54 0430173 633 W MAIN SR 32 WESTFIELD IN 15.114 8 UNL 2.77 38.83
15.114 GAL UNLEADED 538.83
TOTAL CARD 0028 75.934 13.89 202.23
GRAND TOTAL 345.951 63.30 913.37
FEDERAL EXCISE TAX
345.9 GALLONS GASOLINE 63.30 CR
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
6057 0018 GUG 1 7 2 100905 9366 8015 SH26 7802
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007802 Page 3 of 3 FLET2GUG
Prescribed by State hoard of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Shell Fleet Plus Purchase Order No.
Processing Center Terms
P.O. Box 183019
Columbus, OH 43218 -3019 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/5/10 65129116009 monthly a ent 546.27
9/5/10/ 56127193009 monthly payment 850.07
Total 1,396.34
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
®JOUCHER NO. WARRANT NO.
ALLOWED 20
S hell Fleet Plus IN SUM OF
Processing Center
P .O. Box 183019
Columbus, OH 43218 --3019
1,396.34
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po #or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 065127193009 314 850.07 bill(s) is (are) true and correct and that the
1110 065129116009 314 546.27 materials or services itemized thereon for
which charge is made were ordered and
received except
September 21 20 10
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund