191098 10/27/2010 f CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
t ONE CIVIC SQUARE SHELL CREDIT CARD CENTER
CARMEL, INDIANA 46032 PO BOX 183019 CHECK AMOUNT: $1,986.51
COLUMBUS OH 43218 -3019
CHECK NUMBER: 191098
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193010 1,193.33 GASOLINE
1110 4231400 65129116010 793.18 GASOLINE
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065- 127 -193 38 065127193010 SHELL CARD CENTER
P.O. BOX 669081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10 -06 -2010 10.31 -2010 31 TELEPHONE: 1- 8003773150
FAX: 1315- 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
1,298.96 .00 850.07 955.70 OR .00 1,193.33
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 10 -31 -2010
CARD TRANS TRANSACTION LOCATION /DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
10 -01 PAYMENT THANK YOU 850.07 CR
10 -06 DISCOUNT 18.17 CR
0002 09 -08 0556 0854307 1821 E 151ST ST CARMEL IN 13.432 8 UNL 2.46 36.00
13.432 GAL UNLEADED $36.00
0002 09 -18 1428 0664797 320 E SOUTHVIEW DR MARTINSVILLE IN 13.883 8 UNL 2.54 36.50
13.883 GAL UNLEADED $36.50
0002 09 -22 21:10 0024604 1821 E 151ST ST CARMEL IN 13.684 8 UNL 2.50 36.25
13.684 GAL UNLEADED $36.25
0002 09 -24 09:16 0722033 2166 E HADLEY PLAINFIELD IN 12.174 8 UNL 2.23 30.18
12.174 GAL UNLEADED $30.18
0002 09 -25 20:08 0737981 320 E SOUTHVIEW DR MARTINSVILLE IN 14.562 8 UNL 2.66 36.10
14.562 GAL UNLEADED $36.10
0002 10 -02 14:05 0131482 1821 E 151 ST ST CARMEL IN 14.215 8 UNL 2.60 37.50
14.215 GAL UNLEADED $37.50
TOTAL CARD 0002 81.950 14.99 212.53
0004 09 -06 08:40 0534479 1230 S RANGELINE RD CARMEL IN 2.350 8 UNL 0.43 6.50
2.350 GAL UNLEADED $6.50
0004 10 -04 2101 0100552 9510 E 126TH ST FISHERS IN 15.902 8 UNL 2.91 44.51
15.902 GAL UNLEADED $44.51
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 0017 GUG 1 7 2 101006 9366 8015 SH26 313
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0000313 Pape 2 of 6 FLET2GUG
Information About Your Account.
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
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INOUIRIES TO:
SHELL CARD CENTER
065- 127 -193 38 065127193010 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50360 -9081
10 -06 -2010 10-31 -2010 31 TELEPHONE: 1- 800-377-5150
FAX: 1-515- 226 -4045
CARD TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0004 18.252 3.34 51.01 *t
0006 09 -13 17:26 0588194 1230 S RANGELINE RD CARMEL IN 15.391 8 UNL 2.82 44.02
15.391 GAL UNLEADED $44.02
TOTAL CARD 0006 15.391 2.82 44.02
0007 09 -07 1141 0541045 1230 S RANGELINE RD CARMEL IN 16.491 8 UNL 3.02 45.5
16.491 GAL UNLEADED $45.50
0007 09 -10 18:30 0947465 6917 NORTH OLD 27 FREMONT IN 20.083 8 UNL 3.68 53.00
20.083 GAL UNLEADED $53.00
0007 09 -11 11:37 0571810 1230 S RANGELINE RD CARMEL IN 13.990 8 UNL 2.56 40.00
13.990 GAL UNLEADED $40.00
0007 09 -21 07:46 0702571 2166 E HADLEY PLAINFIELD IN 13.132 8 UNL 2.40 34.007/
13.132 GAL UNLEADED $34.00
0007 10 -03 19:38 0744748 1230 S RANGELINE RD CARMEL IN 13.611 8 UNL 2.49 36.60
13.611 GAL UNLEADED $36.60
TOTAL CARD 0007 77.307 14.15 209.10
0011 09 -29 09:43 0613331 633 W MAIN SR 32 WESTFIELD IN 7.411 8 UNL 1.36 20.01
7.411 GAL UNLEADED $20.01
0011 10 -03 23:25 0880492 15150 W COMMERCE RD DALEVILLE IN 11.673 8 UNL 2.14 30.00
11.673 GAL UNLEADED $30.00
TOTAL CARD 0011 19.084 3.50 50.01 j
0016 09.12 12:06 0865741 9510 E 126TH ST FISHERS IN 15.652 8 UNL 2.86 44.75/
15.652 GAL UNLEADED $44.75 J
0016 09 -17 18:45 0625152 8924 E 116TH ST FISHERS IN 16.010 8 UNL 2.93 44.67
16.010 GAL UNLEADED $44.67
0016 10 -04 1700 0747717 8924 E 116TH ST FISHERS IN 15.171 8 UNL 2.78 42.48
15.171 GAL UNLEADED $42.48
TOTAL CARD 0016 46.833 8.57 131.90
0018 09 -13 10:58 0434256 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 17.320 8 UNL 3.17 49.00
17.320 GAL UNLEADED $49.00
0018 09 -13 15:18 0435941 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 10.720 8 UNL 1.96 30.34
10.720 GAL UNLEADED $30.34
0018 09 -13 1521 0435966 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 11.910 8 UNL 2.18 33.72
11.910 GAL UNLEADED $33.72
0016 09 -15 1506 0452227 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 13.432 8 UNL 2.46 38.00
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
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NOTICE: SEE REVERS SID FOR IM INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0000313 Page 3 of 6 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
I SHELL CARD CENTER
065- 127 -193 38 065127193010 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10 -06 -2010 10 -31 -2010 31 TELEPHONE: 1- 8003773150
FAX: 1- 515.2264045
CARD TRAN36CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
13.432 GAL UNLEADED $38.00
0018 09 -15 15:07 0452235 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 8.622 8 UNL 1.58 24.41'
8.622 GAL UNLEADED $24.41
0018 09 -15 1507 0452250 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 7.200 8 UNL 1.32 20.37
7.200 GAL UNLEADED 520.37
0018 09 -15 15:09 0452268 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 12.781 8 UNL 2.34 36.16
12.781 GAL UNLEADED $36.16
0018 09 -17 11:41 0468504 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 8.392 8 UNL 1.54 23.76
8.392 GAL UNLEADED $23.76
0018 09 -17 1142 0468496 1206 E EADS PKWY (US 50) LAWRENCEBURG IN 7.170 8 UNL 1.31 20.30
7.170 GAL UNLEADED $20.30
TOTAL CARD 0018 97.547 17.86 276.06
0021 09 -09 1138 0338574 1 -65 8 SR 252/I EDINBURGH IN 18.164 8 UNL 3.32 49.39
18.164 GAL UNLEADED $49.39
0021 09 -14 08:29 0519314 633 W MAIN SR 32 WESTFIELD IN 4.290 8 UNL 0.79 12.10
4.290 GAL UNLEADED S1Z.10
0021 09 -22 12:46 0710194 2166 E HADLEY PLAINFIELD IN 12.582 8 UNL 2.30 32.21
12.582 GAL UNLEADED $32.21
TOTAL CARD 0021 35.036 6.41 93.70
0022 09 -23 21:24 0666974 8924 E 116TH ST FISHERS IN 17.243 8 UNL 3.16 45.16
17.243 GAL UNLEADED $45.16
0022 09 -29 09:03 0702175 1230 S RANGELINE RD CARMEL IN 4.850 8 UNL 0.89 13.10
4.850 GAL UNLEADED $13.10
0022 09 -29 09:03 0702159 1230 S RANGELINE RD CARMEL IN 15.361 8 UNL 2.81 41.46
15.361 GAL UNLEADED $41.46
0022 10 -02 11:26 0129437 1821 E 151 ST ST CARMEL IN 17.775 8 UNL 3.25 46.91
17.775 GAL UNLEADED $46.91
TOTAL CARD 0022 55.229 10.11 146.63
0028 09 -11 07:36 0500959 633 W MAIN SR 32 WESTFIELD IN 7.530 8 UNL 1.38 19.36
7.530 GAL UNLEADED $19.36
0028 09 -23 19:04 0034744 1821 E 151 ST ST CARMEL IN 15.971 8 UNL 2.92 41.83
15.971 GAL UNLEADED $41.83
TOTAL CARD 0028 23.501 4.30 61.19
0029 09 -14 13:59 0490961 1812 N CUNNINGHAM AVE URBANA IL 7.711 8 UNL 1.41 22.61
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 0017 GUS 1 7 2 101006 9366 8015 SH26 313
NOTIC SE RE V E RS E S IDE F IMPO RTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0000313 Page 4 of 6 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
06 5- 127 -193 38 065127193010 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50360 -9081
10 -06 -2010 10 -31 -2010 31 TELEPHONE: 1- 8003776150
FAX: 1315- 226 -4045
CARD TRANS kCTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
7.711 GAL UNLEADED $22.81
TOTAL CARD 0029 7.711 1.41 22.81
GRAND TOTAL 477.841 87.46 1,298.96
FEDERAL EXCISE TAX
477.8 GALLONS GASOLINE 87.46 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 0017 GUG l 7 2 101006 9366 8015 SH26 313
N SEE REVERSE SIDE FO R IMPORTANT I PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0000313 Page 5 of 6 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 -127 -193 38 065127193010 P.O. BOX CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10.06 -10 10 -31 -10 31 TELEPHONE: 1. 800377-5150
FAX: 1-515- 226 -0045
DISCOUNT LOCATION ADDRESS DISC TIER PRODUCT DISC DISC UNITS DOLLAR DISC
TYPE TYPE BASIS DESCR CENTS PURCH SALES AMOUNT
PROGRAM TAX40002 0 ALL FUELS 1,298.96 18.17
SUB -TOTAL 18.17
TOTAL 18.17
TOTAL DISCOUNT 18.17
DISC TYPE: Percent of Dollar Sales; C Cents per Unit TIER BASIS: U Units Purchased; D Dollar Sales
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0000313 Page 6 of 6 FLET2GUG
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ACCOI;NT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065- 129 -116 22 065129116010 SHELL CARD CENTER
P.O. BOX 669081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10 -06 -2010 10- 31.2010 31 TELEPHONE: 1- 800.377-6150
FAX: 1- 515 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
850.32 .00 546.27 603.41 CR 00 793.18
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 10 -31 -2010
CARD TRANS MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID TRANSACTION LOCATION /DESCRIPTION QUANTITY CO CD TAX AMOUNT
10 -01 PAYMENT THANK YOU 546.27 CR
0003 09-05 14:42 0811851 281 S MAPLE ORLEANS IN 11.440 8 UNL 2.09 30-891/
11.440 GAL UNLEADED S30.a9
0003 09 -19 16:53 0553925 633 W MAIN SR 32 WESTFIELD IN 18236 8 UNL 3.34 49.22 V
18.236 GAL UNLEADED $49.22
0003 10 -04 08:44 0152652 1821 E 151 ST ST CARMEL IN 11.542 8 UNL 2.11 30.00
11.542 GAL UNLEADED $30.00
0003 10 -05 21:02 0658013 633 W MAIN SR 32 WESTFIELD IN 14.463 8 UNL 2.65 40.05
14.463 GAL UNLEADED $40.05
TOTAL CARD 0003 55.681 10.19 150.16
0005 09 -07 11:53 0541110 1230 S RANGELINE RD CARMEL IN 12.322 8 UNL 2.25 34.01
12.322 GAL UNLEADED 534.01
0005 09 -08 1504 0873182 12311 S ARCHER LEMONT IL 12.763 8 UNL 2.34 37.00
12.763 GAL UNLEADED $37.00
TOTAL CARD 0005 25.085 4.59 71.01
0006 09 -23 2202 0008300 808 W MAIN ST CARMEL IN 16.654 8 UNL 3.05 44.9
16.654 GAL UNLEADED S44.95
0006 10 -02 68:20 0029108 808 W MAIN ST CARMEL IN 12.262 8 UNL 2.24 33.11
12.262 GAL UNLEADED $33.11
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 0017 GUG 1 7 2 101006 9366 8015 SH26 7753
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007753 Page 1 of 3 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 129 -116 22 065129116010 SHELL CARD CENTER
P.o. Box sasost
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10 -06 -2010 10- 31-2010 31 TELEPHONE: 1- 800-377-5150
FAX: 1- 515.226 -4045
CARD TRANS TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0006 28.916 5.29 78.06
0007 09 -16 17:46 0611301 1230 S RANGELINE RD CARMEL IN 16.411 8 UNL 3.00 46.92 i
16.411 GAL UNLEADED $46.92
0007 09 -20 12:27 0638296 1230 S RANGELINE RD CARMEL IN 18.224 8 UNL 3.33 50.10
18.224 GAL UNLEADED $50.10
0007 09 -20 2225 0622191 11601 ALLISONVILLE RD FISHERS IN 14.492 8 UNL 2.65 39.5
14.492 GAL UNLEADED 539.55
0007 09 -23 15:01 0694703 1230 WEST SR 32 LEBANON IN 1 a UNL 2.95 41.88
16.113 GAL UNLEADED $41.88
0007 09 -29 09:24 0702357 1230 S RANGELINE RD CARMEL IN 14.964 8 UNL 2.74 40.39
14.964 GAL UNLEADED $40.39
TOTAL CARD 0007 80.204 14.67 218.84
0008 09-20 12:23 0638254 1230 S RANGELINE RD CARMEL IN 14..61 8 UNL 2.59 38.93
14.161 GAL UNLEADED $38.93
TOTAL CARD 0008 14.161 2.59 38.93
0009 09 -05 14:17 0535153 8924 E 116TH ST FISHERS IN 7.351 a UNL 1.35 20.07,-
7.351 GAL UNLEADED $20.07
0009 09 -19 16:38 0637330 8924 E 116TH ST FISHERS IN 9.061 8 UNL 1.66 25.00, 1
9.061 GAL UNLEADED $25.00
0009 09 -21 15:30 0647776 1230 S RANGELINE RD CARMEL IN 10.260 8 UNL 1.88 28.00
10.260 GAL UNLEADED $28.00
0009 10 -01 09:36 0720219 1230 S RANGELINE RD CARMEL IN 14.014 8 UNL 2.56 37.91
14.014 GAL UNLEADED $37.81
TOTAL CARD 0009 40.686 7.45 110.88
0010 09 -15 09:44 0578732 11601 ALLISONVILLE RD FISHERS IN 12.031 8 UNL 2.20 34.05
12.031 GAL UNLEADED $34.05 J
0010 09 -18 14:22 0626556 1230 S RANGELINE RD CARMEL IN 5.990 8 UNL 1.10 16.60
5.990 GAL UNLEADED $16.60
0010 09 -23 09:40 0027318 1821 E 151 ST ST CARMEL IN 26.013 8 UNL 4.76 68.39
26.013 GAL UNLEADED $68.39
0010 10 -01 0928 0720128 1230 S RANGELINE RD CARMEL IN 23.490 8 UNL 4.30 63.40
23.490 GAL UNLEADED $63.40
TOTAL CARD 0010 67.524 12.36 182.44
GRAND TOTAL 312.257 57.14 850.32
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 0017 GUG 1 7 2 101006 9366 8015 SH26 7753
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0007753 Page 2 of 3 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INOUIRIES TO:
065 129 -116 22 065129116010 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
10 -06 -2010 10 -31 -2010 31 TELEPHONE: 1.800377 -5150
FAX: 1 -515- 2264045
CARD TRANS kCTION TRANS MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID TRANSACTION LOCATION /DESCRIPTION QUANTITY CD CD TAX AMOUNT
FEDERAL EXCISE TAX
312.2 GALLONS GASOLINE 57.14 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 0017 GUG 1 7 2 101006 9366 8015 SH26 7753
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007753 Page 3 of 3 FLET2GUG
Prescobed 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
Shell Fleet Plus Purchase Order No.
Processing Center
P.O. Box 183019 Terms
Columbus, OH 43218 --3019
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/6/10 651.27193010 monthly payment 1,193.33
10/6/10 65129116010 monthly payment 793.18
Total 1,986.51
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
Processing Center IN SUM OF
P.O. Box 183019
Columbus, OH 43218 -3019
1,986.51
ON ACCOUNT OF APPROPRIATION FOR
police genera lfund
Board Members
Poq or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
1110 651291.16010 314 793.18 bill(s) is (are) true and correct and that the
1.110 65127193010 314 1,193.33 materials or services itemized thereon for
which charge is made were ordered and
received except
Oc ob' r 18 20 10
Signature
Assistant Chief of Pol
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund