191893 11/17/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
0 ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $1,561.81
CARMEL, INDIANA 46032 0453 -00- 7946296
PO BOX 6293 CHECK NUMBER: 191893
CAROL STREAM IL 60197
CHECK DATE: 11/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 24308881 1,561.81 0453 -00- 794629 -6
FLEET SERVICES INVOICE /STATEMENT
INVOICE NUMBER: 24308881
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 10 31 2010 11 26 2010 2403.16
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
10 -04 -2010 PAYMENT RECEIVED THANK YOU 723.55
10 -29 -2010. RETAIL FUEL PURCHASES 1,476.23
10- 29- 2010 MONTHLY CARD CHG 14.00
BALANCE INCLUDES PAST DUE AMOUNT
IF PAYMENT HAS BEEN MADE, PLEASE DISREGARD THIS
NOTICE. PAST DUE ACCOUNTS ARE SUBJECT TO SERVICE
INTERRUPTION
k
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIG O BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE /STATEMENT
PREVIOUS BALANCE PAYMENTS )PURCHASES )DEBITS CREDITS j LATE FEE )NEW BALANCE
1 592.44 723.55 11,476.23 14.00 0.00 I 44.04 2
k
$10.00 MINIMUM LATE FEE
PAY ONLINE AT: www.wexon line. corn
CALL CUSTOMER SERVICE TO PAY BY PHONE The Late Fee is determined b which is an ANNUAL To the Bala nee subject to late
FEDERAL TAX ID: 84- 1425616 applying a monthly periodic rate of PERCENTAGE RATE of fee for this period which is
2.00 24.00 2,201.81
SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS.
TO ENSURE PROPER CREDIT, TEAR AT PERFORATION AND INCLUDE 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.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 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:1lwww.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- 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: 10 -31 -2010
FL E ET S E y ICES E S ACCOUNT NO: 0453 -00- 794629 -6
r v V 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 356000972 118.51 0.00 FEDERAL E85 647.700 1,634.72 0.18300
-4.34 0.00 FEDERAL GASOLINE 23.710 67.42 0.18300
FEDERAL TOTALS 122.85 0.00 671.410 1,702.14
IN 356000972 0.00 4.26 STATE EXCISE GASOLINE 23.710 67.42 0.18000
-99.21 0.00 STATE SALES E85 647.700 1,634.72 0.07000
-3.85 0.00 STATE SALES GASOLINE 23.710 67.42 0.07000
IN STATE TOTALS 103.06 4.26
ACCOUNT TOTALS 225.91 4.26
I
I
(c) WRIGHT EXPRESS CORPORATION 2010 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 24308881
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453- 00-794629 -6 6 1 000 -00 31 10 -31 -2010 11 -26 -2010 2,403.16
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 078 10 -03 -2010 16:51 SMITH, KEITH 14,500 E85 24,470 2.499 61.14 61.14
MH 001 074 10- 06.2010 11:59 SMITH, KEITH 14,500 E85 17.060 2.499 42.64 42.64
MH 001 074 10 -08 -2010 13:35 SMITH, KEITH 14,500 E85 18.480 2.499 46.18 46.18
MH 001 074 10 -14 -2010 08:47 SMITH, KEITH 14,500 E85 20.770 2.499 51.90 51.90
MH 001 078 10 -17 -2010 11:26 SMITH, KEITH 14,500 E85 17.180 2.559 43.96 43.96
MH 001 074 10 -19 -2010 16:39 SMITH, KEITH 14,500 UNL 11.690 2.859 33.42 33.42
MH 001 074 10 -21 -2010 08:34 SMITH, KEITH 14,500 E85 20.070 2.560 51.37 51.37
MH 001 078 10 -23 -2010 13:01 SMITH, KEITH 450,000 E85 12.940 2.559 33.11 33.11
MH 001 074 10 -25 -2010 09:05 SMITH, KEITH 14,500 E85 18.600 2.559 47.60 47.60
MH 001 074 10 -27 -2010 10:39 SMITH, KEITH 14,500 E85 14.370 2.559 36.77 36.77
CARD SUBTOTALS 175.630 448.09
0002 MH 001 078 09 -30 -2010 14:38 HULETT, MARK 74,785 E85 13.010 2.498 32.50 32.50
MH 001 074 10 -05 -2010 13:08 HULETT, MARK 74,997 E85 12.810 2.498 32.00 32.00
MH 001 074 10 -08 -2010 08:13 HULETT, MARK 75,225 E85 13.210 2.499 33.01 33.01
MH 001 074 10 -13 -2010 06:38 HULETT, MARK 75,453 E85 14.210 2.498 35.50 35.50
MH 001 074 10 -18 -2010 06:40 HULETT, MARK 75,649 UNL 12.020 2.829 34,00 34.00
MH 001 078 10 -22 -2010 11:46 HULETT, MARK 75,897 E85 11.350 2.559 29.05 29.05
MH 001 074 10 -26 -2010 08:24 HULETT, MARK 76,069 E85 11.940 2.559 30.55 30.55
CARD SUBTOTALS 88.550 226.61
0003 MH 001 074 09 -30 -2010 16:39 STEELE, JEFF 18,046 E85 22.880 2.499 57.18 57.18
MH 001 074 10 -05 -2010 15:45 STEELE, JEFF 18,290 E85 20.310 2.499 50.76 50.76
MH 001 074 10 -08 -2010 10:47 STEELE, JEFF 18,554 E85 22.100 2.499 55.22 55.22
MH 001 074 10 -15 -2010 12:07 STEELE, JEFF 18,813 E85 23.550 2.559 60.27 60.27
-MH 001-095 10 -25 -2010 16:37 STEELE, JEFF 19,055 E85 23.320 2.559 59.67 59:67
CARD SUBTOTALS 112.160 283.10
0004 MH 001 074 09 -29 -2010 17:36 HABOUSH, DAVE 31,595 E85 23.210 2.499 58.00 58.00
MH 001 074 10 -07 -2010 10:03 HABOUSH, DAVE 31,888 E85 27.010 2.499 67.51 67.51
MH 001 074 10 -14 -2010 13:35 HABOUSH, DAVE 32,152 E85 22.320 2.499 55.77 55.77
MH 001 074 10 -21 -2010 08:39 HABOUSH, DAVE 32,403 E85 22.010 2.559 56.33 56.33
MH 001 074 10 -23 -2010 20:08 HABOUSH, DAVE 32,653 E85 19.590 2.559 50.13 50.13
CARD SUBTOTALS 114.140 287.74
0007 MH 001 154 10 -03 -2010 20:33 SMITH, KEITH 101,541 E85 20.330 2.498 50.79 50.79
MH 001 154 10 -05 -2010 17:28 SMITH, KEITH 101,760 E85 18.060 2.499 45.13 45.13
MH 001 074 10 -08 -2010 08:20 SMITH, KEITH 102,012 E85 21.300 2.49,c 53.23 53.23
MH 001 074 10 -11 -2010 16:59 SMITH, KEITH 102,256 E85 20.840 2.500 52.09 52.09
MH 001 074 10 -13 -2010 12:47 SMITH, KEITH 102,437 E85 14.460 2.499 36.14 36.14
MH 001 074 10 -15 -2010 09:43 SMITH, KEITH 102,566 E85 11.280 2.498 28.18 28.18
MH 001 154 10 -17 -2010 15:56 SMITH, KEITH 10,276 E85 16.700 2.559 42.73 42.73
MH 001 154 10 -20 -2010 17:30 SMITH, KEITH 102,999 E85 19.720 2.559 50.47 50.47
MH 001 154 10- 23.2010 17:49 SMITH, KEITH 103,199 E85 17.020 2.558 43.54 43.54
MH 001 074 10 -27 -2010 10:10 SMITH, KEITH 103,446 E85 21.220 2.559 54.30 54.30
CARD SUBTOTALS 180.930 456.60
TOTAL PURCHASES 671.410 1,702.14
Y -T -D PURCHASES 3,607.758 8,537.01
PRODUCTS: E85= ETHANL85 UNL= UNLEADED
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 24308881
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 2 OF 2
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
SITES USED THIS MONTH Cont. NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street City State Zip
MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 26 1,210.05
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 5 232.66
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 5 199.76
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 1 59.67
PRODUCTS: E85- ETHANL85 UNL= UNLEADED
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$1,561.81
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept. INVOICE NO. ACCT #ffITLE AMOUNT Board Members
1120 2430881 42- 314.00 $1,561.81 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
Ic
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))
2430881 $1,561.81
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