192737 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH PETROLEUM
1 01� CHECK AMOUNT: $43.74
CARMEL, INDIANA 46032 PO BOX 105080
ATLANTA GA 30348 -5080 CHECK NUMBER: 192737
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 BG1297998 43.74 BG1297998
12/03/2010 3:43:16 PM —0500 FLEETDETAILS PAGE 2 OF 3
Local Office- Crystal Flash Petroleum PL
Mannatec Driven, 655 Engineering Drive, Suite 300 For billing questions call: (800) 903 -9368
Norcross, GA 30092
Account BG1297998
Please reference account on all payments
STATEMENT N1 2 27731879
DATE 12/03/2010
CITY OF CARMEL -FIRE DUE DATE 01/02/2011
1 CIVIC SID
CARMEL IN 46032 TOTAL BALANCE DUE $43.74
PAYMENT TERMS Net 30 MN
Although Crystal Flash sold some locations to Circle K, your Crystal Flash Mannatec fleet cards should stlll work at
the new Circle K locations, and will continue to work at the remaining Crystal Flash locations.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 11/30/2010
Date Description Gallons Amount Due
11/13/2010 PAYMENT: Lockbox Payment Thank You $34.54 CR
12/03/2010 Fleet 1315390 Name: CITY OF CARMEL -FIRE 19.890 $43.74
Current Activity
Previous
Statement Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
11/01/2010 $34.54 $34.54 CR 19.890 $43.74 $43.74
FOR PROPE PAYMEN P PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
12/03/2010 3:43:16 PM —0500 FLEETDETAILS PAGE 3 OF 3
FLEET MANAGEMENT REPORT
Mannalec Driven, 655 Engineering Drive, Suite 300
Norcross, GA 30092 Account BG1297998
FLEET 1315390
Provided By: Name: CITY OF CARMEL FIRE
Crystal Flash Petroleum PL MATCHING STATEMENT NP27731879
(800) 903 -9368
Page: 1 of 1
CITY OF CARMEL -FIRE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 11/1/2010 11/3012010
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL+ 19.890 $33.87 $3.70 $6.17 $0.00 $43.74
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r,,.,. r.. y i r:. e i.. i k,. i r v r.,. �,i.,.i �.i.,,Y_ r Y s}�.Y ,.y,.Y.,ry.,.q.Y, .i ;,.p,.yv� r.,...�., h r
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31; ,r' "'l .�m�!H S!. t! r.,, r�! „,,.zz,',�'ta?<:�_.d�4.. Fin ,.�r ;.,6,�..r�1.�1, rrL::.c:?[>, trt �s .t!C.lf ..�k c .,v�1h. {4. :!s. >c!�re.L. ✓:s >?<t s�t ;.�x2,u
This report is for Information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 473
t: t s i 7� 1 7YYt r t t 2�2Ytr Y tiY i Y Yi��k ii,
tTransactron Detall for CustomerrNa If589dKrC1tY F t 1�/b10 i�U39tl40 r
2us YrE f. t<_,.�._ n.._.. ��,txcs.,s.;%F ?;a•;,).. ;..r,.::. ?is a4•�•s:c+.,, W i'>l.., ;M..,.. »..:s,s '.i,.ri r��c..t J.,.. t�f ;ux�'rv. .y ✓�x +s �t �f;3�s /•t�3�i,.3F�•f:�� *yfl /y
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE°
�,•su
,�(j7't'rjn.- P9QL`,G. R J, Yy 1.�i,• ,sT' ,I ,k ar,��ir,:5- ✓r,:., JrpY qg, �i,Y r �i� f,, Y {5 i �7 ,13 Yi ��I.r. ,Y�y {,s, T�` r,l T, i.1,. YIr <FfF�g� %•I,�r, r�rY }i 5 ni i
r, x,..: R7�9:,,? n.. cx: s:: r,,,. �ls' ��S,:, C n L�>?, iY rhk�c', t', L �J.; �iG: L tis,, ,L,�S ;,�CS�,�/,S;tiJ: ;it ;i�d,.�• Inks „k•',L„S.�;,�,, V.�,:.J�;r,,s1,1:d.:�?Y',b �,s 1 S' �iL, t! k, 15, t�i�$ t, T; a, t,”. V' u; �s�. ut, Ja �r• 1., ;,�.t�.,>2ii�1.nC ,�1.511,.ssiu
10101 16:39 191392 DRIVER 1 101297 23.8 UNL+ 19.690 1.70290 0.49606 $43.74
Miles: 473 23.8 19.890 $43.74
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
191392 Circle K #2368 545 S Rangeline Rd Carmel IN
VOUCHER NO. WARRANT NO,
Crystal Flash ALLOWED 20
IN SUM OF
P.O. Box 684
Indianapolis, IN 46206
$43.74
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# /Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1920 NP27731879 42- 314.00 $43.74 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
DEC 13 2010
IF Alp
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 bifl 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))
NP27731879 $43.74
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