192742 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $1,505.97
CARMEL, INDIANA 46032 0453 -00- 7946296
PO BOX 6293 CHECK NUMBER: 192742
CAROL STREAM IL 60197
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1120 4231400 24569047 1,505.97 0453 -00- 794629 -6
FLEET SERVICES INVOICE /STATEMENT
INVOICE NUMBER: 24569047
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 6,00 0.00 30 11 -30 -2010 12 -23 -2010 1 97
.DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
11 -01 -2010 PAYMENT RECEIVED THANK YOU 841.35
11 -22 -2010 PAYMENT RECEIVED THANK YOU 1,561.81
11 -30 -2010 RETAIL FUEL PURCHASES 1,491.97
11 -30 -2010 MONTHLY CARD CHG 14.00
REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH
PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT
PORTION OF THE REMITTANCE STUB.
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE /STATEMENT
PREVIOUS BALANCE PAYMENTS )PURCHASES DEBITS CREDITS LATE FEE NEW BALANCE
2,403.16 2 1,491.97 14.00 0.00 0.00 1.505
$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: 84- 1425616 applying a monthly periodic rate of PERCENTAGE RATE of fee for this 2eriod which is
2.00 24.00 0.00
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: /www.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: 11 -30 -2010
FL E ET S �w ,•r R I C E S ACCOUNT NO: 0453 -00- 794629.6
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 112.53 0.00 FEDERAL E85 614.900 1,623.47 0.18300
-5.97 0.00 FEDERAL GASOLINE 32 650 91.03 0.18300
FEDERAL TOTALS 118.50. _0.00.:.. j 1 647.550 1,714.50
IN 356000972 0.00 5.87 STATE EXCISE GASOLINE 32.650 91.03 0.18000
-98.85 0.00 STATE SALES E85 614.900 1,623.47 0.07000
-5.18 0.00 STATE SALES GASOLINE 32,650 91.03 0.07000
IN, STATE TOTALS 104.03
ACCOUNT TOTALS 222.53 5.87
r
a
4
(c) WRIGHT EXPRESS CORPORATION 2010 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 24569047
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 6,000.00 30 11 -30 -2010 12 -23 -2010 1.505.97
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 074 10 -29 -2010 11:54 SMITH, KEITH 41,500 E85 19.610 2.558 50.17 50.17
MH 001 074 11 -01 -2010 12:44 SMITH, KEITH 14,500 UNL 16.460 2.758 45.40 45.40
MH 001 074 11 -05 -2010 16:43 SMITH, KEITH 14,500 E85 11.820 2.558 30.24 30.24
MH 001 078 11 -06 -2010 11:37 SMITH, KEITH 14,500 E85 15.710 2.559 40.20 40.20
MH 001 078 11 -08 -2010 12:40 SMITH, KEITH 14,500 E85 19.290 2.559 49.36 49.36
MH 001 074 11 -12 -2010 13:50 SMITH, KEITH 14,500 E85 15.340 2.699 41.41 41.41
MH 001 074 11 -16 -2010 12:23 SMITH, KEITH 14,500 E85 13.600 2.699 36.71 36.71
MH 001 074 11 -19 -2010 12:58 SMITH, KEITH 14,500 E85 23.470 2.699 63.35 63.35
MH 001 074 11 -23 -2010 13:23 SMITH, KEITH 14,500 E85 15.790 2.699 42.61 42.61
MH 001 078 11 -27 -2010 13:26 SMITH, KEITH 14,500 UNL 16.190 2.818 45.63 45.63
CARD SUBTOTALS 167.280 445.08
0002 MH 001 074 11 -03 -2010 14:06 HULETT, MARK 76,628 E85 12.500 2.560 32.00 32.00
MH 001 074 11 -08 -2010 10:51 HULETT, MARK 76,477 E85 12.500 2.560 32.00 32.00
MH 001 074 11 -10 -2010 12:28 HULETT, MARK 76,639 E85 9.690 2.699 26.15 26.15
MH 001 078 11 -16 -2010 08:53 HULETT, MARK 76,837 E85 13.410 2.699 36.20 36.20
MH 001 154 11 -18 -2010 10:20 HULETT, MARK 7,021 E85 11.120 2.698 30.00 30.00
MH 001 078 11 -23 -2010 15:42 HULETT, MARK 77,223 E85 12.230 2.699 33.01 33.01
CARD SUBTOTALS 71.450 189.36
0003 MH 001 074 11 -01 -2010 16:25 STEELE, JEFF 19,281 E85 24.390 2.559 62.42 62.42
MH 001 095 11 -08 -2010 18:05 STEELE, JEFF 19,523 E85 24.790 2.699 66.91 66.91
MH 001 095 11 -13 -2010 16:33 STEELE, JEFF 19,736 E85 21.250 2.699 57.35 57.35
MH 001 074 11 -18 -2010 11:20 STEELE, JEFF 19,966 E85 19.790 2.699 53.41 53.41
MH 001 095 11 -26 -2010 14:54 STEELE, JEFF 20,162 E85 20.450 2.699 55.19 55.19
CARD SUBTOTALS 110.670 295.28
0004 MH 001 074 10 -28 -2010 18:33 HABOUSH, DAVE 3,296 E85 21.430 2.559 54.84 54.84
MH 001 074 11 -02 -2010 13:17 HABOUSH, DAVE 33,113 E85 18.990 2.558 48.58 48.58
MH 001 074 11 -08 -2010 09:25 HABOUSH, DAVE 33,367 E85 23.480 2.559 60.08 60.08
MH 001 074 11 -12 -2010 18:07 HABOUSH, DAVE 33,602 E85 21.290 2.698 57.45 57.45
MH 001 073 11 -19 -2010 17:24 HABOUSH, DAVE 33,893 E85 26.410 2.699 71.29 71.29
MH 001 074 11 -24 -2010 18:00 HABOUSH, DAVE 34,100 E85 17.910 2.700 48.35 48.35
CARD SUBTOTALS 129.510 340.59
0007 MH 001 154 10 -29 -2010 13:53 SMITH, KEITH 103,632 E85 15.530 2.559 39.74 39.74
MH 001 074 11 -01 -2010 11:22 SMITH, KEITH 103,851 E85 19.280 2.559 49.34 49.34
MH 001 154 11 -05 -2010 17:08 SMITH, KEITH 104,098 E85 21.470 2.559 54.94 54.94
MH 001 074 11 -08 -2010 08:20 SMITH, KEITH 104,333 E85 22.190 2.559 56.79 56.79
MH 001 154 11 -11 -2010 15:27 SMITH, KEITH 104,492 E85 16.470 2.699 44.45 44.45
MH 001 154 11 -13 -2010 11:37 SMITH, KEITH 104,643 E85 11.470 2.698 30.95 30.95
MH 001 154 11 -15 -2010 18:03 SMITH, KEITH 104,826 E85 16.180 2.700 43.68 43.68
MH 001 074 11 -18 -2010 15:23 SMITH, KEITH 104,990 E85 14.760 2.700 39.85 39.85
MH 001 154 11 -22 -2010 17:36 SMITH, KEITH 105,227 E85 20.030 2.699 54.07 54.07
MH 001 154 11 -24 -2010 20:15 SMITH, KEITH 105,359 E85 11.260 2.698 30.38 30.38
CARD SUBTOTALS 168.640 444.19
TOTAL PURCHASES 647.550 1,714.50
Y -T -D PURCHASES 4,255.308 10,251.51
PRODUCTS: E85= ETHANL85 UNL= UNLEADED
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 24569047
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 20 931.15
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 8 328.21
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 5 204.40
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 3 179.45
MH 001 073 MEIJER 5347 PIKE PLAZA RD INDIANAPOLIS IN 46254 1 71.29
PRODUCTS: E85= ETHANL85 UNL= UNLEADED
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$1,505,97
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 24569047 42- 314.00 $1,505.97 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
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))
24569047 $1,505.97
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