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Home My WebLink About193013 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1 ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $22.98 CARMEL, INDIANA 46032 0453- 00a946296 •1, oats PO BOX 6293 CHECK NUMBER: 193013 CAROL STREAM IL 60197 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT P O NUMBER INVOICE NU AMOUNT DESCRIPTION 1120 4231400 24587603 22.98 0496 -00- 138012 -0 Invoice Statement INVOICE NUMBER: 24587603 ACCOUNT NAME: City of Carmel Fire PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0496 -00- 138012 -0 3,400.00 30 NOV -30 -2010 DEC -23 -2010 22.98 DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS /CREDITS NOV -30 -2010' FUEL PURCHASES 22.98 REMINDER 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 UNTFL THE NEXT INVOICE/STATEMENT. PREVIOUS BALANCE PAYMENTS PURCHASES )DEBITS CREDITS LATE FEE NEW BALANCE 0.00 0.00 22.98 0.00 0.00 0.00 22.98 CALL CUSTOMER SERVICE TO PAY BY PHONE FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an EFFECTIVE ANNUAL To the balance subject to late applying a m rthly rate of RATE of fee for this period which is 2.00 24.00 0.00 SEE REVERSE SIDE FOR IMPORTANT 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 Mall 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.wextools.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- 866 544 -1715 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 making a payment, you can considered final and binding. also check your balance. Card issuer Payments scheduled by 3:00 PM ET (on business days) The Circle K Fleet 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:llwww.e- fleet.com Call 1- 866 -544 -1715, or ACH payments made 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. PARENT ACCOUNT: REPORT FOR: City of Carmel Fire City of Carmel Fire No 0496 -00- 138012 -0 NOV -01 -2010 TO NOV -30 -2010 Purchase Activity Report PAGE 1 OF 2 I I CARD NUMBER CARD EMBOSSING VEHICLEi/ ASSET IDENTIFIER VEHICLE DESCRIPTION PLATE'S VIN 0001 i 63225 u DATE TIME SITE ADDRESS it PROMPT TRAN ODOM. PROD UNITS COST/ FUEL OTHER EXEMPT NET REPORTED EXC. 9 INFO CODE UNIT TAX TAX CODES PREVIOUS ODOMETER 4 NOV -24 13:12 545 S Range Line R Carmel IN 1 driver OP 14,500 UNL 9.110 2.869 26.14 3.16- 22.98 1.64 PERIOD TOTALS y 9.110 26.14 3.16 22.98 1.64 YTD TOTALS 9.110 26.14 3,16- 22.98 1.64 PERIOD AVERAGE: PPG 2.669 YTDAVERAGE: PPG 2.669 TO ENSURE MORE ACCURATE MILEAGE REPORT] G, VEHICLE iv ILEAGE STA ISTICS ARE N T CALCU -ATED WHEN KEY ODOMETER 3EADINGS RE NOJ WITHIN AN CCEPTABLE RANGE. I TRANSACTION CODES: OP Outdoor Payment Terminal PARENT ACCOUNT: REPORT FOR: City of Carmel Fire City of Carmel Fire 0496 -00- 138012 -0 NOV -01 -2010 TO NOV -30 -2010 Financial Summary PAGE 1 OF 2 DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES OTY COST/FEE TOTAL FEES FUELS OTHER EXEMPTED TAX NET PURCHASES ACCOUNT TOTALS Unleaded Regular 26.14 3.16- 22.98 PERIOD 0.00 26.14. 0.00 3.16- 22.98 22.98 YTD'. 0.00 26.14 0.00 3.16- 22.98 22.98 ACCOUNTS RECEIVABLE SUMMARY- Invoice 24587603 PREVIOUS BALANCE 0.00 PAYMENTS 0.00 PURCHASES 22.98 DEBITS 0.00 CREDITS 0.00 AMOUNT DUE 22.98 PARENT ACCOUNT: REPORT FOR: City of Carmel Fire City of Carmel Fire LNG 0496 -00- 138012 -0 NOV -01 -2010 TO NOV -30 -2010 Site Summary i PAGE 1 OF 2 BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL OTHER EXEMPT NET TRANS TAX Dairy Mart 545 S Range Line Rd Carmel IN 46032 1 9.110 26.14 3.16- 22.98 PERIOD TOTALS 1 9.110 26.14 0.00 3.16- 22.98 PARENT ACCOUNT: REPORT FOR: City of Carmel Fire City of Carmel Fire 0496 -00- 138012 -0 m NOV -01 -2010 TO NOV -30 -2010 Tax Summary PAGE 1 OF 2 TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS UNITS GROSS TAX RATE FEDERAL 356000972 JUN -18 -2012 -1.67 Federal Excise Gasoline Unblended 9.110 26.14 0.18300 FEDERAL TOTALS. -1.67 9.110_ 26.14_, IN 356000972 JUN -18 -2012 -1.49 State Sales Gasoline Unblended 9.110 26.14 0.07000 -1.64 State Excise Gasoline Unblended 9.110 26.14 0.18000 IN STATE TOTALS -1.49 -1.64 ACCOUNT TOTALS -3.16 -1.64 I i i c �i: VO N O. WARRANT NO. ALLOWED 20 Fleet Services N SUM OF P.O. Box 6293 Carol Stream, IL 60197 $22.98 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# l Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 24587603 42- 314.00 $22.98 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 2 0 M CI 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)) 24587603 $22.98 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 1 20 Clerk- Treasurer