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Home My WebLink About193626 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1 ONE CIVIC SQUARE FLEET SERVICES CARMEL, INDIANA 46032 0453 -00- 7946296 CHECK AMOUNT: $182.74 PO BOX 6293 CHECK NUMBER: 193626 CAROL STREAM IL 60197 CHECK BATE: 1!1912011 DEPARTMENT ACCOUNT PO NUMBER IN NUMBE AMOU DE SCRIPTION 1205 4231400 24861687 182.74 0496 -00- 138002 -1 Invoice Statement INVOICE NUMBER: 24861687 ACCOUNT NAME: City of Carmel Admin. PAGE 1 OF 1 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE 0496 00 138002 1 550.00 31 DEC 31 2010 JAN 26 2011 192.74 DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS DEC -27 -2010 PAYMENT THANK YOU 91.99 DEC -3.1 -2010: FUEL PURCHASES 182.74 REMINDER REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT PORTION OF THE REMITTANCE STUB. JAN 17 2011 By PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT. PREVIOUS BALANCE PAYMENTS )PURCHASES DEBITS CREDITS )LATE FEE )NEW BALANCE 91.99 91.99 182.74 0.00 0.00 10.00 192.74 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 morizKy rate of RATE of fee for this period which is 2.00 24.00 242.23 SEE REVERSE SIDE: FOR IMPORTANT INFORMATION AND TERMS. TO ENSURE PROPER CREDITTEAR 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.wextools.com. shorter billing or payment cycle as offered by us. If your payment due date falls on a non business day, payment is Online payments scheduled by 3:00 PM ET (on business days) are credited to your account on the same day. There is no fee for due on the business day before the payment due date. Qe!!nquent 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' o: service or billing: http: /Avww.e- fleet.co 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- 800395 -0809, or ACH payment. Mail to P.O. Box 639, Portland, MB 04104 Be sure to include your account number on all correspondence. PARENT ACCOUNT: REPORT FOR: City of Carmel Admin. City of Carmel Admin. 0496 -00- 138002 -1 DEC -01 -2010 TO DEC -31 -2010 Purch Acti vity Report PAGE 1 OF 2 CARD NUMBER CARD EMBOSSING I VEHICLE/ ASSET IDENTIFIER VEHICLE DESCRIPTION PLATES VIN 0001 Mercury mariner DATE TIME SITE ADDRESS PROMPT TRAN ODOM PROD UNITS COST/ FUEL OTHER EXEMPT NET REPORTED EXC. INFO CODE UNIT TAX TAX CODES PREVIOUS ODOMETER 2,340 DEC -07 12:31 545 S Range Line R Carmel IN 1 Driver OP 2,340 UNL 17.945 2.959 3.28- 49.82 6.28 DEC-14 13:24 545 S Range Line R Carmel IN 1 Driver OP 2,340 UNL 18.132 2.999 54.38 3.32- 51.06 6.39 DEC-17 11:22 545 S Range Line R Carmel IN 1 Driver OP 2,340 SUP 16.261 3.219 52.34 2.98- 49.36 5.97 DEC-30 10:47 545 S Range Line R Carmel IN 1 Driver OP 1,955 UN+ 13.678 2.559 35.00 2.50- 32.50 4.43- PERIOD TOTALS 66.016 '194.82 12.08 182.74 w .23.077, YTDTOTALS i�'� r.._, m. ,100 -135 i293.05 18.32- 274.73 3483x: PERIOD AVERAGE: PPG 2.951 YTD AVERAGE: PPG 2.927 TO ENSURE MORE A URATE MILEAGE EPORTf G, VEHICLE ry ILEAGE STA rISTICS ARE N DT CALCU ATED WHEN KEY ODOMETER 1EADINGS RE NOT WITHIN AN CCEPTABLE RANGE. TRANSACTION CODES: OP Outdoor Payment Terminal This page is intentionally left blank. PARENT ACCOUNT:;' REPORT FOR: City of Carmel Admin. City of Carmel Admin: 0496 -00- 138002 -1 DEC -01 -2010 TO DEC -31 -2010 Financial Summary PAGE 1 OF 2 DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES QTY COST /FEE TOTAL FEES FUEL OTHERS EXEMPTED TAX NET PURCHASES ACCOUNT TOTALS Unleaded Regular 107.48 6.60- 100.88 Unleaded Super 52.34 2.98- 49.36 Unleaded Plus 35.00 2.50- 32.50 PERIOD ..0.00 194.82' 0.00 12.08- 182.74 182.74 Y70 .0.00 .293.05.' 0.00 18.32- 274.73 .274.73 ACCOUNTS RECEIVABLE SUMMARY- Invoice 24861687 PREVIOUS BALANCE 91.99 PAYMENTS 91.99- PURCHASES 18174 DEBITS 0.00 CREDITS 0.00 LATE FEES 10.00 AMOUNT DUE 192.74 O PARENT ACCOUNT; REPORT FOR: City of Carmel Admin. City of Carmel Admin. 1.9e 0496 -00- 138002 -1 DEC -01 -2010 TO DEC -31 -2010 Site Summary PAGE 1 OF 2 BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL OTHER EXEMPT NET TRANS TAX Dairy Man 545 S Range Line Rd Carmel IN 46032 4 66.016 194.82 12.08- 182.74 PERIOD TOTALS 4 66.016 194.82 0.00 12.08- 182.74 kO PARENT ACCOUNT: REPORT FOR: City of Carmel Admin. City of Carmel Admin. NO 0496 -00- 138002 -1 DEC -01 -2010 TO DEC -31 -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 -12.08 Federal Excise Gasoline Unblended 66.020 194.82 0.18300 FEDERAL TOTALS 12.08_ 66.020 194.82 IN 356000972 JUN -18 -2012 -11.19 State Sales Gasoline Unblended 66.020 194.82 0.07000 -11.88 State Excise Gasoline Unblended 66.020 194.82 0.18000 IN STATE TOTALS -23.07 ACCOUNT TOTALS -12.08 -23.07 e n fib: VOUCHER NO. WARRANT NO. ALLOWED 20 i kv �t(Fleet. Services IN SUM OF PO Box 6293 Carol Steam, IL 60197 -6293 $182.74 ON ACCOUNT OF APPROPRIATION FOR Carmel Administration PO# Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members 1205 I 24861687 I 42- 314.00 I $182.74 1 hereby certify that the attached invoice(s), or f 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 Tuesday, January 18, 2011 S Director, Administratio 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)) 01/26/11 24861687 $182.74 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