193627 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
D ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $1,068.43
CARMEL, INDIANA 46032 0453 00.7946296
ory `o PO BOX 6293 CHECK NUMBER: 193627
CAROL STREAM EL 60197
CHECK DATE: 111912011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 24826629 1,068.43 0453 -00- 794629 -6
FLEET SERVICES
INVOICE/STATEMENT
INVOICE NUMBER: 24826629
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 12 -31 -2010 01 -26 -2011 1,068.43
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS. PAYMENTS /CREDITS
12 -20- 2010.: PAYMENT RECEIVED THANK YOU 1,505.97
12 -,31 -2010 RETAIL FUEL PURCHASES `..1,054.43
12 -31 -201.0 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.
E
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
1 1 505.97 1,505.97 1,054.43 14.00 0.00 0.00 1,068.43
$10.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonlinexom
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 oeriod which is.
2.00 24.00 0100
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: /Jwww.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.
Mai! to P.O. Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 24826629
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD I BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453- 00- 79462M 6,000.00 31 12 -31 -2010 01 -26 -2011 1,068.43
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 078 12.01 -2010 19:48 SMITH, KEITH 14,500 UNL 19.870 2.879 57.20 57.20
MH 001 078 12 -14 -2010 16:54 SMITH, KEITH 14,500 E85 15.740 2.600 40.92 40.92
NIH 001 078 12 -17 -2010 16:19 SMITH, KEITH 14,500 E85 16.000 2.599 41.59 41.59
MH 001 078 12 -21 -2010 19:15 SMITH, KEITH 14,500 E85 15.450 2.599 40.16 40.16
MH 001 078 12 -23 -2010 14:05 SMITH, KEITH 14,500 E85 12.000 2.598 31.18 31.18
MH 001 074 12- 28.2010 08:23 SMITH, KEITH 14,500 UNL 21.220 3.200 67.90 67.90
CARD SUBTOTALS 100.280 278.95
0002 MH 001 078 12 -01 -2010 06:12 HULETT, MARK 77,419 UNL 12.680 2.898 36.75 36.75
MH 001 074 12 -07 -2010 07:57 HULETT, MARK 77,677 E85 12.970 2.699 35.01 35.01
MH 001 078 12 -09 -2010 15:48 HULETT, MARK 77,871 E85 11.540 2.600 30.00 30.00
MH 001 074 12 -14 -2010 11:28 HULETT, MARK 78,082 E85 12.700 2.599 33.01 33.01
MH 001 074 12 -16 -2010 13:31 HULETT, MARK 78,241 E85 10.390 2.600 27.01 27.01
MH 001 074 12 -21 -2010 14:22 HULETT, MARK 78,375 E85 8.470 2.599 22.01 22.01
MH 001 078 12 -29 -2010 14:17 HULETT, MARK 78,543 E85 11.300 2.699 30.50 30.50
CARD SUBTOTALS 80.050 214.29
0003 MH 001 074 12 -01 -2010 11:22 STEELE, JEFF 20,431 E85 22.820 2.699 61.60 61.60
MH 001 095 12- 05.2010 12:39 STEELE, JEFF 20,725 E85 24.870 2.699 67.12 67.12
MH 001 074 12- 10.2010 16:43 STEELE, JEFF 20,929 E85 22.490 2.599 58.45 58.45
r. MH 001 074 12 -16 -2010 12:04 STEELE, JEFF 21,153 E85 23.770 2.599 61.79 61.79
MH 001 074 12 -21 -2010 10:13 STEELE, JEFF 21,437 E85 22.550 2.600 58.62 58.62
CARD SUBTOTALS 116.500 307.58
_0004 MH 001 074 11- 29.2010 15:58 HABOUSH, DAVE 34,342 E85 21.270 2.699--- _57.40 57.40
MH 001 074 12 -07 -2010 08:29 HABOUSH, DAVE 34,461 E85 16.690 2.700 45.06 45.06
MH 001 074 12 -11 -2010 07:16 HABOUSH, DAVE 34,696 E85 21.670 2.599 56.32 56.32
MH 001 074 12 -16 -2010 18:48 HABOUSH, DAVE 34,930 E85 23.450 2.598 60.93 60.93
MH 001 074 12 -22 -2010 13:36 HABOUSH, DAVE 35,105 E85 19.140 2.599 49.75 49.75
MH 001 074 12 -27 -2010 14:11 HABOUSH, DAVE 35,381 UNL 27.000 3.039 82.05 82.05
CARD SUBTOTALS 129.220 351.51
0007 MH 001 154 11 -30 -2010 17:02 SMITH, KEITH 105,599 E85 21.010 2.699 56.71 56.71
CARD SUBTOTALS 21.010 56.71
TOTAL PURCHASES 447.060 1,209.04
Y -T -D PURCHASES 4,702.368 11,460.55
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street City State Zip
MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 15 776.91
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 8 308.30
MH 001,095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 1 67,12
MH 001 154 MEIJER 17000 MERCANTILE RD NOBLESVILLE IN 46060 1 56.71
PRODUCTS: L65= ETHANL85 UNL- UNLEADED
FLEET SERVICES
This page is intentionally left blank.
ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 12 -31 -2010
J f1
FLEE S E O/ E° S ACCOUNT NO. 0453 -00- 794629.6
�l �w 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 -67.03 0.00 FEDERAL E85 366.290 955.14 0.18300
-14.78 0.00 FEDERAL GASOLINE 80.770 243.90 0.18300
FEDERAL TOTALS 81.81 D.00_ 447.060 1,209.04-
IN 356000972 0.00 14.54 STATE EXCISE GASOLINE 80.770 243.90 0.18000
-58.76 0.00 STATE SALES E85 356.290 965.14 0.07000
-14.04 0.00 STATE SALES GASOLINE 80.770 243.90 0.07000
IN_.STATE TOTALS -72.80 14.54.
ACCOUNT TOTALS 154.61 14.54
o
c
(o) WRIGHT EXPRESS CORPORATION 2010 PAGE 1
I
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496 -00- 138012 -0
DEC -01 -2010 TO DEC -31 -2010
Financial Summary B 1a! y PAGE 1 OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES
CITY COSTJFEE TOTAL FEES FUEL OTHER EXEMPTED TAX NET PURCHASES
ACCOUNT TOTALS Unleaded Regular 72.07 432- 67.75
PERIOD O.DD 72.07 O.OD 4.32 67.75 67.75
YTQ 0.00 98.21 0.00 7.48- 90.73 90.73
ACCOUNTS RECEIVABLE SUMMARY Invoice 24855868
PREVIOUS BALANCE 22.98
PAYMENTS 22,.98
PURCHASES 67.75
DEBITS 0.00
CREDITS 0.00
LATE FEES 10.00
o
AMOUNT DUE 77.75
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$1,136.18
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# l Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 24855868 42- 314.00 $67.75 1 hereby certify that the attached invoice(s), or
1120 24826629 42- 314.00 $1,068.43 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
JAN 2011
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))
24855868 $67.75
24826629 $1,068.43
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