194075 01/31/2011 CITY OF CARMEL INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES
0 CHECK AMOUNT: $159.99
CARMEL, INDIANA 46032 0496 -00- 138009 -6
PO BOX 6293 CHECK NUMBER: 194075
CAROL STREAM IL 60197 -6293
CHECK DATE: 1/31/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 24855601 159.99 0496 -00- 138009 -6
I
WELCOME
CKMW #2368
317- 574 -1021
808808285572 -001
CIRCLE K 2368
545 S RANGELINE RD
CARMEL IN
46032, 317 -574 -1021
WEX
WX AUTH #394042
SEQ# 0893 EXP
DATE 12/16/10 15:26
REF #3500008032000148
BATCH #01
VEHICLE# 80591
ODOMETER: 36539
PUMP 05 E
PRODUCT: UNLD
APPROVAL 394642
GALLONS: 28.197
PRICE /G: 2.979
FUEL SALE: 84.08
THANK YOU
HAVE A NICE DAY
WELCOME
CKMW #2368
317 574 -102
888000285572 -001
CIRCLE K 2368
545 S RANGELINE RD
CARMEL IN
6832, 317- 574 -1021
EX
X AUTH#379765
SEQ# 0073 E}CP
DATE 12/13/10 12:27
REF #3470080022000119
BATCH #82
VEHICLE# 00591
O'DOMET'ER: 38630
PUMP 11 K
PRODUCT: UNLD
APPROVAL 379765
GALLONS: 28.676
PRICE /G: 2.999
FUEL SALE: 86.86
THANK YOU
HAVE A NICE DAY
Invoice Statement
INVOICE NUMBER: 24855601
loop ACCOUNT NAME: City of Carmel Utilities
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496 -00- 138009 -6 500.00 31 DEC -31 -2010 JAN -26 -2011 159.59
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
DEC -31- 2010. FUEL PURCHASES 159.59
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 UNTIL THE NEXT INVOICEISTATEMENT.
PREVIOUS BALANCE PAYMENTS )PURCHASES (+)D BITS CREDITS )LATE FEE )NEW BALANCE
0.1 0.00 159.59 0.00 0.00 0.00 159.59
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 subiect to late
applying a monthiv 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 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 vy us.
Online payments scheduled by 3:00 PM ET (on business days)
If your payment due date falls on anon- business day, payment 1s
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 no 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:/Iwww.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 -095 -0809, or ACH payment.
Mail to P.O. Box 639, Portland, ME 04104
Be sure tc in clude your account ,umber on all correspondence.
VOUCHER 106955 WARRANT ALLOWED
69001
IN SUM OF
(`,'�cf,� .[Ly lce�`
/RATION
Carmel
Ga7q�
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
24855601 01- 7500 -08 $159.99
Voucher Total $159.99
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
69001
CRYSTAL FLASH Purchase Order No.
PETROLEUM CORPORATION Terms
PO BOX 105080 Due Date 12/29/2010
Atlanta, GA 30348 -5080
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/2011 24855601 $159.99
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
Date Officer