195255 03/09/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES
CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $1,072.88
CAROL STREAM IL 60197 CHECK NUMBER: 195255
CHECK DATE: 3/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 25390039 1,072.88 0453 -00- 794629 -6
FLEET SERVICES INVOICE /STATEMENT
INVOICE NUMBER: 25390039
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 fi 000.00 28 02 -28 -2011 03 -25 -2011 1 072.88
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
02 -22 -2011 PAYMENT RECEIVED THANK YOU 1,128.74
02 -28 -2011 RETAIL FUEL PURCHASES 1,058.88
02 -28 -2011 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 INVOICEISTATEMENT
PREVIOUS BALANCE PAYMENTS )PURCHASES I DEBITS CREDITS LATE FEE )NEW BALANCE
1128.74 1 128.74 1058.88 14.00 0.00 0.00 1072.88
$10.00 MINIMUM LATE FEE
PAY ONLINE AT:www.wexonline.cotn
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 monthiy periodic rate of PERCENTAGE RATE of fee for this period 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: 02 -28 -2011
F T S E� r l C E ACCOUNT NO: 0453 -00- 794629 -6
DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC Sn
CARMEL IN 46032 -2584
Tax Summary
I
I
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
w
FEDERAL 356000972 74.80 0.00 FEDERAL E85 408.750 1,138.58 0.18300
4.38 0.00 FEDERAL GASOLINE 23.900 73.30 0.18300
FEDERAL TOTALS_ 79.18 432.650 1,211.88
IN 356000972 0.00 4.30 STATE EXCISE GASOLINE 23.900 73.30 0.18000
-69.59 0.00 STATE SALES E85 408.750 1,138.58 0.07000
-4.23 0.00 STATE SALES GASOLINE 23.900 73.30 0.07000
IN STATE TOTALS
1 -7182 4.30
ACCOUNT TOTALS 153.00 4.30
i
(c) WRIGHT EXPRESS CORPORATION 2011 PAGE 1
I
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 25390039
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 28 02 -28 -2011 03 -25 -2011 1,072.88
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 074 01 -31 -2011 16:09 SMITH, KEITH 14,500 E85 16.470 2.760 45.45 45.45
MH 001 074 02 -03 -2011 12:22 SMITH, KEITH 14,500 E85 16.340 2.759 45.09 45.09
MH 001 078 02 -05 -2011 12:18 SMITH, KEITH 14,500 E85 17.000 2.758 46.89 46.89
MH 001 074 02 -07 -2011 14:48 SMITH, KEITH 14,500 E85 17.190 2.758 47.41 47.41
MH 001 074 02 -09 -2011 07:03 SMITH, KEITH 14,500 E85 14.750 2.758 40.68 40.68
MH 001 078 02 -11 -2011 16:54 SMITH, KEITH 14,500 E85 16.460 2.759 45.42 45.42
MH 001 074 02 -15 -2011 12:56 SMITH, KEITH 14,500 E85 18.000 2.759 49.67 49.67
MH 001 074 02 -18 -2011 12:09 SMITH, KEITH 14,500 E85 15.880 2.758 43.80 43.80
MH 001 078 02 -22 -2011 1911 SMITH, KEITH 14,500 E85 22.790 2.859 65.15 65.15
MH 001 074 02 -24 -2011 13:52 SMITH, KEITH 14,500 E85 11.930 2.859 34.11 34.11
MH 001 078 02 -26 -2011 13:13 SMITH, KEITH 14,500 E85 13.610 2.860 38.92 38.92
CARD SUBTOTALS 180.420 502.59
0002 MH 001 074 02 -01 -2011 06:09 HULETT, MARK 80,346 UNL 10.470 3.181 33.30 33.30
MH 001 078 02 -05 -2011 01:54 HULETT, MARK 80,558 E85 11.750 2.757 32.40 32.40
MH 001 078 02 -09 -2011 16:29 HULETT, MARK 80,775 E85 12.690 2.759 35.01 35.01
MH 001 078 02 -14 -2011 16:20 HULETT, MARK 80,982 E85 13.680 2.760 37.75 37.75
MH 001 074 02 -17 -2011 12:17 HULETT, MARK 81,176 E85 11.960 2.760 33.01 33.01
MH 001 074 02 -22 -2011 07:09 HULETT, MARK 81,403 UNL 13.430 2.978 40.00 40.00
MH 001 078 02 -24 -2011 16:52 HULETT, MARK 81,646 E85 13.010 2.859 37.20 37.20
CARD SUBTOTALS 86.990 248.67
0003 MH 001 074 02 -09 -2011 16:30 STEELE, JEFF 23,271 E85 22.740 2.759 62.74 62.74
MH 001 074 02 -15 -2011 08:00 STEELE, JEFF 23,535 E85 24.190 2.759 66.74 66.74
MH 001 095 02 -20 -2011 17:14 STEELE, JEFF 23,794 E85 25.010 2.759 69.00 69.00
MH 0 095 02 -25 -2011 18:36 STEELE, JEFF 23,991 E85 23.240 2.859 66.45 66.45
CARD SUBTOTALS 95.180 264.93
0004 MH 001 074 02 -07 -2011 08:25 HABOUSH, DAVE 36,631 E85 21.020 2.759 58.00 58.00
MH 001 074 02- 15.2011 14:47 HABOUSH, DAVE 36,891 E85 24.960 2.759 68.86 68.86
MH 001 074 02 -22 -2011 17:54 HABOUSH, DAVE 37,151 E85 24.080 2.858 68.83 68.83
CARD SUBTOTALS 70.060 195.69
TOTAL PURCHASES 432.650 1,211.88
Y -T -D PURCHASES 860.810 2,420.76
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 15 737.69
MH 001 078 MEIJER 5303E SOUTHPORT RD INDIANAPOLIS IN 46237 8 338.74
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 2 135.45
PRODUCTS: E85= ETHANL85 UNL UNLEADED
FLEET SERVICES
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VOUCHER NO. WARRANT N O.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$1,072.88
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 25390039 42- 314.00 $1,072.88 1 hereby certify that the attached invoice(s), or
1120 42- 314.00 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
d
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))
25390039 $1,072.88
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