196221 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $50.82
CARMEL, INDIANA 46032 PO BOX 6293
!p hcoN �u. CAROL STREAM IL 60197 CHECK NUMBER: 196221
CHECK DATE: 4/13/2011
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBE A DESCRIPT
1110 4231400 25659124 50.82 0496 -00- 138007 -0
I nvaive Statement
INVOICE NUMBER: 25659124
ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496.00-138007 -0 2100.00 31 MAR -31 -2011 APR 26-2011 90.82
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
MAR -18 -2011 PAYMENT THANK YOU 36.93
MAR -31 -2011 FUEL PURCHASES 50.82
REMINDER
BALANCE INCLUDES PAST DUE AMOUNT IF PAYMENT HAS
BEEN MADE, PLEASE DISREGARD THIS NOTICE. PAST DUE
ACCOUNTS ARE SUBJECT TO SERVICE INTERRUPTION
PURCHASE$ RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
CURRENT PERIO ONE BILLING PERIOD PAST DUN TWO BILLING PERIODS PAST DUE I THREE+ BILLING PERIODS PAST DUE1 TOTAL DUE
60.82 30.00 0.00 0.00 90.82
PREVIOUS BALANCE PAYMENTS (,)PURCHASES )DEBITS CREDITS LATE FE NEW BALANCE
66.93 36.93 50.82 0.00 0.00 10.00 90.82
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 monthly rate of RATE of fee for this period which is
2.00 24.00 30.00
SEE REVERSE Si DE FOR IMPORTANT INFORMATION AND TERMS.
TO FNq IPF PP0PFP CPFr IT TPAP AT PFPF:0PGTInN GNTI INCI I Ir)P Pr)TTr)KA PnPTI(1N WITW Vfll IP PGYMPMT
Prescribed by State board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Fleet Services Purchase Order No.
PO Box 6293
Carol Stream, IL 60197 -6293 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/31/11 25659124 payment for gasoline 50.82
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
PO Box 6293
Carol Stream, IL 60197 -6293
50.82
ON ACCOUNT OF APPROPRIATION FOR
Police general fund
I)L( 9� b D X06 -7 -0 Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 25659124 314 50.82 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
April 6, 20 11
Si
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund