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Home My WebLink About198387 06/21/2011 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 Q� ONE CIVIC SQUARE SHELL CREDIT CARD CENTER I' CHECK AMOUNT: $459.43 CARMEL, INDIANA 46032 PO BOX 183019 ox COLUMBUS OH 43218 -3019 CHECK NUMBER: 198387 CHECK DATE: 6/2112011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM DESCRIPTION 1110 4231400 065129116106 4S9.43 065 129 -116 www.shel)tleetcard. acco unton li ne.co m ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: SHELL CARD CENTER 065- 129 -116 9 065129116106 P.O. BOX 669081 CLOSING DAVE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 06 -05 -2011 06 -30 -2011 30 TELEPHONE: 1.800-377.5150 FAX: 1 -515. 226 -4045 NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE 481.28 .00 538.77 560.62 CR .00 459.43 PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 06 -30 -2011 The "ANNUAL PERCENTAGE RATE" includes all transaction and periodic finance charges imposed this billing period on all balances on which finance charges were imposed. If the "ANNUAL PERCENTAGE RATE" is N /A, no finance charges (after adjustments) were imposed this billing period. Finance charges may be accruing on promotional balances and may be billed to your account under the terms of the promotional offer. Refer to the corresponding APR for the APR that applies to each balance. CARD TRAN86CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 05 -29 PAYMENT THANK YOU 538.77 CR 0006 05 -29 21:23 0153973 1590 N RILEY HWY SHELBYVILLE IN 17.892 8 UNL 3.27 69.78 17.892 GAL UNLEADED $69.78 TOTAL CARD 0006 17.892 3.27 69.78 0009 05 -20 01:12 0591958 2040 E WASHINGTON INDIANAPOLIS IN 15.831 8 UNL 2.90 61.11 15.831 GAL UNLEADED $61.11 0009 05 -25 12:43 0601278 2040 E WASHINGTON INDIANAPOLIS IN 12.873 8 UNL 2.36 50.99 12.873 GAL UNLEADED $50.99 0009 05 -27 15:49 0394429 7788 E 96TH ST FISHERS IN 10.100 8 UNL 1.85 40.02 Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump 2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale SCHEDULE OF LATE FEE PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE (MONTHLY) PERCENTAGE RATE SEE REVERSE SIDE 0.000% 0.00% 0.00 .00 6057 0020 GUG l 7 2 110605 9366 8015 SH33 3624 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0003624 Page 1 of 2 FLET2GUG Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week. Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. Note: Your account is owned and serviced by Citibank (South Dakota), N.A. PLOCOMM Rev 06/08 www.shelifleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: SHELL CARD CENTER 065.129 -116 9 065129116106 P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 06 -05 -2011 06 -30 -2011 30 TELEPHONE: 1.800 -377 -5150 FAX: 1 -515- 226 -4045 CARD TRANS kCTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 10.100 GAL UNLEADED $40.02 0009 06 -02 15:06 0780940 7203 N MICHIGANRD INDIANAPOLIS IN 10.521 8 UNL 1.93 43.77 10.521 GAL UNLEADED $43.77 TOTAL CARD 0009 49.325 9.04 195.89 0010 05 -07 19:15 0352161 1821 E 151 ST ST CARMEL IN 12.221 8 UNL 2.24 50.0 12.221 GAL UNLEADED $50.00 0010 05 -12 0535 0407809 1821 E 151 ST ST CARMEL IN 16.742 8 UNL 3.06 70.30(/ 16.742 GAL UNLEADED $70.30 0010 05 -15 16:06 0918094 808 W MAIN ST CARMEL IN 11.061 8 UNL 2.02 45.01 11.061 GAL UNLEADED $45.01 0010 06 -03 10:34 0501908 1230 S RANGELINE RD CARMEL IN 12.152 8 UNL 2.22 50.30 12.152 GAL UNLEADED $50.30 TOTAL CARD 0010 52.176 9.54 215.61 GRAND TOTAL 119.393 21.85 481.28 FEDERAL EXCISE TAX 119.3 GALLONS GASOLINE 21.85 CR Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump 2 Keyed Sale Authorization 5 Keyed Sale without Authorization 9 Manual Sale 6057 0020 GUG 1 7 2 110605 9366 8015 SH33 3624 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0003624 Page 2 of 2 FLET2GUG Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week. Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. Note: Your account is owned and serviced by Citibank (South Dakota), N.A. PLOCOMM Rev 06/08 VOUCHER NO. WARRANT NO. Shell Fleet Plus ALLOWED 20 Processing Center IN SUM OF P.O. Box 183019 Columbus, OH 43218 -3019 $459.43 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1110 65129116106 42- 314.00 $459.43 I hereby certify that the attached invoice(s), or bills) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday, June 17, 2011 Q 3Z, k Chief of Police 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)) 06/16/11 65129116106 monthly payment $459.43 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