199332 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
4� ONE CIVIC SQUARE FLEET SERVICES
CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $71.42
CAROL STREAM IL 60197 CHECK NUMBER: 199332
CHECK DATE: 7120/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 26503585 71.42 GASOLINE
Invoice Statement
INVOICE NUMBER: 26503585
L!90D 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
2100.00 30 JUN -30 -2011 JUL -26 -2011 106.42
]BATE ACTIVITY DESCRIPTION CHARGES/DESIT.SI PAYMENTSlCREDITS
„.:JUN.24:201' PAYMENT THANK YOU 564.06
JUN 30 <2b11 FUEL PURCHASES 81.42;
REMINDER
BALANCE INCLUDES PAST DUE AMOUNT IF PAYMENT HAS
BEEN MADE, PLEASE DISREGARD THIS NOTICE. PAST DUE
ACCOUNTS ARE SUBJECT TO SERVICE INTERRUPTION
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILUNG DATE MAY NOT APPEAR UNTIL THE NEXT INVOICElSTATEMENT.
CURRENT PERIO ONE BILLING PERIOD PAST DU TWO BILLING PERIODS PAST DU4 THREE BILLING PERIODS PAST DUE1 TOTAL DUE
71.42 35,00 0.00 0.00 106.42
PREVIOUS BALANCE PAYMENTS )PURCHASES )DEBITS CREDITS LATE FEE NEW BALANCE
599.06 564.06 61.42 0.00 0.00 10.00 106.42
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
apOying a month! y rate of RATE of fee for this period which is
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 1 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 e 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 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 subjectio late fees, suspension, ortermination
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- 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: /www_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- 395 -0809, or ACH payment.
Mail to P.O. Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
PARENT ACCOUNT: REPORTIFOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE 1 OF 2
jjj; PLA S F IN:
V
0145 822 Police
DATE TIME SITE ADDRESS PROMPT TRAIN ODOM. PROD UNITS COST/ FUEL OTHER EXEMPT NET$ REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 4,883
JUN-01 07.22 546 S Range Line R Carmel IN I Driver Op 5,060 SUP 2,750 4.089 11.29 0.51- 10.78 1.17
JUN-02 1120 10598 N College Av Indianapol IN I Driver OF 5,239 SUP 3.840 4.399 1691 0.70- 16.21 1.70
JUN -08 15,55 545 S Range Line R Carmel IN 1 Driver OF 5,371 SUP 4.290 4.099 1761 0,79- 16.82 1.82-
RR1Od TOTALS
43 ,'81
0 890: 45 81 2 00
:TOTALS
2�8 C
OFS
63: 6 55"
PERIOD AVERAGES, MPG, PPG, CPIV 44.81 4.207 0.09
YTD AVERAGE: PPG 4.173
To ENSURE MORE ACC RATE M LEAGE RE IORTINC, VEHICLE MILEAGE STAT STICS ARE NCT
CALCU.ATED WHEN KEY ODOMETER READINGS ARE NO WITHIN AN A CCEPTABLE RANGE,
TRANSACTION CODES:
OF Outdoor Payment Terminal
R
PARENT ACCOUNT. REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
He
JUN -01 -2011 TO JUN -30 -2011
Purchase Activity Report PAGE 2 OF 2
DEPART-MEN
IDENTIFIER r:
10117 1 790AAQ UNASSIGNED
DATE TIME SITE ADDRESS PROMPT TPAN ODOM. PROD UNITS COSTI FUEL OTHER EXEMPT NET REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 225
JUN-CS 08.15 10598 N Col4ge Av Indianapol IN 1 Driver OP 649 UNL 4,420 4.159 18.42 081- 17.61 1.90- 20 18 42 Q 81 1.i 61 90
A
Y7D;TOTA pq so 1:
L :8 13U
PERIOD AVERAGE: PPG 4.167
YTD AVERAGE: PPG 4.023
70 ENSURE MORE ACC RATE M LEAGE RE'ORTING, VEHICLE MI LEAGE STAT STICS ARE NC T
CALCU -ATED WHEN KEY ODOMETER READINGS ARE NO WITHIN AN ACCEPTABLE RANGE,
TRANSACTION CODES:
OP Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496 -00- 138007 -0
JUN -01 -2011 TO JUN -30 -2011
Financial Summary PAGE OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES
QTY COSTIFEE TOTAL FEES FUEL OTHER EXEMPTED TAX NET PURCHASES
Police Unleaded Super 46.81 2.00- 43.81
P RIOQ D 00 0'00. 2;00 43:81 43 Bi
121sT}.. W. 5.;60 999 >?V1 9j9911
UNASSIGNED Unleaded Regular 18.42 0.81 17.61
PERdOQ
0;00: 18:42 0,00 ;81 17;61, „j9761.!;
689:34 689.34
ACCOUNT TOTALS Unleaded Super 45.81 2.00- 43.81
Unleaded Regular 18.42 0.81 17,61
FEREOD 0.00; 64 23 000
YTD ..'i 11.001. $43; 7 Q00 4Q 72 808;45, 80845,;';
ACCOUNTS RECEIVABLE SUMMARY Invoice 26503585
PREVIOUS BALANCE 599.06
PAYMENTS 564.06
PURCHASES 61.42
DEBITS 0.00
CREDITS 0.00
LATE FEES 10.00
AMOUNT DUE 106.42
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496 -00- 138007 -0
He JUN -01 -2011 TO JUN -30 -2011
Site Summary PAGE OF 2
BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL OTHER EXEMPT NET
TRANS TAX
SHELL 545 S Range Llne Rd Carmel IN 46032 2 7,050 28.90 1.30- 27.60
10598 N College Ave Indianapolis IN 46280 2 8.260 35.33 1.51- 33.82
PERIOD TOTALS 4 15.310 64.23 0.00 2.81- 61.42
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
NO JUN-01-2011 TO JUN-30-2011
T ax Summary PAGE I OF 2
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS UNITS GROSS$ TAX RATE
FEDERAL 356000972 JUN -18 -2012 -2.81 Federal Excise Gasoline Unblended 15,310 64.23 0.18300
�TEDERAL: TOTALS�i�;;
2AT j::: 15 31 64.21
XY,
IN 356000972 JUN-18-2012 -3,83 State Sales Gasoline Unblended 16.310 154.23 0.07000
.2.76 State Excise Gasoline Unblended 15.310 64.23 0.18000
WSTATETO
ACCOUNT TOTALS -2.91 -6.59
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))
06/30/11 26503585 payment for gasoline $71.42
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197 -6293
$71.42
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1110 I 26503585 I 42- 314.00 I $71.42 1 hereby certify that the attached invoice(s), or
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
Thursday, July 14, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund