199317 07/19/2011 �M CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
e \f ONE CIVIC SQUARE FLEET SERVICES
CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $862.94
CAROL STREAM IL 60197
CHECK NUMBER: 199317
CHECK DATE: 711 912 01 1
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 26473134 862.94 0496 -00- 138012 -0
Invoice Statement
INVOICE NUMBER: 26473134
S ID ACCOUNT NAME: City of Carmel Fire
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496 00 138012 3400.00 30 JUN 30 2011 JUL 26 2011 862 94
LATE i ACTIVITY DESCRIPTION HARGESIDEBST:SI PAYMENTSIGREDITS
JUN 24.201.1..>! PAYMENT THANK YOU 518.26
JUN 3�7 >2011. FUEL PURCHASES $6294
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 BILUNG DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS )PURCHASES DEBITS CREDITS LATE FEE NEW BALANCE
518.26 518.26 862.94 0.00 0.00 0.00 862.94
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 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
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 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 [ate 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- 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: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE2 OF 6
1:.('..ARDIN
0002 Asst Chief Hoffman 74957
DATE TIME SITE ADDRESS PROMPT TRAIN ODOM. PROD UNITS CO571 FUEL OTHER EXEMPT NET$ REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 2,301
JUN -18 15:23 2166 E Hadley Plainfield IN 1 driver Op 3,200 UNIL 24,960 3.479 85.86 4.67- 8229 9.58
JUN -23 07:07 2166E Hadley Plainfield IN 1 ddver OF 3,537 UNIL 24.000 3.399 81.58 439- 7719 9.09
JUN-29 16:32 2080 1 Shadeland A Indianapol IN 1 driver CP 3,927 UNIL 27.039 3,479 94.07 1046- 8361 4.87-
262 51:::;
.1: 626:
.42, 54
239 789_
�XXX:.:
PERIOD AVERAGES: MPG, PPG, CPrV 21.40 3.454 0.16
YTD AVERAGE: PPG 3.548
TO ENSURE MORE ACC L JRATE M LEAGE RE ORTI NC VEHICLE MI EAGE STAT STICS ARE I T
CALCU -ATED WHEN KEY ODOMETER READINGS ARE NO WITHI AN CCEPTABLE RANGE.
TRANSACTION CODES:
OP Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
se JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE1 OF 6
CARO ;CARD EMBOSSiNiGr
gazt:IDENTI
0001 1 Chief Smith 163225 1
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST[ FUEL OTHER EXEMPT NET$ REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 14,500
JUN-03 16:43 3801 N Post Road Indianapol IN 1 driver Op 14,500 UNIL 8.470 4.099 34.74 1.55- 33.19 3.59
JUN-13 09:05 545 S Range Line R Carmel IN 1 driver OF 14,500 UNIL 16,710 3,399 56.80 3.06- 53.74 6.33
JUN-16 13:11 545 S Range Line R Carmel IN 1 driver OP 14,500 UNIL 12.290 3.399 41.77 2,25- 39.52 4.65
JUN-17 08.49 545 S Range Line R Carmel IN 1 driver OP 14,500 UNIL 13.560 3.399 46.17 2,49- 43.68 5.14
JUN-20 I7:05 3801 N Post Road Indianapol IN 1 driver OP 14,500 UNIL 15,400 3.499 53.91 2.82- 51.09 5.93-
PERIOW TOTALS 25.64
YTDTOTALS
857 :9 43.49 81371 9317
PERIOD AVERAGE: PPG 3.512
YTD AVERAGE: PPG 3.609
To ENSURE MORE ACCI, IRATE M LEAGE RE ORTINC VEHICLE MI -EAGE STAT STICS ARE NCT
CALCU -ATED WHEN KEY OD METER READINGS ARE NO WITHIN AN CCEPTABLE RANGE.
TRANSACTION CODES:
OP Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
LN JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE 3 OF 6
CARD IUMl3ER;:„ o'
'f.ji E
Vlhd
0004 EMS Chief Hulett 70614
DATE TIME SITE ADDRESS PROMPT TRAIN ODOM, PROD UNITS COST/ FUEL OTHER EXEMPT NET REPORTED EXC,
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 85,711
MAY-31 15:00 645 S Range Line R Carmel IN 1 driver OP 86,880 UNL 11.660 3.399 3965 2,13- 37.52 4.42
JUN-20 13:35 545 S Range Line R Carmek IN 1 driver OP 87,996 UNL 9,380 3.339 31.35 1.72- 29.53 3.52
JUN-22 09.30 545 S Range Line R Carmel IN I driver OP 88,172 UNL 11.080 3.339 37.00 2,03- 34.97 4.15
JUN-29 09:35 545 S Range Line R Carmel IN 1 driver Op 88,610 UNL 12 3.259 41.00 2.30- 38.70 4.64-
PEMODTOTALS'..'. 14d�62
:17S,77- 4492
q r �p
NX...
jjq SO
PERIOD AVERAGE: PPG 3.333
YTO AVERAGE: PPG 3.345
TO ENSURE MORE ACC( )RATE M LEAGE RE QRTINC, VEHICLE MI -EAGE STAT STICS ARE i T
CALCU.ATED WHEN KEY ODOMETER READINGS ARE NOT WITHIN AN CCEPTABLE RANGE.
TRANSACTION CODES:
OP Outdoor Payment Terminal
No.-
PARENT ACCOUNTS REPORT FOP,:
City of Carmel Fire City of Carmel Fire
NO 0496 -00- 138012 -0
JUN -01 -2011 TO JUN -30 -2011
Purchase Activity Report PAGE OF 6
GAF2D1VUMgER GARDEMBOSSING> VEHItF_ElnSSET1DEhITIFIER VEFI[CLE'DESCRIPFION PLpT115 $T VlN
0005 1 1 Bruce Knott 77258
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COSTI FUEL OTHER EXEMPT NET REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER
JUN -08 13:07 777 Scott St Napoleon OH 1 driver OP 26,060 UNL 21.540 3.699 79.68 3.94- 75.74 6.03-
PERIOIO. TOTALS 21,54Q 79 68 3 94 75 74 6 03
YTD TOTALS
79 66 94 T.S 74 6 03
PERIOD AVERAGE: PPG 3,699
YTD AVERAGE: PPG 3.699
To ENSURE MORE ACCI, RATE M LEAGE RE ORTIN VEHICLE MI EAGE STAT STICS ARE NCT
CALCU -ATED WHEN KEY ODOMETER :READINGS ARE NO WITHIN AN I CCEPTABLE RANGE.
TRANSACTION CODES:
OP Outdoor Payment Terminal
PARENT ACCOUNT. REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE6 OF 6
L.VI
CA EME30$51N5 .��T:NP--HIGLE;I.AWET
CARD: NUMSEW:!`;:�:; RD:� N
0009 kaith Freer 70615
DATE TIME SITE ADDRESS PROMPT TRAIN ODOM. PROD UNITS COS71 FUEL$ OTHER EXEMPT NET REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 138,076
JUN-06 16:28 14554 Herrman BIv Noblesvill IN 1 driver OP 139,554 UNL 13,491 4.059 54.76 5.73- 49.03 2.43
JUN-20 0821 14554 Harriman Blv Noblesvill IN 1 driver OP 140,560 UNL 12.286 3.499 43.00 4,77- 38.23 2.21-
JUN-23 16:20 645 S Range Line R Carmel IN 1 driver OP 140,787 UNL 13.850 3.299 45.71 2.53- 43,18 5.15
JUN-25 00-31 863 S Main St Upland IN 1 driver OP 141,021 UNL 4.413 3.399 15.00 1,69- 13.31 0.79-
OD 44 042
PERIOD 0:;::::�:
1513:47—: ::;::;1.417.5 N N' 10 8"
157,644:
PERIOD AVERAGE: PPG 3,598
YTD AVERAGE: PPG 3.502
TO ENSURE MORE ACC RATE M LEAGE RE ORTINQ VEHICLE M EAGE S7A7 STICS ARE NCT
CALCU -ATEDWHEN KEY ODOMETER READINGS ARE NO WITHIN AN ACCEPTABLE RANGE,
TRANSACTION CODES:
OP Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
He JUN-01-2011 TO JUN-30-2011
Purchase Activity Report PAGE 5 OF 6
Cfi13D:IVEIMBER z' :GAROEf41BOSSING'. VEHICLE l,4SSE1'IDEIVT.I�IER dEf3ECL� DESCRIPTION PLATE ST ::VIN
0008 Chris Ellison 182907
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL OTHER EXEMPT NET REPORTED EXC.
INFO CODE UNIT TAX TAX CODES
PREVIOUS ODOMETER 7,151
JUN-03 08:15 545 S Range Line R Carmel IN 1 driver OR 7,316 UNL 11.910 3.399 40.50 2.18- 38.32 4.51-
165
PEWOOi:707ALS"
A 4.5
PERIOD AVERAGES: MPG, PPG, CPU 13.85 3.401 0.25
YTD AVERAGE: PPG 3.266
To ENSURE MORE ACC k IRATE M LEAGE RE DORTING, VEHICLE M I EAGE STAT STICS ARE N
I CT
CALCU -ATED WHEN KEY ODOMETER READINGS ARE WITHIN AN 'CCEPTABLE RANGE.
TRANSACTION CODES:
OP Outdoor Payment Terminal
No.-
PARENTACCOUNT: REPORTFOR:
City of Carmel Fire City of Carmel Fire
L MJ 0496-00-138012-0
JUN -01 -2011 To JUN-30-2011
Financial Summary PAGE1 OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES
CITY cOS71FEE TOTAL FEES FUEL$ OTHER$ EXEMPTED TAX NET$ PURCHASES
ACCOUNT TOTALS Unleaded Regular 923.55 60.61- 862.94
P.. ERIOD D 00 923;55 OOD 6U 51 862 94 94
T :21 7 2
ACCOUNTS RECEIVABLE SUMMARY Invoice 26473134
PREVIOUS BALANCE 51826
PAYMENTS 51&26
PURCHASES 862.94
DEBITS 0.00
CREDITS 0.00
AMOUNT DUE 862.94
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
Ne 0496 -00- 138012 -0
JUN -01 -2011 TO JUN -30 -2011
Site Summary ary PAGE OF 2
BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL OTHER EXEMPT NET$
TRANS TAX
Dairy Mart 777 Scott St Napoleon OH 43545 1 21.540 79.68 3.94- 75.74
14554 Harriman Blvd Noblesville IN 46050 2 25.779 97.76 10.50- 87.26
2080 N Shadeland Ave Indianapolis IN 46219 1 27.039 94.07 10,46- 83.61
MARATHON 863 S Main St Upland IN 46989 1 4.413 15.00 1.69- 13.31
SHELL 545 S Range Line Rd Carmel IN 46032 9 113.040 379.95 20.69- 359.26
2166 E Hadley Plainfield IN 46158 2 48.960 168,44 8.95- 159.48
3801 N Post Road Indianapolis IN 46226 2 23.870 88.65 4.37 84,28
PERIOD TOTALS 18 264.641 923.55 0.00 60.61- 862.94
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
JUN-01-2011 TO JUN-30-2011
Tax Summary PAGE OF 2
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT GLASS UNITS GROSS$ TAX RATE
FEDERAL 355000972 JUN -18 -2012 -48L44 Federal Excise Gasoline Unblended 264 923.55 0.18300
iFEDERA
64
'640,:
4 44i
I
.1.1.1-1 1 #9 55 Ci
IN 355000972 JUN-18-2012 -12.17 -37.27 State Sales Gasoline Unblended 243.100 843.87 0.07000
-43,73 State Excise Gasoline Unblended 243.100 843.87 0.18000
IN S TO'rALs
1 2 1 7
-6.03 State Excise Gasoline Unblended 21.540 79.68 0.28000
.0111.:�STATE P.T. A S
L
ACCOUNT TOTALS -60.61 -87.03
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$862.94
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 I 26473134 I 42- 314.00 I $862.94 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
JUL 18 2011
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))
26473134 $862.94
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
2a
Clerk- Treasurer