199318 07/19/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES
i CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $886.10
CAROL STREAM IL 60197 CHECK NUMBER: 199318
CHECK DATE: 7/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 26474116 886.10 0453 -00- 794629 -6
FLEET SERVICES INVOICE /STATEMENT
INVOICE NUMBER: 26474116
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 8100.00 30 06 -30 -2011 07 -26 -2011 886.10
OATS ACTIVITY DESCRIPTION GHARGESi.D597S. PAYMENTS /CREDITS
<;06 17 2011 PAYMENT RECEIVED THANK YOU 948.63
Q6 3Q -2011 RETAIL FUEL PURCHASES 864 14
OS 30 -2011 MONTHLY CARD CHG 22.90
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 INVOICE/STATEMENT
PREVIOUS BALANCE PAYMENTS )PURCHASES )DEBITS CREDITS LATE FEE )NEW BALANCE
948.63 948.63 864.10 22.00 0.00 0.00 886.10
$10.00 MINIMUM LATE FEE
PAY ONLINE AT: www- wexonline.com
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 appJying a monthly 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 void late fees. Mail payments to:
Allow 10 business days prior to the due date for mailing to help
avoid
by the applicable periodic rate to determine your late fee. In the a
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 50197 -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.corn.
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:/AArww.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.
C ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 06 -30 -2011
FL S E RV I■ E ACCOUNT NO: 0453-00-794629-6
VVV DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SO
CARMEL IN 46032 -2584
Tax Summary
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
FEDERAL 356000972 -50.53 0.00 FEDERAL E85 276.140 932.49 0.18300
-2.28_ 000 FEDERAL GASOLINE 12.470 44.74 0.18300
F!~DERAL Ttl7ALS 288;610. 977;23.
IN 356000972 0.00 2.24 STATE EXCISE GASOLINE 12.470 44.74 0.18000
-57.69 0.00 STATE SALES E85 276.140 932.49 0.07000
-2.63 0.00 STATE SALES GASOLINE 12.470 44.74 0.07000
)N STATE TOTAI S.... 6q 32 2 24
ACCOUNT TOTALS 413.13 2.24
(c) WRIGHT EXPRESS CORPORATION 2011 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 26474116
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE1 OF 2
ACCOUNT NUMBER CREDIT LIMIT S THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00 794629 -6 8,100.00 30 06 -30 -2011 07 -26 -2011 886.10
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 074 06 -02 -2011 12:13 SMITH, KEITH 14,500 E85 16.190 3.398 55.02 55.02
MH 001 074 06 -07 -2011 08:42 SMITH, KEITH 14,500 E85 23.760 3.399 80.77 80.77
MH C01 074 06 -10 -2011 12:47 SMITH, KEITH 14,500 E85 21.890 3.399 74.40 74.40
MH 001 074 06 -22 -2011 12:20 SM17H, KEITH 14,500 E85 18.100 3.299 59.72 59.72
MH 001 078 06 -24 -2011 13:11 SMITH, KEITH 14,500 E85 13.310 3.298 43.90 43.90
CARD SUBTOTALS 93.250 313.81
0002 MH 001 078 06 -05 -2011 16:02 HULETT, MARK 87,056 E85 10.890 3.398 37.00 37.00
MH 001 078 06 -07 -2011 15:20 HULETT, MARK 87,313 E85 13.540 3.399 46.02 46.02
MH 001 074 05 -10 -2011 13:42 HULETT, MARK 87,488 E85 11.470 3.400 39.00 39.00
MH 001 078 06 -14 -2011 13:11 HULETT, MARK 87,677 E85 12.250 3.400 41.55 41.65
MH 001 078 06 -17 -2011 14:18 HULETT, MARK 87,843 E85 10.300 3.399 35,01 35.01
MH 001 078 06 -24 -2011 20:47 HULETT, MARK 88,398 E85 13.140 3.299 43.35 43.35
CARD SUBTOTALS 71.590 242.03
0003 MH 001 095 06 -01 -2011 10:54 STEELE, JEFF 2,700 E85 25,880 3.399 87.97 87.97
MH 001 095 06 -06 -2011 16:06 STEELE, JEFF 2,967 E85 25.220 3.398 85,71 85.71
CARD SUBTOTALS 51.100 173.68
0004 MH 001 074 06 -14 -2011 08:06 HABOUSH, DAVE 2,389 E85 20.240 3.399 68.79 68.79
MH 001 074 06 -19 =2011 20:31 HABOUSH, DAVE 2,630 E85 23560 3.399 80.08 80.08
MH 001 074 06 -24 -2011 21:30 HABOUSH, DAVE 2,800 E85 16,400 3.299 54.10 5410
CARD SUBTOTALS 60.200 202.97
0007 MH 001 154 06 -18 -2011 07.16 SMITH, KEITH 120,111 UNL 12.470 3.588 44.74 44.74
CARD SUBTOTALS 12.470 44.74
TOTAL PURCHASES 288.610 977.23
Y -T -D PURCHASES 2,242.570 6,944.27
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street City State Zip
MH 001 074 MEIJER 1426 W CARMEL OR CARMEL IN 45032 8 51188
MH 001 076 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 5 246.93
MH C01 095 MEIJER 8225 E 95TH ST INDIANAPOLIS IN 46256 2 173.68
MH 001 154 VIDJER 17000 MERCANTILE RD NOBLESVILLE IN 46050 1 44.74
PRODUCTS: 285- ETHANL85 UNL UNLEADED
FLEET SERVICES
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VOUCHER NO. WARRANT NO.
Fleet Services ALLOWED 20
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$886.10
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 I 26474116 I 42- 314.00 $886.10 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 2019
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))
26474116 $886.10
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