166535 12/09/2008 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH
CARMEL, INDIANA 46032 PO BOX 105080 CHECK AMOUNT: $148.15
ATLANTA GA 30348 -5080 CHECK NUMBER: 166535
CHECK DATE: 12/912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
7205 4231400 BG1298100 148.15 BG1298100
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2fi13401. 2W8120153201 00W5
CRY_S ,AL 'F�.� H Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
Account BG1298100
Please reference account on all payments
II II� Illllll I� ��I II� Illll s STATEMENT NP15498887
DATE 121D112008
CITY OF CARMEL MAINTENANCE DUE DATE 1211512008
1 CIVIC SQ TOTAL BALANCE DUE $411.90
CARMEL IN 46032 -2684
PAYMENT TERMS Net 14 days MN
Your account terms and conditions include late fee, finance charge, and statement fee provisions which have been waived,
These provisions will be applied going forward. For free online statements and payments, log onto www.fleetnet.net.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 11130/2008
Date Description Gallons Amount Due
12/01/2008 Fleet 1315492 Name: CITY OF CARMEL- MAINTENANCE 77.762 $173.15
Current Activity
Previous
Statement. Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
11101/2008 $237.43 $0.00 77.762 $174.47 $411.90
FOR P ROPER PA YMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
2671 1.2"120153200 A45
C/TY=AJz7PE..al�A FLEET MANAGEMENT REPORT
PO BOX 105080
ATLANTA, GA 30348 -5080 Account BG1298100
FLEET 1315492
Provided By: Name: CITY OF CARMEL MAINTENANCE
Crystal Flash Petroleum PL
(800) 903 -9368 MATCHING STATEMENT NP15498887
Page: 1 of 1
CITY OF CARMEL MAINTENANCE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 11/4/2008 11/30/2008
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 77.762 $111.09 $14.43 $22.63 $0.00 $148.15
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Late Fee on Invoicek 151321rB $2
Finance Charge $1.32
Report Total $174.47
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 0
EXCEPTION CODES:
11 Odometer entry is out of sequence.
Trans coon D a Lfor Custo er NW1315492 '"GIIY' O CARiNEL= MAINTENANCE 19'0i/2Q08 �t'113UI2008 I
J::..r .a.,u ...N.:.° ..4 I, rr s
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE"
5$14Q0 =CRASS 42 0 3 k f WR r H d 3
"�'"w M t.. x a,:zfi: d -fi .fie n.:,,;, 51
and a a ,.mswa ';��cM k;«`
11101 11:06 885419 DRIVER 1 0 0.0 UNL 15834 1.70330 0.49518 $34.82 11
11105 16:38 885419 DRIVER 1 0 0.0 UNL 15.687 1.51650 0.48229 $31.36 11
11114 16:32 885419 DRIVER 1 0 0.0 UNL 16.040 1.42270 0.47556 $30.46 11
11120 11:43 885419 DRIVER 1 0 0.0 UNL 13.596 1.32910 0.46934 $24.46 11
11/25 11:10 885419 DRIVER 1 0 0.0 UNL 16.605 1.17070 0.45770 $27.05 11
Miles: 77.762 $148.15
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
PTSCribed 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
Crystal Flash Petroleum PL Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12.10110-8- NP15498, G,8s $411.90
Total 'S411 90
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 NtPJG WARRANT NO.
I Flash e ro eum Corp ALLOWED 20
OX lubU80 IN SUM OF
Atlanta GA 30348 -5080
$4
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1245 Administration
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 PIP15498887 314 materials or services itemized thereon for
which charge is made were ordered and
received except
20
S
,Sign e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund