166536 12/09/2008 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH
CHECK AMOUNT: $83.80
PO BOX 105080
CARMEL, INDIANA 46032 ATLANTA GA 30348 -5080 CHECK NUMBER: 166536
CHECK DATE: 12/9/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 BG1298219 83.80 BG1298219
i
2M4012 120153201,00008
Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
Account BG1298219
Please reference account on all payments
I�III II�I�Illll�l �III�IIIIIII 2 STATEMENT# NP15498892
DATE 12/01/2008
CITY OF CARMEL ITILITIES DUE DATE 12/1512008
1 CIVIC SQ TOTAL BALANCE DUE $109.27
CARMEL IN 46032 -2584
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 11/30/2008
Date Description Amount Due
12/01/2008 Fleet 1315591 Name: CITY OF CARMEL- UTILITIES $25.00
Current Activity
Previous
Statement Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
11/01/2008 $83.80 $0.00 0.000 $25.47 $109.27
FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
VOUCHER 086862 WARRANT ALLOWED
69001 IN SUM OF
CRYSTAL FLASH
P
4 Po a Af j h 6P 30348
I„' O
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
NP15498892 01- 7202 -05 $83.80
I
i
Voucher Total $83.80
0M3t distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
69001
CRYSTAL FLASH Purchase Order No.
PETROLEUM CORPORATION Terms
PO BOX 684 Due Date 12/8/2008
INDIANAPOLIS, IN 46206
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/8/2008 NP15498892 $83.80
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 i
,J e
i d/o 2 cam' �-f' �L f.S
Date Officer