160318 06/10/2008 0 ,s� CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH
0 P o Box 664 CHECK AMOUNT: $687.92
1, CARMEL, INDIANA 46032 INDPLS IN 46206 CHECK NUMBER: 160318
CHECK DATE: 6/10/2008
DEPARTMENT c ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DE
1120 4231400 687.92 GASOLINE
I
Invoice
Crystal Flash Petroleum Corp.
P.O. Box 684
Indianapolis, IN 46206 USA
(317) 879 -2849
Account Number: 613375 (317) 879 -2855
Invoice Date: 05/19/08
Transactions from 05/01/08 to 05/15/08
City of Carmel -Fire
One Civic Square
Attn: Shelly Lingelbaugh
Carmel, Indiana 46032 Pump
Transaction Date Purchase Site Product Odometer Qty Price Amount
Cara# 5671482-- -rar -4501
05/01/08 08:20 am CF CARMEL Mid NL 14,500 17.482 3.249 56.80
05/02/08 08:27 am CF CARMEL Mid NL 14,500 8.897 3.239 28.82
05/06/08 11:08 am CF CARMEL Mid NL 14,500 10.522 3.139 33.03
05/08/08 08:24 am CF CARMEL Mid NL 14,500 13.489 3.359 45.31
05/09/08 08:17 am CF CARMEL Mid NL 14,500 12.499 3.349 41.86
05/13/08 08:23 am CF CARMEL Mid NL 14,500 23.102 3.259 75.29
Totals for Card# 5671482 85.991 281.11
Card# 5671484 car 4503
05/01/08 12:58 pm CF CARMEL Mid NL 24,247 10.274 3.239 33.28
05/03/08 08:23 pm CF CARMEL Mid NL 24,423 9.375 3.219 30.18
05/06/08 07:19 am CF S EMERSON 87 NL 24,705 13.492 3.559 48.02
05/09/08 07:23 pm CF CARMEL Mid NL 24,938 11.645 3.299 38.42
05/12/08 06:14 am CF CARMEL Mid NL 25,169 12.015 3.259 39.16
05/14/08 03:36 pm CF CARMEL Mid NL 25,445 15.099 3.459 52.23
Totals for Card# 5671484 71.900 241.29
Card# 5671492 Car 4508
05/02/08 10:37 am CF CARMEL Mid NL 54,321 10.586 3.239 34.29
05/05/08 08:58 am CF CARMEL Mid NL 54,505 10.291 3.159 32.51
05/08/08 10:03 am CF CARMEL Mid NL 54,893 12.962 3.359 43.54
05/09/08 02:25 pm CF CARMEL Mid NL 55,029 7.814 3.299 25.78
05/12/08 02:19 pm CF CARMEL Mid NL 55,229 10.828 3.259 35.29
Page 1 of 2
Invoice
Crystal Flash Petroleum Corp.
P.O. Box 684
Indianapolis, IN 46206 USA
(317) 879 -2849
Account Number: 613375 (317) 879 -2855
Invoice Date: 05/19/08
Transactions from 05/01/08 to 05/15/08
City of Carmel -Fire
One Civic Square
Attn: Shelly Lingelbaugh
Carmel, Indiana 46032 Pump
Transaction Date Purchase Site Product Odometer Qty Price Amount
..Gard #_567_1492___ __.Car 4508.
05/14/08 08:54 am CF CARMEL Mid NL 55,412 10.546 3.459 36.48
Totals for Card# 5671492 63.027 207.89
Invoice Taxes Amount Due Exempt
Indiana Inspection Fee 2.21 No Products Total: 605.30
Indiana Excise Tax Gas 39.77 No Tax Total: 124.99
Federal Excise Tax Gas 40.43 No Invoice Total: 730.29
Indiana Excise Tax Distillate 0.00 No
Federal Excise Tax Distillate 0.00 No Tax Exempt Total: 42.37
Indiana Sales Tax 42.37 Yes Net Invoice: 687.92
Leaking Underground Storage Tank 0.22 No
Tax Total 124.99 Total Due: 687.92
If Payment received by Thursday, 05 /29 /2008Subtract from Total Due: $8.84
Date For Period Amount
Balance Fwd 0.00
Invoice 10/05/07 49/01/07 to 09/30/07 1,337 -96
Invoice 11/06/07 10/16/07 to 10/31/07 786.21
Payment 11/12/07 09/01/07 to 09/30/07 1,285.54
Discount 10/31/07 10/16/07 to 10/31/07 -16.25
Discount 12/20/07 09/01/07 io 09/30/07 -16.25
Discount 12/20/07 10/16/07 to 10/31/07 -10.62
Prev Invoice Balance 795.51
Current Invoice 687.92
Balance Due 1,483.43
Page 2 of 2
VOUCHER NO. WARRANT NO.
Crystal Flash ALLOWED 20
IN SUM OF
P.O. Box 684
Indianapolis, IN 46206
$687.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 42- 314.00 $687.92 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
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 invoices) or bill(s))
$687.92
1 hereby certify that the attached invoice(s), or bill(s), is (ate) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer