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Home My WebLink About203692 11/16/2011 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1 ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $931.53 CARMEL, INDIANA 46032 PO BOX 6293 CAROL STREAM IL 60197 CHECK NUMBER: 203692 CHECK DATE: 11116/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231400 27608227 931,53 0453 -00- 794629 -6 FLEET SERVICES INVOICE /STATEMENT INVOICE NUMBER: 27608227 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 31 10 31 2011 11 25 2011 931,53 ?AT ACTIVITY DESCRIPTION :CHAIR- �ESOESIT:S PAYMENTS /CREDITS :1{~14 201 1 PAYMENT RECEIVED THANK YOU 1,060.96 b31 2fit11 RETAIL FUEL PURCHASES 909,53; 31 11 MONTHLY CARD CHG 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 1 1 060.96 909, 53 22.00 0.00 0.00 931.53 $10.00 MINIMUM LATE FEE PAY ONLINE AT: www.wexonfine.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 applying 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 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 wilt 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.wexonline.com. shorter billing or payment cycle as offered by us. Online payments scheduled by 3:00 PM ET (on business days) d your payment due date falls anon-business due day, payment is are credited to your account on the same day. There is n9 for. due on the business day before a t 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: hftp: /Avww,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. ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 10 -31 -2011 FLEET SERVICES ACCOUNT NO: 0453 -00- 794629 -5 DELIVER TO: DENISE SNYDER CARMEL FIRE DEPARTMENT 2 CIVIC Sa 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 -45.32 0.00 FEDERAL E85 247.620 760.73 0.18300 14.87 000 FEDERAL GASOLINE 81.220 271.65 018300 FEC R 4 Tt?CXL:& c: X 1 1 8 :Odd 3? 8+34 4 G132 38 IN 356000972 0.00 14.52 STATE EXCISE GASOLINE 81,220 271.65 0.18000 -46.81 0.00 STATE SALES E85 247.620 760.73 0.07000 -15 0.00 STATE SALES GASOLINE 81.220 271 65 0 07000 IN STfi FE 1 OTALS:: X52:65 f410 ACCOUNT TOTALS 122.85 14.62 M PDA (c) WRIGHT EXPRESS CORPORATION 2011 PAGE 1 FLEET SERVICES STANDARD REPORT INVOICE NUMBER: 27608227 ACCOUNT NAME: CARMEL FIRE DEPARTMENT PAGE 1 OF 2 ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD I BILL CLOSING DATE PAYMFNTDUE7 AMOUNT DUE 0453 -0 0 794629 B 8 00.00 31 10 -31 -2011 11 -25 -2011 931.53 CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL NO. NO. UNIT TOTAL AMOUNT 0001 MH 001 076 10 -02 -2011 16:57 SMITH, KEITH 14,500 E85 19370 2.999 58.10 58.10 MH 001 074 10 -06 -2011 11:52 SMITH, KEITH 14,500 E85 23.860 3.000 71.57 71.57 MH 001 074 10 -11 -2011 14:02 SMITH, KEITH 14,500 UNL 21.130 3.299 69.70 69.70 MH 001 074 10 -13 -2011 11:10 SMITH, KEITH 14,500 UNL 10.250 3.291 33.73 33.73 MH 001 074 10 -27 -2011 11:45 SMITH, KEITH 14,500 E85 17.650 3.099 54.70 54.70 CARD SUBTOTALS 92.260 287.80 0002 MH 001 078 09 -30 -2011 14:54 HULETT, MARK 93,744 E85 10.550 3.199 33.75 33.75 MH 001 078 10 -08 -2011 22:03 HULETT, MARK 94,146 E85 12.340 2.998 37.00 37.00 MH 001 078 10 -19 -2011 22:31 HULETT, MARK 94,761 E85 12.710 3.098 39.37 39.37 MH 001 078 10 -29 -2011 22:54 HULETT, MARK 95,153 E85 13.040 3.098 40.40 40.40 CARD SUBTOTALS 48.640 150.52 0003 MH 001 074 09 -30 -2011 12:33 STEELE, JEFF 7,751 E85 24.270 3.199 77.65 77.65 MH 001 074 10 -06 -2011 14:46 STEELE, JEFF 8,015 E85 23.560 2.999 70.66 70.66 MH 001074 10 -11 -2011 08:17 STEELE, JEFF 8,285 UNL 24.600 3.299 81.16 81,16 MH 001 074 10 -20 -2011 13:10 STEELE, JEFF 8,594 UNL 25.240 3.449 87.06 87.06 MH 001 095 10 -30 -2011 11:22 STEELE, JEFF 8,948 E85 25.490 3.099 79.00 79.00 CARD SUBTOTALS 123.160 395.53 0004 MH 001 074 10 -07 -2011 07:21 HABOUSH, DAVE 6,735 E85 21.910 2.999 65.70 65.70 MH 001 074 10 -17 -2011 19:40 HABOUSH, DAVE 6,963 E85 22.050 3.098 68.32 68.32 MH001074 10 -23 -2011 09:37 HABOUSH,DAVE 7,177 E85 20.820 3.098 64.51 64.51 CARD SUBTOTALS 64.780 198.53 TOTAL PURCHASES 328.840 1,032.38 Y -T -D PURCHASES 3,532.790 11,187.02 SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT Location No. Brand Street City State Zip MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 11 744.76 MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 45237 5 208.62 MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 1 79.00 PRODUCTS: E85= ETHANL85 UNL= UNLEADED VOUCHE NO. WARRANT NO. ALLOWED 20 Fleet Services IN SUM OF P.O. Box 6293 Carol Stream, IL 60197 $931.53 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO, I ACCT /TITLE I AMOUNT Board Members 1120 I 27608227 I 42- 314.00 I $931.53 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 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)) 27608227 $931.53 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