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Home My WebLink About204681 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CARMEL, INDIANA 46032 PO BOX 183019 CHECK AMOUNT: $549.23 COLUMBUS OH 43218 -3019 CHECK NUMBER: 204681 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065127193112 549.23 065 127 -193 www.shelifleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065 127 -193 13 065127193112 SHELL CARD CENTER P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 12 -06 -2011 12 -31 -2011 32 TELEPHONE: 1- 800377 -5150 FAX: 1315. 226.4045 NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE 581.93 00 1,104.47 1,137.17 CR 00 549.23 A PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 12 -31 -2011 CARD TRANS MIQN TRANS TRANSACTION LOCATION I DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 11 -25 PAYMENT THANK YOU 1,104.47 CR 0013 11 -25 13:16 0770792 8924 E 116TIl ST FISHERS IN 15.873 8 UNL 2.90 50.00 15.873 GAL UNLEADED S50.00 TOTAL CARD 0013 15.873 2.90 50.00 0014 11 -23 16:35, 0909390 1230 S RANGELINE RD CARMEL IN 14.652 8 UNL 2.68 46.01%, 14.652 GAL UNLEADED S46.01 TOTAL CARD 0014 14.652 2.68 46.01 0023 11 -10 1253 0083030 8015 LORTON RD LORTON VA 12.330 8 UNL 2.26 43.39 12.330 GAL UNLEADED $43.39 0023 11 -20 20:20 0026088 2600 PRINCE WILLIAM PKWY WOODBRIDGE VA 10.650 8 UNL 1.95 36.01 10.650 GAL UNLEADED $36.01 0023 11 -22 1413 0495622 5498 BUCKEYSTOWN PIKE FREDERICK MD 4.881 8 UNL 0.89 16.42 4.881 GAL UNLEADED $16.42 0023 11 -22 22:10 0674002 1136 N STATE GREENFIELD IN 13.341 8 UNL 2.44 43.36 13.341 GAL UNLEADED S43.36 0023 11 -28 11:11 0978452 1500 HILLIARD ROME ROAD COLUMBUS OH 12.091 8 UNL 2.21 37.00 12.091 GAL UNLEADED $37.00 TOTAL CARD 0023- 53.293 9.7S 176.18 t• 0028 11 -14 10:15 0763599 1821 E 151ST ST CARMEL IN 15.514 8 UNL 2.84 Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump o 2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale SCHEDULE OF LATE FEE PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE (MONTHLY) PERCENTAGE RATE SEE REVERSE SIDE 0.000% 0.00% 0.00 .00 6057 0015 GUG 1 7 2 111206 9366 8015 SH33 4865 NOTICE: SEE R SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0064B65 Page 1 of 2 FLET2GUG Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week, Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. This Account is Issued by Citibank, N.A. PLOCOMM Rev 07/11 I www.shelifleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065 127 193 13 065127193112 SHELL CARD CENTER P.O. BOX 669061 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081 12 -06 -2011 12 -31 -2011 32 TELEPHONE: 1- 8003773150 FAX: 1 -515- 226 -4045 CARD TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 15.514 GAL UNLEADED S53.68 0028 11 -24 07:27 0878132 1821 E 151ST ST CARMEL IN 15.562 8 UNL 2.85 48.71 15.562 GAL UNLEADED $48.71 TOTAL CARD 0028 31.076 5.69 102.39 0029 11 -21 11:27 0887620 1230 S RANGELINE RD CARMEL IN 16.551 8 UNL 3.03 52.80 16.551 GAL UNLEADED 552.80 0029 11 -24 13:37 0177337 104 S MAIN ST RUSHVILLE IN 17.231 8 UNL 115 55.14 17.231 GAL UNLEADED $55.14 0029 11 -28 19:31 0019224 1821 E 151 ST ST CARMEL IN 14.970 8 UNL 2.74 50.30 14.970 GAL UNLEADED $50.30 TOTAL CARD 0029 48.752 8.92 158.24 0030 11 -23 10:09 0982132 7788 E 96TH ST FISHERS IN 15.064 8 UNL 2.76 49.11 15.064 GAL UNLEADED $49.11 TOTAL CARD 0030 15.064 176 49.11 GRAND TOTAL 178.710 32.70 581.93 FEDERAL EXCISE TAX 178.7 GALLONS GASOLINE 32.70 CR TOTAL *FINANCE CHARGE' BILLED IN 2011 $0.00 Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump 2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale 6057 0015 GUG 1 7 2 111206 9366 8015 SH33 4865 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0004865 Page 2 of 2 FLET2GL!G Information About Your Account Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7 days a week. Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement. Proper Form. For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order. No cash or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged $14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time, your payment will be credited as of the next day. We may process your payment electronically after we verify your identity. This Account is Issued by Citibank, N.A. PLOCOMM Rev 07/11 VOUCHER NO. WARRANT NO. ALLOWED 20 Shell Fleet Plus Processing Center IN SUM OF P.O. Box 183019 Columbus, OH 43218 -3019 $549.23 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# INVOICE NO. ACCT /TITLE AMOUNT Board Members 1110 65127193112 I 42- 314.00 I $549.23 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 T hursday, December 15, 2011 Chief of Police 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)) 12/06/11 65127193112 monthly payment $549.23 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