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Home My WebLink About204682 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $547.53 CARMEL, INDIANA 46032 PO BOX 183019 COLUMBUS OH 43218 -3019 CHECK NUMBER: 204682 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 65129116112 547.53 065 129 -116 www.shelifleetcard .accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065 129 -116 13 065129116112 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: 1-515- 226 -4045 NEW CHARGES FLEET FEE P.REVIOUS.BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE 580.06 .00 520.82 553.35 CR .00 547.53 PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 12 -31 -2011 CARD TRANS QTIQN1 TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 11 -25 PAYMENT THANK YOU 520.82 CR 0002 11 -22 21:07 0753095 808 W MAIN ST CARMEL IN 13.781 8 UNL 2.52 44.50 13.781 GAL UNLEADED S44.50 0002 12 -02 09:18 0051805 1821 E 151ST ST CARMEL IN 17.584 8 UNL 3.22 59.05/ 17.584 GAL UNLEADED 559.05 TOTAL CARD 0002 31.365 5.74 103.55 0006 12 -05 0928 0080200 7788 E 96TH ST FISHERS IN 9.202 8 UNL 1.68 30.00✓ 9.202 GAL UNLEADED $30.00 0006 12 -05 22:37 0849158 8924 E 116TH ST FISHERS IN 7.670 8 UNL 1.40 25.0 7.670 GAL UNLEADED 525.02 TOTAL CARD 0006 16.872 3.08 55.02 0007 11 -04 1600 0656413 1821 E 151ST ST CARMEL IN 21.434 8 UNL 3.92 72.00 21.434 GAL UNLEADED $72.00 TOTAL CARD 0007 21.434 3.92 72.00 0009 11 -16 20:41 0853762 1230 S RANGELINE RD CARMEL IN 12.581 8 UNL 2.30 42.01 12.581 GAL .UNLEADED $42.01 0009 11 -17 20:45 0714420 8924 E. 116TH ST FISHERS IN 10.670 8 UNL 1.95 35.00 10.670 GAL UNLEADED 535.00 0009 11 -27 15:10 0978254 2040 E WASHINGTON INDIANAPOLIS IN 7.552 8 UNL 1.38 22.34 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 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 4866 NOTICE: SEE REVERSE SIDE FOR IM INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS CC04C6C Pace 1 of 2 FLE T2000 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: 065 129 -116 13 065129116112 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: 1- 515 226 -4045 CARD TRANaaCTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION NUMBER DATE TIME ID CD CD TAX AMOUNT 7.552 GAL UNLEADED $22.34 0009 11 -28 17:31 0794453 8924 E 116TH ST FISHERS IN 8.090 8 UNL 1.48 25.00 8.090 GAL UNLEADED $25.00 TOTAL CARD 0009 38.893 7.11 124.35 0010 11 -06 14:17 0792556 692 S STATE RD 135 GREENWOOD IN 19.480 8 UNL 3.56 65.26 19.480 GAL UNLEADED $65.26 0010 11 -11 1452 0888438 800 NORTH US 31 GREENWOOD IN 16.230 8 UNL 2.97 56.01 16.230 GAL UNLEADED $56.01 TOTAL CARD 0010 35.710 6.53 121.27 0014 11 -26 16:32 0779348 8924 E 116TH ST FISHERS IN 20.391 8 UNL 3.73 63.0✓ 20.391 GAL UNLEADED $63.01 0014 11 -28 1613 0793786 8924 E 116TH ST FISHERS IN 13.223 8 UNL 2.42 40.861/ 13.223 GAL UNLEADED $40.86 TOTAL CARD 0014 33.614 6.15 103.87 GRAND TOTAL 177.888 32.53 580.06 FEDERAL EXCISE TAX 177.8 GALLONS GASOLINE 32.53 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 4866 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0004666 Page 2 of 2 FLET26UG 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 verity 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 $547.53 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1110 65129116112 I 42- 314.00 $547.53 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 Thursday, 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. 291 (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)) 12/06111 65129116112 monthly payment $547.53 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