179057 11/10/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH PETROLEUM CHECK AMOUNT: $339.08
CARMEL, INDIANA 46032 PO BOX 105080
ATLANTA GA 30348 -5080 CHECK NUMBER: 179057
CHECK DATE: 11/1012009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 BG1297998 339.08 BG1297998
11 /0 /2009 3:28:58 PM —0500 FLEETDETAILS PAGE 2 OF 3
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Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
Account BG1297998
Please reference account on all payments
STATEMENT NP21869119
DATE 11/02/2009
CITY OF CARMEL -FIRE DUE DATE 12102/2009
1 CIVIC SQ
CARMEL IN 46032 TOTAL BALANCE DUE $349,09
PAYMENT TERMS Net 30 MN
For online statements and simple, automated payment setup, contact customer service at
cardservices @fleetcor.com.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 10/31/2009
Date Description Gallons Amount Due
11/02/2009 Fleet 1315390 Name: CITY OF CARMEL FIRE 150.821 $339.08
10/17/2009 PAYMENT: Lockbox Payment Thank You $235.07 CR
Current Activity
Previous
Statement Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
1010112009 $245.08. $235.07 CR 150.821 $339.08 $349.09
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FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY T RE MITTANCE COPY g,
11/02/2009 3:28:58 PM -0500 FLEETDETAILS PAGE 3 OF 3
C IWPL A -S.
PO Box 105080 FLEET MANAGEMENT REPORT
ATLANTA, GA 30348 -5080 Account BG1297998
FLEET 1315390
Provided By- Name: CITY OF CARMEL FIRE
Crystal Flash Petroleum PL MATCHING STATEMENT NP21869119
(800) 903 -9368
Page: 1 of 1
CITY OF CARMEL -FIRE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 1011!2009 10/31/2009
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 9.571 $18.98 $1.78 $3.16 $0.00 $23.92
UNL+ 141.250 $244.84 $26.25 $44.07 $0.00 $315.16
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This report is for information only.
Ploase see remittance copy on the statement for the total payment amount.
TOTAL MILES: 587
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FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE OTY PRICE TAXES AMT CODE
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t, s,.. c'., C�•, s��i, .:kt,.:3�F,,3+a..,�rt�:�r,�,.,� u,. T> E� .�..�•�r..nt..>?,,.tl,,.,u...�,
10126 13:37 885419 DRIVER 1 18769 0.0 UNL+ 21.403 1.75960 0.49971 $48.35
Miles: 21.403 $48.35
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10/02 09:35 885419 DRIVER 1 14500 0.0 UNL+ 20.384 1.66600 0.49315 $44.01
10/05 13 :53 885419 DRIVER 1 14500 0.0 UNL+ 18.142 1.66580 0.49331 $39.17
10109 13:15 885419 DRIVER 1 14500 0.0 UNL 9.571 1.98310 0.51591 $23.92
10112 08:27 885419 DRIVER 1 14500 0.0 UNL+ 19.801 1.62870 0.49054 $41.96
10128 08:27 885419 DRIVER 1 14500 0.0 UNL+ 19.087 1.88980 0.50897 $45.79
10130 08 :35 885419 DRIVER 1 14500 0.0 UNL+ 14.539 1.89010 0.50865 $34.88
Miles: 101.524 $229.73
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;567.1.48;... "s=' 2r, rr, Mil, ra fir., t tr<, t z xr. kr trr zr.. err, 4r.r �r.:r tr,, rn trn �r,i lr„ �rn.a�;: -:tr„ tr,, tr•r trr• �r':i-K.� taxi %c':a'?L�: <.:3i:Yr •frs. [ra kra •ir: �r:�. rv;.�•.:;
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10/13 06:35 885419 DRIVER 1 55997 0.0 UNL+ 14.393 1.62930 0.49054 $30.50
10/22 11:18 885419 DRIVER 1 56584 43.5 UNL+ 13.501 1.75910 0.49959 $30.50
Miles: 587 43.5 27.894 $61.00
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
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))
$339.08
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
VOUrHER NO. WARRANT NO.
ALLOWED 20
crystal Flash
IN SUM OF
P.O. Box 684
Indianapolis, IN 46206
$339.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 42- 314.00 $339.08 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
NOV 9 2009
ey
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund