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177061 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1 F O ONE CIVIC SQUARE CRYSTAL FLASH CHECK AMOUNT: $126.39 CARMEL, INDIANA 46032 PO BOX 105080 ATLANTA GA 30348 -5080 CHECK NUMBER: 177061 CHECK DATE: 9/1512009 'DEP ACCOUNT PO NUMBER I NVOICE NUM BER AMOUNT DESCRIPTION >�1110 4231400 BG1298138 126.39 BG1298138 2073101 20f, 99395201 W136 CA?Y APPLAH Local Office: Crystal Flash Petroleum PL PO BOX 105080 For billing questions call: (800) 903 -9368 ATLANTA, GA 30348 -5080 Account BG1298138 Please reference account on all payments "I�I IIIIIIII IN 136 STATEMENT# NP20891993 DATE 09/04/2009 CITY OF CARMEL- POLICE DUE DATE 10104/2009 1 CIVIC SQ TOTAL BALANCE DUE $176.47 CARMEL IN 46032 -2584 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 8/31/2009 Date Description Gallons Amount Due 08/20/2009 CREDIT: FINANCE CHARGE $.20 CR 08/20/2009 CREDIT: LATE FEE $25.00 CR 08/24/2009 PAYMENT: Lockbox Payment Thank You $191.05 CR 09/04/2009 Fleet 1315510 Name: CITY OF CARMEL- POLICE 46.541 $151.39 Current Activity Previous Statement Prior Balance Payments and Gallons Charges Total Balance Due Date Adjustments 08/0112009 $240.98 $216.25 CR 46.541 $151.74 $176.47 FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW. 267,111 2WO 50395201 W136 f I PO BOX 105080 FLEET MANAGEMENT REPORT ATLANTA, GA 30348 -5080 Account BG1298138 FLEET 1315510 Provided By: Name: CITY OF CARMEL- POLICE Crystal Flash Petroleum PL (800) 903 -9368 MATCHING STATEMENT NP20891993 Page: 1 of 1 CITY OF CARMEL- POLICE 1 CIVIC SQ CARMEL IN 46032 FLEET MANAGEMENT REPORT FOR 8/1/2009 8/31/2009 SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET PRODUCT QUANTITY BASE PRICE FEDERAL STATE OT TOTAL UNL+ 46.541 $101.79 $8.64 $15.96 $0.00 $126.39 Total 46 541 $101 79 $8 64 $15 96 $0 00 l $126 39 w�1 ..his a Late Fee on Invoice #19811655 $25.00 Finance Charge $0.35 Report Total $151.74 This report is for information only. Please see remittance copy on the statement for the total payment amount. TOTAL MILES: 1,472 Transaction Detail for Customer N01315510 C I1Y`OF CARMEL POLICE 811/2009 8/31/2009' _...1.. FUEL NET TOTAL EXCEPT DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE 167169 CAR 129 r r s E 08/01 11:55 885412 DRIVER 10 9843 33.6 UNL+ 4.347 2.07960 0.52083 $11.30 08/10 11:37 885412 DRIVER 10 9995 36.4 UNL+ 4.177 2.25760 0.53391 $11.65 r 08/14 13:59 885412 DRIVER 10 10152 35.8 UNL+ 4.381 2.20950 0.53112 $12.00- 08/26 10:39 885419 DRIVER 10 10248 34.5 UNL+ 2.780 2.23380 0.53417 $7.70 Miles: 551 35.1 15.685 $42.65 '567168 CAR 119 WO 08/03 09:56 885419 DRIVER 10 25307 34.5 UNL+ 3.193 2.07960 0.52310 $8.30 08/11 10:11 885419 DRIVER 10 25450 38.0 UNL+ 3.760 2.20750 0.53016 $10.30- 08/18 10:30 885419 DRIVER 10 25594 35.2 UNL+ 4.092 2.11390 0.52497 $10.80 08/26 07:33 885419 DRIVER 10 25735 35.5 UNL+ 3.972 2.23820 0.53199 $11.00 Miles: 538 35.8 15.017 $40.40 56716 CAR118 j a. 08/10 10:34 885419 DRIVER 10 21394 32.5 UNL+ 4.395 2.21160 0.53062 $12.04 08/15 07:35 885419 DRIVER 10 21484 31.1 UNL+ 2.891 2.20690 0.53156 $7.92 08/26 1039 885419 DRIVER 10 21634 35.7 UNL+ 4.200 2.23570 0.53304 $11.63 Miles: 383 33.1 11.486 $31.59 567168 `CAR 128o� ;r 08/28 08:42 885419 DRIVER 10 4958 0.0 UNL+ 4.353 2.173 20 0.52752 $11.75 Miles: 4353 $11.75 SITE LEGEND SIT SITE NAME ADDRESS CITY STATE 885412 Crystal Flash #41 10598 N College Ave Indianapolis IN 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 Cr ystal Flash Petroleum PL Purchase Order No. PO Box 105080 Terms Atlanta GA 30348 -5080 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9/4/09 NP20891993 payment for gasoline Total 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Crystal Flash Petroleum -PL IN SUM OF PO Box 105080 Atlanta, GA 30348 -5080 UL ON ACCOUNT OF APPROPRIATION FOR Police general fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 NP20891993 314 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 Sept 11, 2009 ChSiW a o t f e Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund