176537 08/20/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH
CARMEL, INDIANA 46032 PO BOX 105080 CHECK AMOUNT: $184.76
ATLANTA GA 30348 -5080 CHECK NUMBER: 176537
CHECK DATE: 8/20/2009
;EPAR TMEN T ACCOUNT PO NUMBER INVOICE NU AM DESCRIPTION
1160 4231400 BG1298100 29.00 GASOLINE
:1205 4231400 BG1298100 155.76 GASOLINE
2673101 2W.M. 80124501 01113
i w
CCYST E17AFLAH" Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
Account BG1298100
Please reference account on all payments
IIIIIIIIIIIIIIVIIIVIIIIIIIII 1113 STATEMENT# NP20351906
DATE 08/03/2009
CITY OF CARMEL- MAINTENANCE DUE DATE 09/02/2009
1 CIVIC SQ TOTAL BALANCE DUE $290.34
CARMEL IN 46032 -2584
PAYMENT TERMS Net 30 MN
For online statements and simple, automated payment setup, contact customer service at cardsery ices @fleetcor.com.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 7/31/2009
Date Description Gallons Amount Due
07/25/2009 PAYMENT: Lockbox Payment Thank You $153.48 CR
08/03/2009 Fleet 1315492 Name: CITY OF CARMEL- MAINTENANCE 76.029 $209.76
Current Activity
Previous
Statement Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
07/01/2009 $233.43 $153.48 CR 76.029 $210.39 $290.34
FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
%t PO BOX 105080 FLEET MANAGEMENT REPORT
ATLANTA, GA 30348 -5080 Account BG1298100
FLEET 1315492
Provided By: Name: CITY OF CARMEL- MAINTENANCE
Crystal Flash Petroleum PL MATCHING STATEMENT NP20351906
(800) 903 9368
Page: 1 of 3
CITY OF CARMEL MAINTENANCE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 7/1/2009 7/31/2009
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 63.415 $123.24 $11.80 $20.72 $0.00 $155.76
UNL+ 12.614 $22.66 $2.34 $4.00 $0.00 $29.00
otal y 76 029
V $145 90 $14;14 $24 72 $0 00 $184 6
Late Fee on Invoice #18532996 $25.00
Finance Charge $0.63
Report Total $210.39
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 284
DEPARTMENTAL SUMMARIES
DEPARTMENT PIAME OEPT ABASE FED STATE LOCAL MAINT /OTH EXTENDED EXCEPT.
CE
NUM PRI M TAXES TAXES TAXES "'a° Non Fuel s T „OTAL e '`COUNT%
No Department 0 63.415 123.24 11.80 20.72 0.00 0.00 155.761 0
MAYOR 8090161 12.614 22.66 2.34 4.00 0.00 0.00 29.001 0
EXCEPTION CODES:
11 Odometer entry is out of sequence.
FLEET MANAGEMENT REPORT
�L Account BG1298100
CRYSTT�L]FL��f�.
PO BOX 105080 FLEET 1315492
ATLANTA, GA 30348 -5080 Name: CITY OF CARMEL- MAINTENANCE
MATCHING STATEMENT NP20351906
Page: 2 of 3
Transaction Detatl for Customer N0.`1 315492 .CITY:OF'CARMEL MAINTENANCE, 711/2009 „7/31(2009
Department: No Department
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE
581400 GRASS 42
07/06 12:30 885419 DRIVER 1 0 0.0 UNL 16.987 2.13280 0.52601 $45.17 11
07/17 17:05 885419 DRIVER 1 0 0.0 UNL 16.006 1.79680 0.50210 $36.80 11
07/21 15:09 885419 DRIVER 1 0 0.0 UNL 14.310 1.89030 0.50867 $34.33 11
07/28 16:33 885419 DRIVER 1 0 0.0 UNL 16.112 1.93640 0.51244 $39.46 11
Miles: 63.415 $155.76
Department: UNL 63.415 $155.76
Department Totals 63.415 $155.76
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
a
FLEET MANAGEMENT REPORT
�L Account BG1298100
FLEET 1315492
1 PO BOX 105080
ATLANTA, GA 30348 -5080 Name: CITY OF CARMEL- MAINTENANCE
MATCHING STATEMENT NP20351906
Page: 3 of 3
Transaction.Detall forC stomer NU X1315492 GITY..OF CARMEL MAI,NTENANCE,711 /2009 7/31/2009
Department: MAYOR
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE
1 MAYOR x s
07/09 07:46 885419 MAYOR 32359 "22.5 UNL 12.614 1.79640 0274.., $29 .00 yY
Miles: 284 22.5 12.614 $29.00
Department: MAYOR UNL+ 12.614 $29.00
Department Totals 12.614 $29.00
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Crystal Flash Petroleum PL Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
184.76
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 117 /09 WARRANT NO.
ALLOWED 20
IN SUM OF
Atlanta, GA 30348 -5080
$184.7.6
ON ACCOU6T PQPU!AT FOR
IN
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bills) is (are) true and correct and that the
materials or services itemized thereon for
1160 BG12981100 314 $29.00 which charge is made were ordered and
received except
20
Signat re,
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund