173690 06/22/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH CHECK AMOUNT: $197.56
CARMEL, INDIANA 46032 PO BOX 105080
ATLANTA GA 30348 -5080
CHECK NUMBER: 173690
CHECK DATE: 6/22/2009
DEPA ACCOUNT P O NUMBER INVOICE NUMB A MOUNT DESCR IPTION
1205 4231400 BG1298100 197.56 GASOLINE
2673101,2N H 333WiO 43
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
III III IIIIIIIIIIIIIII�II 843 STATEMENT# NP18532996
DATE 06/01/2009
CITY OF CARMEL- MAINTENANCE DUE DATE 07/15/2009
1 CIVIC SO TOTAL BALANCE DUE $377.51
CARMEL IN 46032 -2584
PAYMENT TERMS Net 30 MN
For online statemen and simple, automated payment setup, contact customer service at cardserVices@fleetcor.com.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 5/31/2009
Date Description Gallons Amount Due
06/01/2009 Fleet 1315492 Name: CITY OF CARMEL- MAINTENANCE 84317 $197.56
Current Activity
Previous
Statement Prior Balance Payments and
Ad Adjustments
Gallons Charges Total Balance Due
Date 1
05/01/2009 $179.95 $0.00 84.317 $197.56 $377.51
FOR PROPER PAYMENT POSTING PI FASF RtIRMIT Y0IIR CHFr'K WITH r1Nl Y THE RFMITTANCF C( RFI nw
2e73101 2 m ,V,33001 wars
pig S--p— J p M
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 NP18532996
(800) 903 9368
Page: 1 of 3
CITY OF CARMEL- MAINTENANCE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 5/1/2009 5/31/2009
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 79.815 $148.12 $14.85 $25.59 $0.00 $188.56
UNL+ 4.502 $6.83 $0.83 $1.34 $0.00 $9.00
w
Total 84 317 $154 95 $15 68
26 93 ,Z $0' 00 $197-.56
Ow
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 0
DEPARTMENTAL SUMMARIES
DEPT ;BASES FEDSTATE LOCAL MAINT /OTH EXTENDED EXCEPT'
DEPARTMENTNAMEF� QTY.
c Y,,.,', ,,,1� NUM PRICE k, TAXES 21 TAXES TAXES (Non Fuet 0
11 COUNTS
No Department 01 79.815 148.12 14.85 25.59 0.00 0.00 188.56 0
MAYOR 1 8090161 4.502 6.83 0.83 1.34 0.00 0.00 9.00 0
EXCEPTION CODES:
11 Odometer entry is out of sequence.
FLEET MANAGEMENT REPORT
Account BG1298100
PO BOX 105080 FLEET 1315492
ATLANTA, GA 30348 -5080 Name: CITY OF CARMEL- MAINTENANCE
MATCHING STATEMENT NP18532996
Page: 2 of 3
TransactionDetail for Customer NQ 1315492 CITY OF CARMEL MAINTENANCE,TS /1/2009 5!3112009 g w s
Department: No Department
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE CITY PRICE TAXES AMT CODE
581400 GRAS$42 d x M
"k N
05105 16:41 885419 DRIVER 1 0 0.0 UNL 16.776 179660 0.50227 $38.57 11
05/11 11:11 885419 DRIVER 1 0 0.0 UNL 16.075 1.71260 0.49658 $35.51 11
05/11 16:24 885419 DRIVER 1 0 0.0 UNL 13.693 1.89000 0.50881 $32.85 11
05/18 1127 885419 DRIVER 1 0 0.0 UNL 18.484 1.78700 0.50195 $42.31 11
05/28 13:27 885419 DRIVER 1 0 0.0 UNL 14.787 2.13300 0.52603 $39.32 11
Miles: 79.815 $188.56
Department: UNL 79.815 $188.56
Department Totals 79.815 $188.56
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
FLEET MANAGEMENT REPORT
Account BG1298100
C;7YS.L7a=LAH14. FLEET 1315492
PO BOX 105080
ATLANTA, GA 30348 -5080 Name: CITY OF CARMEL- MAINTENANCE
MATCHING STATEMENT NP18532996
Page: 3 of 3
Transaction Detail for Customer NO 1315492 CITY�OF CARM,EL MAINTENANCE�;,Si1 /2009;y #5(31/2009
Department: MAYOR
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE"
r 1 MAYOR s�..
05/27 11:02 885419 MAYOR 30795 0.0 UNL+ 4.502 1.51710 0.48252 $9.00
Miles: 4.502 $9.00
Department: MAYOR UNL+ 4.502 $9.00
Department Totals 4.502 $9.00
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
Crystal Flash Petroleum PL Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Gas
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 P61 22 /09 WARRANT NO.
ALLOWED 20
Box 105080 IN SUM OF
Atlanta, GA 30348 -5080
$197.56
ON ACCOIttjENEV FOR
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1205 FIG41298100 814 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
20
a,
ig_natu�
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund