172283 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH
CARMEL, INDIANA 46032 PO BOX 105080 CHECK AMOUNT: $75.38
ATLANTA GA 30348 -5080
CHECK NUMBER: 172283
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DES CRIPTION
1110 4231400 BG1298138 75.38 BG1298138
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4
2(]3101 2009050(5 5201 00112
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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 BG1298138
Please reference account on all payments
�III IIIIIIIIII III I IIIIIIIIIII 112 STATEMENT NP18045755
DATE 05/01/2009
CITY OF CARMEL- POLICE DUE DATE 05/31/2009
1 CIVIC SQ TOTAL BALANCE DUE $102.03
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 4/30/2009
Date Description Gallons Amount Due
04/17/2009 CREDIT: FINANCE CHARGE $137.40 CR
04/17/2009 CREDIT: LATE FEE $6.42 CR
04/18/2009 PAYMENT: Lockbox Payment Thank You $190.57 CR
05/01/2009 Fleet 1315510 Name: CITY OF CARMEL- POLICE 35.425 $100.38
Current Activity
Previous
Statement Payments and
Date Prior Balance Adjustments Gallons Charges Total Balance Due
0410112009 $334.21 $334.39 CR 35.425 $102.21 $102.03
FOR PROPER PAYMENT POSTING PLEASE SUBMIT YOUR CHFCK WITH ONI Y THE RFMITTONCF r OPY RFI nW
2,73101 200905 (1050201 00112
ti
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 NP18045755
Page: 1 of 1
CITY OF CARMEL- POLICE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 4/1/2009 4/30/2009
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 13.711 $20.78 $2.55 $4.08 $0.00 $27.41
UNL+ 21.714 $37.22 $4.01 $6.74 $0.00 $47.97
:Total z 35.425 WOO $6.56„ $10 82 $0 00 .1 $75 38
Late Fee on Invoice #16769326 $25.00
Finance Charge $1.83
Report Total $102.21
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 518
Transaction`Detail for Customer`N0��1315510`- CITY OF CARM EL-PO
LICE,
a
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES A CODE
167169 ;CAR 12 9,.;
04/27 13:53 885419 DRIVER 10 8244 31.2 UNL+ 4.615 1.70530 0.49508 $10.15
Miles: 144 31.2 4.615 $10.15
567162 ,'CAR 23 ...E!Mt�
04/28 03:41 885419 DRIVER 10 96555 X 0.0 UNL 13.711 1.51560 0.48311 1 27.41
Miles: 13.711 $27.41
„567168 4R, 119x�R
04/02 14:12 M. 885419 DRIVER 10 m 23088 31.2 UNL+� _3.906 1.61290 0.48855
$8.20
04/27 09:02 885419 DRIVER 10 23218 30.4 UNL+ 4.274 1.70570 0-49523- $9.40
Miles: 252 30.8 8.180 $17.60
567168 iCAR 118 E
u
04/19 07:46 885419 DRIVER 10 19379 29.9 UNL+ 4.087 1.72990 0.49824 $9.11
Miles: 122 29.9 4.087 $9.11
567169 SCAR 12$ Y
04/23 13:52 885419 DRIVER 10 4273 0.0 UNL+ 4.832 1.79840 0.50214 $11.11
Miles: 4.832 $11.11
SITE LEGEND
SITE SITE NAME ADDRESS CITY STATE
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
Prescri�'J by State Board of Accounts City Form No. 201 (Rev. 1995)
<3 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
C rystal Flash Petroleum Purchase Order No.
P.O. Box 105080 Terms
Atlanta, GA 30348 -5080 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/1/09 monthly payment 102.03
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
C ostal Flash Petroleum IN SUM OF
P.O. Box 105080
Atlanta, GA 30348 -5080
ON ACCOUNT OF APPROPRIATION FOR
pniicegeneral fund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 314 1 °B�S3 bill(s) is (are) true and correct and that the
`75 ?g materials or services itemized thereon for
which charge is made were ordered and
received except
May 8 2 0 09
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund