167777 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
0 c,q ONE CIVIC SQUARE CRYSTAL FLASH CHECK AMOUNT: $137.19
CARMEL, INDIANA 46032 PO BOX 105080
ATLANTA GA 30348 -5080 CHECK NUMBER: 167777
CHECK DATE: 112012009
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
1205 4231400 BC1298100 137.19 BG1298100
I
I
2673101 2W 010. 6101.00089
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
II�III
11 IN 89 STATEMENT NP15910486
DATE 0110212009
CITY OF CARMEL MAINTENANCE DUE DATE 01116/2009
1 CIVIC SQ TOTAL BALANCE DUE $191.29
CARMEL IN 46032 -2584
PAYMENT TERMS Net 14 days MN
Your account terms and conditions include late fee,_ finance charge, and statement fee provisions which_haxe_ been waived.-
Tnese previsions will be applied going forward. For free online statements and payments, log onto www.fleetnet.net.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 1213112008
Date Description Gallons Amount Due
12112/2008 PAYMENT: Lockbox Payment Thank You $148.15 CR
12/19/2008 PAYMENT: Lockbox Payment Thank You $237.43 CR
01/02/2009 Fleet 1315492 Name: CITY OF CARMEL- MAINTENANCE 82.007 $162.19
Current Activity
Previous
Statement Prior Balance Payments and
Ad Adjustments
Gallons Charges Total Balance Due
Date 1
12101/2008 $411.90 $385.58 CR 82.007 $164.97 $191.29
FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
201]101.20(XptO]46101 00084
/L.
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
(800) 903 -9368 MATCHING STATEMENT NP15910486
Page: 1 of 1
CITY OF CARMEL- MAINTENANCE
1 CIVIC SQ
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 12/1/2008 12/31/2008
SUMMARY -OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 82.007 $99.40 $15.19 $22.60 $0.00 $13 7.19
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$137 ,191
8 u�a.»...,.'.p.`..$,:� �a�r�„ #.L$1.! 5 1 9 y�,,µ�$22 60, -�d�t� 00
Late Fee on Invoice# 15498887 $25,00
Finance Charge $2.78
Report Total $164.97
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 0
EXCEPTION CODES:
11 Odometer entry is out of sequence.
Transaction Detatl forCustomerNQ 13154 OFCARMEL MAINTENANCE X12/1/2008. °12/31/
I •uw. s u, v;; a:a...'.. .a:,,• a .o.._...... waw....:...ya. z ..,»;s 5 y
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE"
581400'.'GRAS$ 42� ii i E x
12/01 16:34 885419 DRIVER 1 0 0.0 UNL 16.924 1.29230 0.46619 $29.77 11
12/08 16:42 885419 DRIVER 1 0 0.0 UNL 16.634 1.08690 0.45214 $25.60 11
12/14 11:30 885419 DRIVER 1 0 0.0 UNL 17.020 1.33020 0.46920 $30.62 11
12/19 12:23 885419 DRIVER 1 0 0.0 UNL 16.439 1.17100 0.45792 $26.78 11
12/29 16:31 885419 DRIVER 1 0 0.0 UNL 14.990 1.17150 0.45791 $24.42 11
Miles: 82.007 $137.19
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 property 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.
r
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))
OV116/0 B61298110 0 Gas $137.19
Total
1 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 IMTIVWWARRANT NO.
a as e ro eum Corp
ALLOWED 20
ox 105080 IN SUM OF
Atlanta, G- A 30349-5080
$137.19
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
D o f INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice or
bill(s) is (are) true and correct and that the
298100 314 $137.19 materials or services itemized thereon for
which charge is made were ordered and
received except
20
c
S�j� tur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund