168836 02/16/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL FLASH CHECK AMOUNT: $679.43
v. CARMEL, INDIANA 46032
Po eox 105080
ATLANTA GA 30348 -5080 CHECK NUMBER: 168836
CHECK DATE: 2/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 BG1297998 679.43 BG1297998
-4
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Local Office: Crystal Flash Petroleum PL
PO BOX 105080 For billing questions call: (800) 903 -9368
ATLANTA, GA 30348 -5080
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Account BG1297998
Please reference account on all payments
III II III IIIII II I I II 88 STATEMENT NP16368668
DATE 02/02/2009
CITY OF CARMEL -FIRE DUE DATE 02/16/2009
2 CIVIC SQ TOTAL BALANCE DUE $814.44
CARMEL IN 46032 -7543
PAYMENT TERMS Net 14 days MN
For online sfateiments and simple, automated payment setup, contact customer sevice at cardser•,iices @fleetcor.com.
DESCRIPTION OF CURRENT ACTIVITIES
Services and Fees as reported 1/31/2009
Date Description Gallons Amount Due
01/23/2009 PAYMENT: Lockbox Payment Thank You $394.25 CR
02/02/2009 Fleet 1315390 Name: CITY OF CARMEL -FIRE 295.775 $704.43
Current Activity
Previous
Statement Prior Balance Payments and Gallons Charges Total Balance Due
Date Adjustments
01/01/2009 $502.20 $394.25 CR 295.775 $706.49 9+*.44
FOR PROPER PAYMENT POSTING, PLEASE SUBMIT YOUR CHECK WITH ONLY THE REMITTANCE COPY BELOW.
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PO BOX 105080 FLEET MANAGEMENT REPORT
Ar ATLANTA, GA 30348 -5080 Account BG1297998
FLEET 1315390
Provided By: Name: CITY OF CARMEL -FIRE
Crystal Flash Petroleum PL
(800) 903 -9368 MATCHING STATEMENT NP16368668
Page: 1 of 2
CITY OF CARMEL -FIRE
2 CIVIC SO
CARMEL IN 46032
FLEET MANAGEMENT REPORT FOR 1/1/2009 1/31/2009
SUMMARY OF TRANSACTIONS THIS REPORTING PERIOD FOR ALL VEHICLES IN YOUR FLEET
PRODUCT QUANTITY BASE PRICE FEDERAL STATE OTHER TOTAL
UNL 91.896 $132.60 $17.10 $26.81 $0.00 $176.51
UNL+ 203.879 $281.71 $37.91 $58.63 $0.00 $378.25
FUEL 295.775 $414.31 $55.01 $85.44 $0.00 $554.76
NON -FUEL $124.67 $0.24 $0.00 $0.00 $124.67
Total $538 98 $55.25 x$85 44$0 00� $679:43`
u
Late Fee on Invoice# 15910485
Finance Charge
Report Total 49
This report is for information only.
Please see remittance copy on the statement for the total payment amount.
TOTAL MILES: 1,758
Transactwn Detatl for'Gustomer NO.1315390 CITY OF CARMEL FIRE• 1f1120`09 1131/2009
mow... ....a 4�_
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRICE TAXES AMT CODE"
56714& CAR 45G s y
01/02 13:28 885414 DRIVER 1 14500 0.0 UNL 17.477 1.38530 0.47374 $32.49
01/05 08:18 885419 DRIVER 1 14500 0.0 UNL+ 18.758 1.35680 0.47186 $34.31
01/08 16:47 885419 DRIVER 1 14500 0.0 UNL+ 16.473 1.35740 0.47181 $30.13
01/09 08:14 885419 DRIVER 1 14500 0.0 UNL+ 5.155 1.35790 0.47095 $9.43
01110 20:08 885414 DRIVER 1 14500 0.0 UNL 15.633 1.46930 0.47953 $30.47
01/12 08:24 885419 DRIVER 1 14500 0.0 UNL+ 6.156 1.35640 0.47174 $11.26
01113 13:04 885419 DRIVER 1 14500 0.0 UNL 19.899 1.42270 0.47641 $37.79
01/16 08:12 885419 DRIVER 1 14500 0.0 UNL 19.109 1.51600 0.48266 $38.20
01120 08:11 885419 DRIVER 1 14500 0.0 UNL+ 14.784 1.35690 0.47195 $27.04
01/23 08:21 885419 DRIVER 1 14500 0.0 UNL 19.778 1.42280 0.47601 $37.56
01/26 08:18 885419 DRIVER 1 14500 0.0 UNL+ 20.363 1.42270 0.47608 $38.67
01/29 12:39 885419 DRIVER 1 14500 0.0 UNL+ 13.638 1.42250 0.47635 $25.90
01/30 08:22 885419 DRIVER 1 14500 0.0 UNL+ 10.142 1.42180 0.47647 $19.26
Miles: 197.365 $372.51
567148 CAR 4502 z
Oil
Non -Fuel Transactions
01/15 12:45 885419 DRIVER 1 99999 $124.67
Kerosene
Sub Total: $124.67
56 +48 CAR 45�" yE E:
1
01/05 14:47 885419 DRIVER 1 38993 25.3 UNL+ 11.481 1.35790 0.47171 $21.00
01/07 12:47 885419 DRIVER 1 39146 15.5 UNL+ 9.841 1.35760 0.47142 $18.00
01/09 11:20 885419 DRIVER 1 39269 15.5 UNL+ 7.927 1.35610 0.47177 $14.50
01/13 13:14 885419 DRIVER 1 39468 15.3 UNL+ 12.985 1.35770 0.47139 $23.75
01/16 06:39 885419 DRIVER 1 39668 15.2 UNL+ 13.121 1.35810 0.47193 $24.00
01/21 07:01 885419 DRIVER 1 39950 25.8 UNL+ 10.934 1.35720 0.47193 $20.00
01/23 13:25 885419 DRIVER 1 40133 16.2 UNL+ 11.321 1.42300 0.47660 $21.50
01/27 13:14 885419 DRIVER 1 40341 15.2 UNL+ 13.691 1.42280 0.47597 $26.00
FLEET MANAGEMENT REPORT
Account BG1297998
Po Box 105080 FLEET 1315390
ATLANTA, GA 30348 -5080
Name: CITY OF CARMEL -FIRE
MATCHING STATEMENT NP16368668
l
Page: 2 of 2
FUEL NET TOTAL EXCEPT
DATE TIME SITE DRIVER ODOMETER MPG TYPE QTY PRI TAXES AMT CODE
562148, -CAR 4504 (cont%nued)
01/30 12:38 885419 DRIVER 1 40460 16.7 UNL+ 7.109 1.42360 0.47577 $13.5D
Miles: 1758 17.9 98.410 $182.25
SIT LEGEND
SITE SITE NAME ADDRESS CITY STATE
885414 Crystal Flash #43 7935 -d S Emerson Indianapolis IN
885419 Crystal Flash #67 545 S Rangeline Rd Carmel IN
Prescribed by State Board of Accounts amity Form No. 201 (Rev. 1995)
r
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
NP16368668 Fuel Kerosene $679.43
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 NO. WARR NO.
ALLOWED 20
Crystal Flash
IN SUM OF
P.O. Box 684
Indianapolis, IN 46206
$679.43
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 NP16368668 427314.00 $679.43 1 hereby certify that the attached invoice(s), or
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
FEB 13 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund