205768 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $621.73
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CARMEL, INDIANA 46032 PO BOX 183019
COLUMBUS OH 43218 -3019 CHECK NUMBER: 205768
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65129116201 621.73 GASOLINE
I
www.shelifleetcard .accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065.129 -116 15 065129116201 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
01 -06 -2012 01 -31 -2012 31 TELEPHONE: 1.800. 377 -5150
FAX: 1.515- 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
658.04 .00 547.53 583.1 CR .00 621.73
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 01 -31 -2012
CARD TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
12 -22 PAYMENT THANK YOU 547.53 CR
I
0002 12 -06 21:15 0237511 8501 E WASHINGTON ST INDIANAPOLIS IN 25.760 8 UNL 411 85.01
25.760 GAL UNLEADED $85.01
0002 12 -19 16:28 0420612 9611 ALLISONVILLE RD INDIANAPOLIS IN 22.300 8 UNL 4.08 70.00
22.300 GAL UNLEADED $70.00
TOTAL CARD 0002 48.060 8.79 155.01 x
0006 12 -06 13:26 0009134 1201 S HOLT RD INDIANAPOLIS IN 14.150 8 UNL 2.59 48
14.150 GAL UNLEADED $48.96
0006 12 -07 17:05 0848291 5020 E 62ND ST INDIANAPOLIS IN 2.890 8 UNL 0.53 10.01
2.890 GAL UNLEADED $10.01
0006 12 -22 09:51 0224972 7788 E96TH ST FISHERS IN 8.820 8 UNL 1.61 30.0
8.820 GAL UNLEADED S30.00
TOTAL CARD 0006 25.860 4.73 88.97 xx
0011 12 -20 12.40 0093724 1230 S RANGELINE RD CARMEL IN 18.281 8 UNL 3.35 57.22
18.281 GAL UNLEADED $57.22
xx
TOTAL CARD" 0011 18.281 3.35 57.22
0014 12 -06 15:20 0993477 1230 S RANGELINE RD CARMEL IN 12.511 8 UNL 229 40.05✓
12.511 GAL UNLEADED,. S40.05
0014 12 -09 11:00 08764D9 8924 E i 16TH ST FISHERS IN 5.710 8 UNL 1.04 19.77•
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8- Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
SCHEDULE OF LATE FEE
PERIODIC RATE ANNUAL MONTHLY MINIMUM BALANCE SUBJECT TO LATE FEE
(MONTHLY) PERCENTAGE RATE SEE REVERSE SIDE
0.000% 0.00% 0.00 .00
6057 0015 GUG 1 7 2 120106 9366 8015 SH33 4933
NOTICE: SEE RE V E RSE SIDE FOR IMPORTANT inwonIMIATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0004933 Page 1 of 2 FLET2GUG
Information About Your Account
Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7
days a week.
Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we
do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as
of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a
payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by
regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by
express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement.
Proper Form. For a payment sent by mail or courier to be in proper form, you must:
Enclose a valid check or money order. No cash or foreign currency please.
Include your name and account number on the front of your check or money order.
If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If
we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive
the check. Also, the check will be destroyed.
Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged
$14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time,
your payment will be credited as of the next day. We may process your payment electronically after we verify your identity.
This Account is Issued by Citibank, N.A.
PLOCOMM Rev 07/11
www.shelitleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065 129.116 15 065129116201 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
01 -06 -2012 01 -31 -2012 31 TELEPHONE: 1- 800.377 -5150
FAX: 1- 515- 226.4045
CARD ION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
5.710 GAL UNLEADED $19.77
0014 12 -14 1919 0918599 8924 E 116TH ST FISHERS IN 13.462 8 UNL 2.46 44.01
13.462 GAL UNLEADED $44.01
0014 12 -16 0952 0928119 3748 N HIGH SCHOOL RD INDIANAPOLIS IN 4.501 8 UNP 0.82 15.34
4.501 GAL UNL PLUS $15.34
0014 12 -22 1654 0198168 9510 E 126TH ST FISHERS IN 7.991 8 UNL 1.46 26.94
7.991 GAL UNLEADED 526.94
0014 12 -23 16:47 0317834 11601 ALLISONVILLE RD FISHERS IN 15.344 8 UNL 2.81 51.71
15.344 GAL UNLEADED 551.71
0014 12 -25 19:37 0004507 8924 E 1 ?6TH ST FISHERS IN 16.022 8 UNL 293 53.66;/
16.022 GAL UNLEADED $53.66
0014 12 -28 1622 0596130 1551 N ILLINOIS INDIANAPOLIS IN 16.674 8 UNL 3.05 56.01-✓
16.674 GAL UNLEADED 556.01
0014 12 -31 2052 0167262 1230 S RANGELINE RD CARMEL IN 14.100 8 UNL 2.58 49.35
14.100 GAL UNLEADED S49.35
TOTAL CARD 0014 106.315 19.44 356.84
GRAND TOTAL 198.515 36.31 658.04
FEDERAL EXCISE TAX
198.5 GALLONS GASOLINE 36.31 CR
TOTAL *FINANCE CHARGE' BILLED IN 2011 $0.00
Message Codes: 1 Electronic Sale with Authorization 4 Electronic Sale without Authorization 8 Electronic Sale at Pump
2 Keyed Sale with Authorization 5 Keyed Sale without Authorization 9 Manual Sale
6057 0015 GUG 1 7 2 120106 9366 8015 SH33 4933
NOTICF:.SEE RFVERSF• SIDE FOR IMPORTANT INFORMATION PLEASE YEEP THIS PORTION FOR YOUR RECORDS
0004933 Page 2 of 2 FLET2GUG
Information About Your Account
Report a Lost or Stolen Card Immediately: Our Customer Service Representatives are available by phone 24 hours a day, 7
days a week.
Payment Instructions: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we
do, it will be credited as of that day. A payment received at the processing facility in proper form after that time will be credited as
of the next day. Allow 5 to 7 days for payments by regular mail to reach us. There may be a delay of up to 5 days in crediting a
payment we receive that is not in proper form or is not sent to the correct address. The correct address for a payment sent by
regular mail is the address listed on the return envelope or on the front of the payment coupon. If you wish to send a payment by
express courier, you must call us for the correct address at the Customer Service number shown on the front of this statement.
Proper Form. For a payment sent by mail or courier to be in proper form, you must:
Enclose a valid check or money order. No cash or foreign currency please.
Include your name and account number on the front of your check or money order.
If you send an eligible check with the payment coupon, you authorize us to complete your payment by electronic debit. If
we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive
the check. Also, the check will be destroyed.
Optional Pay by Phone Service. You may use this optional service any time to make a payment by phone. You will be charged
$14.95 to use this service. Call by 5 p.m. Eastern time to have your payment credited as of that day. If you call after that time,
your payment will be credited as of the next day. We may process your payment electronically after we verify your. identify
This Account is Issued by Citibank, N.A.
PLOCOMM Rev 07/11
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/06/12 65129116201 gasoline $621.73
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. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
Processing Center
IN SUM OF
P.O. Bc
Columk
�w
ON P ON FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 I 65129116201 I 42- 314.00 I $621.73 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
Thursday, January 26, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Circle K
SALES RECEIPT
57 442 118281
SHELL
9518 EAST 126TH STRE
FISHERS
1
E
C
GALLONS FUEL TOTAL
15.288 51.51
TOTAL SALE 51.51
Thank You*
:Come Again*
x
Circle K
SALES RECEIPT
57 442 111209
SHELL
7788 EAST 96TH STREE
FISHERS
IN 46038
DATE12 /21/11 10:59AM
INVOICE# 215756
RUTH# 021886
SHELL FLT
ACCOUNT NUMBER
PUMP PRODUCT */G
83 UNLD $3.119
GALLONS FUEL TOTAL
18.550 32.91
TOTAL SALE 32.91
Thank You*
Come Again*
Circle K
SALES RECEIPT
57 442 119281
SHELL
9519 EAST 126TH STRE
FISHERS
IN 46938
DATE91/92/12 7:49PM
INVOICE## 321595
RUTH* 992125
SHELL FLT
ACCOUNT NUMBER
CARMEL POLICE DEPART
PUMP PRODUCT */G
97 UNLD $3.389
GALLONS FUEL TOTAL
15.971 51.98
TOTAL SALE 51.98
Thank You*
Come Again
P x t 4
VIelcone To
Manassas Shell
SHELL 57543991400
8904 CENTREUILLE RD
tIANASSAS UA
20110
1211612011 01:54:32 PII 344637625
SHELL FLT
IHUDICE 804864
RUTH 016708
PUIIPO 1
Regular 6.9120
PRICEIGAL 3.179
FUEL TOTAL 21.97
Subtotal 21.97
Tax 0.00
Total 21.97
CREDIT 21.97
Shell Hitrogen Enriched Gasolines.
Helping you get the post out of every
drop!
Thank You And
Please Cone Again
703 -368 -9398