206530 02/22/2012 CITY OF CARMEL, INDIANA VENDOR: 00352984 Page 1 of 1
ONE CIVIC SQUARE FLEET SERVICES CHECK AMOUNT: $135.62
CARMEL, INDIANA 46032 PO BOX 6293
4 oe ac CAROL STREAM IL 60197 CHECK NUMBER: 206530
CHECK DATE: 2/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 28435060 135.62 0490 -00- 138007 -0
I nvoi ce Statement
INVOICE NUMBER: 28435060
ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00- 138007 -0 2100.00 31 JAN -31 -2012 FEB-24 -2012 135.62
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
JAN -19 -2012 PAYMENT THANK YOU 270.66
JAN -31 -2012 FUEL PURCHASES 28.43
REMINDER
BALANCE INCLUDES PAST DUE AMOUNT IF PAYMENT HAS
BEEN MADE, PLEASE DISREGARD THIS NOTICE PAST DUE
ACCOUNTS ARE SUBJECT TO SERVICE INTERRUPTION
FEB 1 6 2012
By
PURCHASES, RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
CURRENT PERIO ONE BILLING PERIOD PAST DU TWO BILLING PERIODS PAST DUE I THREE+ BILLING PERIODS PAST DUE TOTAL DUE
38.43 97.19 0.00 0.00 135.62
PREVIOUS BALANCE PAYMENTS )PURCHASES )DEBITS CREDITS (,)LATE FE )NEW BALANCE
367.85 270.66 28.43 0.00 0.00 10.00 135.62
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an EFFECTIVE ANNUAL To the balance subject io late
applyingarnon thl rate of RATE of fee for this period which is
2.0B 24.99 125.62
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
TO ENSURE PROPER CREDIT_TEAR AT RERFOBATION AND INCLUDE BOTTOM_PORTION WI TH YOUR PAYMENT.
ACCOUNT NAME City of Carmel Polio
ACCOUNT NUMBER 0495 -00. 136007 -0 Circle K Fleet
INVOICE NUMBER 28435060
BILL CLOSING DATE JAN -31 -2012 FAX CHANGE OF ADDRESS REQUEST TO 1- 800 395-0809.
Make check payable to: FLEET SERVICES.
AMOUNT DUE 135.62 Use endosW envelope or seed to:
AMOUNT ENCLOSED 3 Z
PAYMENT DUE DATE FEB -24 -2012
PAYMENTS RECEIVED AFTER THIS DATE SUBJECT TO LATE FEES
A
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FLEET SERVICES
P.O. BOX 6293
CAROL STREAM IL 60197 -6293
Prescribed by State board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Fle Services Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/16/12 28435060
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 N09 2116/12 WARRANT NO.
ALLOWED 20
Fleet Services
IN SUM OF
PO Box 6293
Carol Stream, IL 60197 6293
$135.62
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
Board Members
POO or
DEPT. INVOICE NO, ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
28435060 314 135.62 materials or services itemized thereon for
which charge is made were ordered and
received except
R
20
atur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund