177308 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 357956 Page 1 of 1
ONE CIVIC SQUARE MARATHON PETROLEUM CO LLC CHECK AMOUNT: $219.74
CARMEL, INDIANA 46032 P 0 Box 740109
CINCINNATI OH 45274 -0109 CHECK NUMBER: 177308
CHECK DATE: 9/15/2009
DEP ACCOUNT PO NUMBER INVOICE NUMBER A AMOU DESC
1110 4231400 1005116148 219.74 GASOLINE
P ;tAILDESK v
FINDLAY, OH 45840
k
CALL: 1- 800 -537 -9580
FAX: (419)- 421 -4516
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TRANS TRANS, DOCUMENT'S L
3DATE TIME NUMBER LOCATION or DESCRIPTION qF TRANSACTION x A ;Rp u P RO
CODE
CALa' PR ICtz' AMOUNT.4
CURRENT CREDIT LI11IT IS: $1000.00
PREVIOUS BALANCE
08 -31 TOTAL TAX CREDITS
08 -24 0 PAYMENT THANK YOU
08 -05 948 5047028 12512 E 116TH STREET FISHERS IN 02 13.7 2.65 36.48
08 -11 2222 5020017 12512 E 116TH STREET FISHERS IN 02 14.4 2.57 37.10
TOTAL CARD 262 28.1 73.58
08 -20 641 5023029 12512 E 116TH STREET FISHERS IN 02 17.7 2.43. 43.25
TOTAL CARD 265 17.7 43.25
08 -23 1716 5017018 12512 E 116TH STREET FISHERS IN 02 13.6 2.55S 34.91
08 26 1105 5056032 509 EAST HWY 20 MICHIGAN CITY IN 02 13.7 2.471 33.94
TOTAL CARD 270 27.3 68.85
08 -14 1225 5009015 3303 45TH STREET HIGHLAND IN 02 13.5 2.45 33.14
08 -24 1943 5024080 6302 WEST WASHINGTON ST INDIANAPOLIS IN 02 13.5 2.47 33.37
TOTAL CARD 271 27.0 66.51
TOTAL ALL CARDS 100.1 252.19
Form OL06 08/2007
X3vp
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STATEMENT OF CREDIT CARD TERMS the account is referred to an attorney or collection agency, you agree to pay, in addition to
MARATHON REGULAR AND the full amount owed, reasonable attorney's fees, court costs, or collector's fees, as
PREMIER CARDS ASHLAND REGULAR CARD allowed by applicable state law. Where permissible by law, MPC will impose a processing
EFFECTIVE 11 -01 -06 charge for each dishonored check submitted in payment of your account. The charge will
equal the lesser of $25 or the maximum amount allowed by law in your state of residence
If you have a REGULAR ACCOUNT with revolving credit the Minimum Payment Due must or billing address. MPC reserves the right to assess a reprint fee of up to $2 for each reprint
be paid on or before the due date. Revolving credit is not available to government or com- of documents and for each ticket copy requested.
mercial accounts, which must be paid in full on or before the due date.
CANCELLING OR SUSPENDING CREDIT
If you have a PREMIER ACCOUNT with revolving credit the Minimum Payment Due must
be paid on or before the due date. Revolving credit is not available to government or com- MPC can cancel or suspend a credit card account at any time. The credit card holder must
mercial accounts, which must be paid in full on or before the due date. To terminate cred- return the card on demand.
it availability under the account to avoid paying any applicable renewable fees, write: BILLING RIGHTS SUMMARY
Marathon Petroleum Company LLC, 539 S. Main St., Attn: Credit Card Center, Findlay, OH
45840 -3229 or call toll -free 1- 800 537 -9580 upon receipt of this statement of credit card In case of Errors or Questions About Your Bill:
terms.
If you think your bill is wrong, or if you need more information about a transaction on your
FINANCE CHARGE CALCULATION bill, write us on a separate sheet at Marathon Petroleum Company LLC, 539 S. Main St.,
If Marathon Petroleum Company LLC (MPC) has not received payment in full of the "New Attn: Credit Card Center, Findlay, OH 45840 -3229, as soon as possible. We must hear
Balance" by the due date shown on the front of this statement, we assess a FINANCE from you no later than 60 days after we sent you the first bill on which the error or problem
CHARGE applied to the Average Daily Balance. The Average Daily Balance and FINANCE appeared. You can telephone us, but doing so will not preserve your rights. In your letter,
CHARGE are calculated as follows: give us the following information:
1. The balance at the beginning of each day is added to new purchases applied to Your name and account number.
your account that day. (New purchases are not included in computing your The dollar amount of the suspected error.
Average Daily Balance in the states of ME, MN, MS, MT, ND, NE, NM, and RI.)
From the sum, we subtract payments or credits, insurance premiums, mail order Describe the error and explain, if you can, why you believe there is an error. If you
merchandise charges, unpaid charges for dishonored checks, previously assessed need more information, describe the item you are not sure about.
unpaid finance charges and late payment fees. You do not have to pay any amount in question while we are investigating, but you are still
2. We then add up all the daily balances for the billing period and divide the total by obligated to pay the parts of your bill that are not in question. After we receive your letter,
the number of days in the billing cycle. This gives us the "Average Daily Balance we cannot try to collect any amount you question, or report you as delinquent.
3. The FINANCE CHARGE is computed by applying the periodic rate allowable by S pecial Rule for Credit Card Purchases:
law in your state of residence to the "Average Daily Balance" on your account. If you have a problem with the quality of property or service that you purchased with a cred-
4. Computed FINANCE CHARGES of less than $.50 are adjusted to $.50 except in it card, and you have tried in good faith to correct the problem with the merchant, you may
AK, AR, CA, CT, DE, FL, GA, HI, ID, KY, MD, MI, MO, NC, ND, NE, NH, NM, NV, have the right not to pay the remaining New Balance on the property or services. There are
NY, OH, OR, RI, TN, TX, UT and WA. two limitations on this right: (a) You must have made the purchase in your home state or,
if not within your home state, within 100 miles of your current mailing address; and (b) The
Residents of North Dakota: The amount of the FINANCE CHARGE is computed by purchase price must have been more than $50. These limitations do not apply if we own
multiplying the periodic rate by the "Adjusted Balance" of the account. MPC gets the or operate the merchant, or if we mailed you the advertisement for the property or services.
Adjusted Balance by taking the balance owed at the end of the previous billing cycle
and subtracting amounts from Item 1, above, received during the current billing cycle. As required by law, you are hereby notified that a negative credit report reflecting on
your credit record may be submitted to a credit reporting agency if you fail to fulfill
NOTICE TO CARD HOLDER the terms of your credit obligations.
To avoid additional FINANCE CHARGES being applied to your account purchases on next For questions or account information write:
month's statement, pay the New Balance on this statement in full by the due date. You may
at any time pay your total unpaid balance to avoid additional FINANCE CHARGES. MARATHON PETROLEUM COMPANY LLC
DEFAULT, COLLECTION COSTS, DISHONORED CHECKS, REPRINT FEES 539 S. MAIN ST.
ATTN: CREDIT CARD CENTER,
If your account is not paid according to terms, MPC reserves the right to demand immedi- FINDLAY, OH 45840 -3229 OR
ate payment of the full amount outstanding on your account, subject to applicable law. If CALL: 1 -800- 537 -9580 FAX 419- 421 -4516
Form 50480 REV. 11/06
EXEMPT ACCOUNTS
Page 1 of I
ACCOUNT NUMBER 1005116148
Keep thi fo r your records S T IEMENLC.L9�IN A1�_
PHLIIOUSflALANCE PMTSlGREDI S eCI♦FRGfSlADJ +fIIdAIdCL=CHARTC P1BVRALAWCE'
$81.60 $114.05 5252.19 $.00 :5219.74
r0 AVOID ADDITION
YEAR 10 DATE ANNUAL AVERAGE DAILY FINANCE. CHARGE PAYr
MOf�LHLYHEHIODIC
FINANCE PERCENTAGE bAIAN6E SUWECT TO OF AMOUNT DUE MU:
CHARGE RATE IN] ERESTRATE FINANCE CHARGE HE RECEIVED BY n
DUE DATE SHOWN hE
$.00 21.0 1.75 $.00 09 -25
PROD CODES:
01 Reg. Unleaded F/S 07 Diesel
02 Reg. Unleaded S/S 08 Misc. FUelS(Kerosene,L,
03 Mid Grade Unl F/S 09 Misc. Products(Washer
04 Mid Grade Unl S/S 10 Service /Labor,Parts
05 Prem Unleaded F/S 12 C Store "Item
npany LLC 06 Prom Unleaded S/S
URCHASES LESS 6Ebk •ION F O APPLICABLE TAXES
3 GROSS 5
MISC'n AMOUNT FEDERAL r LATE FEDERAL STALE STATE` INVOICE
AMOUNT -i y GAS TAX GAS TAX :DSL TAX DoL LAX 5
SLS TAX oL TAX
$81.60
$32.45CR
$81.60CR
'.pry
36.48 2.51 2.0 31.91
37.10 2.641 2.0 32.37
73.58 5.15 4.1 $64.28
43. 2 3.2ei 2.4 37.60
f
43.25 3.2 2.4 $37.60
34.91 2.4 1.9c 30.46
33.9 2.51 1.8 29.54
68.8E 5.0 3.8 $60.00
33.1 2.47 1.8 28.82
33.3 2.4 1.81 29.04
66.51 4.% 3.7 $57.86 F
252.19 18.3 14.1 $219.74
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CAR-MEL
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
Mar athon Petroleum Company Purchase Order No.
PO Box 740109
Terms
Cincinnati, OH 45274 -0109
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/11/2009 monthly payment 219.74
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
Marathon Petroleum Company IN SUM OF
1O Box 740109
Cincinnati, OH 45274 -0109
219.74
ON ACCOUNT OF APPROPRIATION FOR
police general fund
1 0 tG 1b I r f 9 Board Members
POM or DEPT INVOICE NO. I A #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 314 219.74 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
Sept 11, 20 09
Si
.SS7 Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund