177539 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $1,788.95
s CARMEL, INDIANA 46032 PO BOX 183019
COLUMBUS OH 43218-3019 CHECK NUMBER: 177539
CHECK DATE: 9/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193909 903.13 GASOLINE
1110 4231400 65129116909 885.82 GASOLINE
www.shelifleetcard .accountonline.com
ACCOUI;IT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065 127 -193 29 065127193909 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -02 -2009 09 -27 -2009 29 i o TELEPHONE: 1-800-377 -5150
FAX: 1 -515. 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
970.40 .00 834.71 901.98 CR .00 903.13
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 09 -27 -2009
;CARD TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
08 -21 PAYMENT THANK YOU 834.71 CR
0002 08.07 1500 0852137 1230 S RANGELINE RD CARMEL IN 14.172 8 UNL I 2.59 37.70
14.172 GAL UNLEADED $37.70
0002 08 -17 09:13 0048926 1821 E 151ST ST CARMEL IN 13.991 8 UNL I 2.56 34.00
13.991 GAL UNLEADED $34.00
0002 08 -26 08:48 0994657 1230 S RANGELINE RD CARMEL IN 14.474 8 UNL 2.65 37.20
14.474 GAL UNLEADED S37.20
0002 09 -01 1352 0036798 1230 S RANGELINE RD CARMEL IN 13.760 8 UNL 2.52 34.40
13.760 GAL UNLEADED $34.40
TOTAL CARD 0002 56.397 10.32 143.30
0004 08 -14 1009 0728089 165 SR 160 HENRYVILLE IN 12.030 8 UNL 2.20 32.00
12.030 GAL UNLEADED $32.00
0004 08 -18 13:54 0059568 1821 E 151ST ST CARMEL IN 15.533 8 UNP 2.84 39.44
15.533 GAL UNL PLUS $39.44
0004 08 -30 0409 0097865 9510 E 126TH ST FISHERS IN 14.001 8 UNL 2.56 34.15
14.001 GAL UNLEADED S34.15
TOTAL CARD 0004 41.564 7.60 105.59
0005 08 -27 11:31 0852111 8924 E 116TH ST FISHERS IN 8.540 8 UNL 1.56 20.83
8.540 GAL UNLEADED $20.83
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7892
NOTICE: SEE REVERSE SIDE F IM INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007892 Page 1 of 3 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.
o Include your name and account number on the front of your check or money order. J
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.
Note: Your account is owned and serviced by Citibank (South Dakota), N.A.
PLOCOMM Rev 06/08
www.sheliFleetcard.accountonli ne.com
4CCOUNT ;,'UMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065 -127 -193 29 065127193909 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, lA 50368 -9081
09 -02 -2009 09- 27.2009 29 TELEPHONE: 1.800 -377.8150
FAX: 1. 515.226 -4045
CARD A CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
0005 08 -28 13:16 0722843 1360 N GREEN BROWNSBURG IN l 11851 8 UNL 2.53 3420
13.851 GAL UNLEADED 7 9(x834.20
TOTAL CARD 0005 22,391 J ii J 22.391 4.09 55.03
'i!006 08.04 16:18 0928184 1821 T C MEL IN.yy �7 Ll,� 8 MIS 35.01
OIL FILTR 7�i� L $35.01
0006 08 -09 13:11 0168153 10 N MORTON STREET FRANKLIN IN 13 740 8 UNL 2.51 36.01)
13.740 GAL UNLEADED $36.00
0006 08 -20 16:43 0954487 1230 S RANGELINE RD CARMEL IN 15.242 8 UNL 279 3902
15.242 GAL UNLEADED $39.02
0006 08 -26 17:42 0999052 1230 S RANGELINE RD CARMEL IN 12.604 8 UNL 2.31 31.51
12.604 GAL UNLEADED S31.51
0006 08-27 18:59 02428G7 501 N FARES EVANSVILLE IN 14.985 8 U.NL. 2.74 37.00
14.985 GAL UNLEADED $37.00
0006 08 -29 11'.47 0018473 1230 S RANGELINE RD CARMEL IN 13.800 8 UNL 2.53 34.50
13.800 GAL UNLEADED $34.50
TOTAL CARD 0006 70.371 12.88 213.04 J
0007 08 -04 15:48 0826347 1230 S RANGELINE RD CARMEL IN 14.954 8 UNL 2.74 3915-
14.954 GAL UNLEADED $39.75
0007 08 -13 20:12 0902353 1230 S RANGELINE RD CARMEL IN 15.364 8 UNL 2.81 39.01
15.364 GAL UNLEADED $39.01
0007 08 -23 0652 0828400 11601 ALLISONVILLE RD FISHERS IN 8 -412 8 UNL 1.54 21.20
8.412 GAL UNLEADED $21.20
TOTAL CARD 0007 38.730 7.09 99.96
0011 08 -16 18:34 0116376 633 W MAIN SR 32 WESTFIELD W 10.300 8 UNL 1.88 25.03-
10.300 GAL UNLEADED 525.03
0011 OB -28 18.31 0152546 1821 E 151ST ST CARMEL IN 6.170 8 UNL 1.13 15.00
6.170 GAL UNLEADED $15.00
TOTAL CARD 0011 16.470 3.01 40.03 YY
0016 08 -08 1220 0714329 8924 E 116TH ST FISHERS IN 15.130 8 UNL 2.77 39.34
15.130 GAL UNLEADED $39.34
0016 08 -23 1428 0810382 7788 E 96TH ST FISHERS IN 15.602 8 UNL 2,86 39.63/
15.602 GAL UNLEADED 539.63
TOTAL LARD 0016 30.732 5.63 78.97
0021 08 -04 16:26 0102780 1601 EAST STATE RD 44 SHELBYVILLE IN 18.804 8 UNL 344 50.00
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7892
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007x92 Page 2 of 3 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065- 127 -193 29 065127193909 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -02 -2009 09 -27 -2009 29 TELEPHONE: 1- 8003776150
FAX: 1 -515- 226 -4045
CARD TRANS, CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
18.804 GAL UNLEADED 550.00
TOTAL CARD 0021 18.804 3.44 50.00
0022 08 -21 23:02 0145912 633 W MAIN SR 32 WESTFIELD IN 8.002 8 UNL 1.46 20.23
8.002 GAL UNLEADED $20.23
TOTAL CARD 0022 8.002 1.46 20.23 J
0024 08 -07 16:29 0273185 1 -75 HWY 25/627/1) RICHMOND KY 9.520 8 UNL 1.74 25.43✓
9.520 GAL UNLEADED S25.43
0024 08 -10 20:12 0107136 200 EASTERN BYP 175 RICHMOND KY 12.643 8 UNL 2.31 32.86✓
12.643 GAL UNLEADED $32.86
0024 08 -14 13:19 0412726 5521 ATHENS BOONESBRO RD LEXINGTON KY 10.243 8 UNL 1.87 25.71
10.243 GAL UNLEADED $25.71
TOTAL CARD 0024 32.406 5.92 84.00
0028 08 -08 17:03 0967042 1821 E 151ST ST CARMEL IN 15.810 8 UNL 2.89 40.95
15.810 GAL UNLEADED $40.95
0028 08 -27 11:15 0174631 633 W MAIN SR 32 WESTFIELD IN 16.040 8 UNL 2.94 39.30
16.040 GAL UNLEADED $39.30
TOTAL CARD 0028 31.850 5.83 80.25
GRAND TOTAL 367.717 67.27 970.40
FEDERAL EXCISE TAX
367.7 GALLONS GASOLINE 67.27 CR
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7892
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007892 Page 3 of 3 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065- 129 -116 27 065129116909 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09- 02-2009 09- 27.2009 29 TELEPHONE: 1- 800377 -5150
FAX: 1. 515 226 -4045
NEW CHARGES FLEET FEE PREVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
955.37 .00 458.47 528.02 CR 00 885.82
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 09 -27 -2009
CARD TRANS TRANSACTION LOCATION I DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
08 -21 PAYMENT THANK YOU 458.47 CR
0003 08 -04 14:18 0450189 9599 N MERIDIAN ST INDIANAPOLIS IN 15.911 8 UNL 2.91 42.31'✓ CR
15.911 GAL UNLEADED $42.31
0003 08 -08 11:51 0379792 2224 N 600 WEST GREENFIELD IN 13.500 8 UNL 2.47 35.64✓
13.500 GAL UNLEADED $35.64
0003 08 -09 19:15 0085266 4121 NATIONAL RD W RICHMOND IN 11950 8 UNL 2.19 31.18
11.950 GAL UNLEADED $31.18
0003 08 -12 16:53 0744680 8924 E 116TH ST FISHERS IN 15.482 8 UNL 2.83 39.31
15.482 GAL UNLEADED $39.31
0003 08 -17 11:04 0927921 1230 S RANGELINE RD CARMEL IN 16.191 8 UNL 2.96 39.49v
16.191 GAL UNLEADED 539.49
0003 08 -21 20:02 0633578 1551 N ILLINOIS INDIANAPOLIS IN 16.062 8 UNL 2.94 41.12
16.062 GAL UNLEADED 541.12
0003 08.27 09:08 0838078 6995 E US HIGHWAY 36 AVON IN 13.952 8 UNL 2.55 33.89
13.952 GAL UNLEADED 533.89
0003 08 -31 17:58 0887919 11601 ALLISONVILLE RD FISHERS IN 16.221 8 UNL 2.97 40.05
16.221 GAL UNLEADED $40.05 S
TOTAL CARD 0003 119.269 21.82 302.99 'j
0006 08 -20 07:07 0949610 1230 S RANGELINE RD CARMEL IN 19.302 8 UNL 3.53 47.08
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7893
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION P KEEP THIS PORTION FOR YOUR RECORDS
0007893 Page 1 of 3 FLET2GUG
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ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065 129 116 27 065129116909 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -02 -2009 09 -27 -2009 29 TELEPHONE: 1. 8003773150
FAX: 1 -515- 226 -4045
CARD TRANS CTION TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
19.302 GAL UNLEADED $47.08
0006 08 -27 23:49 0533778 1230 WEST SR 32 LEBANON IN 23.704 8 UNL 4.34 59.00✓
23.704 GAL UNLEADED S59.00
TOTAL CARD 0006 43.006 7.87 106.08
0007 08 -05 07:51 0183855 9611 ALLISONVILLE RD INDIANAPOLIS IN 19.044 8 UNL 3.49 50.64
19.044 GAL UNLEADED $50.64
0007 08 -12 09:21 0080333 7024 N KEYSTONE AVE INDIANAPOLIS IN 17.723 8 UNL 3.24 45.00
17.723 GAL UNLEADED 545.00
0007 08 -14 08:10 0088641 7024 N KEYSTONE AVE INDIANAPOLIS IN 18.905 8 UNL 3.46 48.00
18.905 GAL UNLEADED $48.00
0007 08 -16 0926 0640326 2434 N KEYSTONE AVE INDIANAPOLIS IN 15.123 8 UNL 2.77 37.49f
15.123 GAL UNLEADED 537.49
0007 08 -20 0704 0949594 1230 S RANGELINE RD CARMEL IN 18.954 8 UNL 3.47 46.23
18.954 GAL UNLEADED $46.23
0007 08 -27 06:49 0142224 7024 N KEYSTONE AVE INDIANAPOLIS IN 16.335 8 UNL 2.99 40.48
16.335 GAL UNLEADED $40.48
0007 09 -01 18:22 0872515 9599 N MERIDIAN ST INDIANAPOLIS IN 19.766 8 UNL 3.62 49.00
.19.766 GAL UNLEADED $49.00
TOTAL CARD 0007 125.850 23.04 316.84
0009 08 -17 21:02 0905125 6402 W 10TH INDIANAPOLIS IN 9.423 8 UNL 112 21.57✓
9.423 GAL UNLEADED $21.57
0009 08 -24 14:50 0332734 4624 LAFAYETTE RD INDIANAPOLIS IN 3.970 8 UNL 0.73 10.01
3.970 GAL UNLEADED $10.01
0009 08 -27 1605 0923177 721 E 81ST AVE MERRILLVILLE IN 6.141 8 UNL 1.12 15.36
6.141 GAL UNLEADED $15.36
0009 08 -28 16:16 0464628 2224 N 600 WEST GREENFIELD IN 8.141 8 UNL 1.49 20.02./
8.141 GAL UNLEADED 520.02
0009 08 -31 14:46 0290510 8598 N MIGHIGAN RD INDIANAPOLIS IN 8.071 8 UNL 1.48 20.011
8.071 GAL UNLEADED S20.01
TOTAL CARD 0009 35.746 6.54 86.97
0010 08 -05 15:44 0693911 8924 E 116TH ST FISHERS IN 7.942 8 UNL 1.45 2104
7.942 GAL UNLEADED $21.04
0010 08 -20 14:52 0915389 6402 W 10TH INDIANAPOLIS IN 11.561 8 UNL 2.12 29.25
11.561 GAL UNLEADED $29.25
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7893
NOTICE: S REV SI F OR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007893 Page 2 of 3 FLET2GUG
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-ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES
SHELL CARD CENTE
065- 129.116 27 065129116909 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
09 -02 -2009 09 -27 -2009 29 TELEPHONE: 1.800.377-5150
FAX: 1 -515- 226 -4045
CARD TRA TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
NUMBER DATE TIME ID CD CD TAX AMOUNT
0010 08 -22 15:14 0970244 1230 S RANGELINE RD CARMEL IN 7.782 8 UNL 1.42 20.00
7.782 GAL UNLEADED $20.00
.0010 08 -26 2220 0919027 721 E 81ST AVE MERRILLVILLE IN 14.693 8 UNL 2.69 36.72
14.693 GAL UNLEADED S36.72
0010 08 -27 16:04 0923151 721 E 81ST AVE MERRILLVILLE IN 14.192 8 UNL 2.60 35.48
14.192 GAL UNLEADED $35.48
TOTAL CARD 0010 56.170 10.28 142.49
GRAND TOTAL 380.041 69.55 955.37
FEDERAL_ EXCISE TAX
380.0 GALLONS GASOLINE 69.55 CR
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 0028 GUG 1 7 2 090902 9366 8015 SH26 7893
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
0007893 Page 3 of 3 FLET2GUG
PrescnA by State Board of Accounts �r a- City Form No. 201 (Rev. 1995)
ACC:UUNITS 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
'Shell Fleet Plus Purchase Order No.
_Processing Center Terms
P.O. BOx 183019
C61umb.us, ON 43218 -3019 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/2/09 65127193909 monthl payment 903.13
9/2/09 65129116909 monthly payment 885.82
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
VQUCHER NO. WARRANT NO.
ALLOWED 20
R
Shell Fleet Plus
Processing Center IN SUM OF
P.O. Bbx 183019
Columbus, OH 43218 -3019
1,788.95
ON ACCOUNT OF APPROPRIATION FOR
olice general fund
k
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 65129116909 314 885.82 bill(s) is (are) true and correct and that the
1110 65127193909 314 903.13 materials or services itemized thereon for
which charge is made were ordered and
received except
September 22 2 0 09
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund