207718 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
0 ONE CIVIC SQUARE WRIGHT EXPRESS FSC CHECK AMOUNT: $865.67
CARMEL, INDIANA 46032 PO BOX 6293
CAROL STREAM IL 60197 -6293 CHECK NUMBER: 207718
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 28995399 146.75 0496 -00- 138007 -0
1207 4231400 28996496 157.59 0496 -00- 138002 -1
1120 4231400 29003807 561.33 0496 -00- 138012 -0
2v5
I nvoi Rede ent
INVOICE NUMBER: 28996496
ACCOUNT NAME: City of Carmel Admin.
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496- 00.138002 -1 550.00 31 MAR -31 -2012 APR 262012 157.59
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
MAR -12 -2012 PAYMENT THANK YOU 31.46
MAR -30 -2012 FUEL PURCHASES 15759'
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
D
Q a
APR 0 2 2012
By
PURCHASES, RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS (,)PURCHASES )DEBITS CREDITS )LATE FE )NEW BALANCE
31.46 31.46 157.59 0.00 0.00 0.00 157.59
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 to late
applying a monthly rate of RATE of fee for this period which is
2.08 24.99 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
TO cnl(3 IPC DPf)P rPFTIIT TEAR AT PFRFf1RATI ON ANTI IK]rl I ITIF Rr)TTOKA Pr)PT1(IN WITH Yrll IR PAVMFNT
I nvoim Statement
INVOICE NUMBER: 29003807
ACCOUNT NAME: City of Carmel Fire
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496 -00- 138012 -0 3400.00 31 MAR -31 -2012 APR 262012 561.33
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
MAR -12 -2012 PAYMENT THANK YOU 677.24
MAR -30 -2012 FUEL PURCHASES 561.33
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
D
APR 0`2 2012
By
PURCHASES, RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
PREVIOUS BALANCE PAYMENTS )PURCHASES )DEBITS CREDITS LATE FE NEW BALANCE
677.24 677.24 561.33 0.00 0.00 0.00 561.33
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 to late
applying a monthly rate of RATE of fee for this period which is
2.08 24.99 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
ERFORATION AND INCLUDE BOTTOM _PORTION WITH YOUR PAYMENT.
I nvoioe Statement
INVOICE NUMBER: 28995399
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 MAR -31 -2012 APR -26 -2012 146.75
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
MAR -30 -2012 FUEL PURCHASES 146.75
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
D i
APR 0'2 2012
By
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS )PURCHASES (,)DEBITS CREDITS LATE FE NEW BALANCE
0.00 0.00 146.75 0.00 0.00 0.00 146.75
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 to late
applying a monthly rate of RATE of fee for this period which is
2.08 24.99 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
REDIT TEAR AT PERFORATION AND INCLUDE BOTTOM_PORTION WITH Y— OUR PAYMENT.
v.
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
Wright Express FSC
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04102112 28996495 Gasoline Charges Admin $157.59
04/02/12 29003807 Gasoline Charges Fire 561.33
04/02/12 28995399 Gasoline Charges Police 146.75
Total $865.67
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 N0 04togtig WARRANT NO.
ALLOWED 20
Wright Express FSC IN SUM OF
PO Box 6293
Carol Stream, IL 60197 -6293
$865.67
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
Board Members
PO# 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
1205 28996495 314 $157.59 materials or services itemized thereon for
1120 29003807 `3) $561.33 which charge is made were ordered and
28995399 -3�4 $146.75 received except
A20
ZOO
33
d
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund