207825 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WRIGHT EXPRESS FSC
CARMEL, INDIANA 46032 PO Box 6293 CHECK AMOUNT: $967.03
CAROL STREAM IL 60197 -6293
CHECK NUMBER: 207825
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 29009166 967.03 GASOLINE
FLEET SERVICES INVOICE /STATEMENT
INVOICE NUMBER: 29009166
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0453 -00 794629 -6 8,100.00 31 03 -31 -2012 04 -26 -2012 967.03
DATE ACTIVITY DESCRIPTION CI fARGES/ESEBfT.S PAYMENTS /CREDITS
43 15 20it2 PAYMENT RECEIVED THANK YOU 699 92
Q3 3Q 20;12 RETAIL FUEL PURCHASES 945.03
Q3 n 26 MONTHLY CARD CHG 22.OD`
REMINDER
PLEASE BE SURE TO INCLUDE REMITTANCE STUB WITH
PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE RIGHT
PORTION OF THE REMITTANCE STUB.
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 FEE NEW BALANCE
699.92 699.92 945.03 22.00 0.00 0.00 967.03
$10.00 MINIMUM LATE FEE
PAY ONLINE AT: www.wexonline.com
CALL CUSTOMER SERVICE TO PAY BY PHONE The Late Fee is determined by Which is an ANNUAL To the Balance subject to late
FEDERAL TAX ID: 84- 1425616 applying a monthly 2eriodic rate of PERCENTAGE RATE of fee for this period which is
2.08 24.99 0.00
SEE REVERSE SIDE FOR MORE INFORMATION AND TERMS.
TO ENSURE PROPER CREDIT, TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH Yni IR PAYMFAIT
Balance Subject to Late Fee Payment Options
The late fee will be calculated by determining the total balance Mail
due on the date your account becomes delinquent, as follows: Be sure to include bottom portion of invoice with your payment.
adding the total amount due on your account on the payment due Write your account number or invoice number on the check to help
date together with any purchases posted to your account from avoid delays in payment processing if the check and remit stub
the end of the last billing cycle through the payment due date and become separated.
subtracting from that amount any payments and /or credits entered
during that period. The total balance due will then be multiplied Allow 10 business days prior to the due date for mailing to help
by the applicable periodic rate to determine your late fee. In the avoid late fees. Mail payments to:
event that the calculated late fee is less than ten dollars ($10.00), Fleet Services
a minimum late fee of ten dollars ($10.00) will be charged. PO Box 6293
Your account will be delinquent if you do not pay it in full within Carol Stream, IL 60197 -6293
26 calendar days of the billing date appearing on your invoice. Online
Certain customers, based upon our credit review, may be required Authorized users can elect to receive an email notification when an
to make payment in less than 26 calendar days on a cycle that we invoice is ready for online viewing and payment. Log in or register to
may establish for you. In addition, certain customers may elect a set up an online account at www.wexonline.com.
shorter billing or payment cycle as offered by us.
Online payments scheduled by 3:00 PM ET (on business days)
If your payment due date falls on a non business day, payment is are credited to your account on the same day. There is no fee for
due on the business day before the payment due date. Delinquent online payments.
accounts will be subject to late fees, suspension, or termination
of credit privileges, without notice. All charges must be paid in Phone
full regardless of disputes. Charges must be disputed in writing Call Customer Service at 1- 888 387 -5665 and select the menu
no later than sixty (60) days from the billing date or they will be option for Billing Inquiries. In addition to scheduling a payment, you
considered final and binding. can also check your balance.
Card Issuer Payments scheduled by 3:00 PM ET (on business days)
The Fleet Services Card is issued by, and all card transactions are credited to your account on the same day.
are funded by and payable to, Wright Express Financial Services Be prepared with your Fleet card account number and a sample
Corporation, under a Business Charge Account Agreement with check to enter your bank account number and routing number.
the cardholder named on the reverse. There is no fee for phone payments.
Customer Service Automated Clearing House (ACH)
For account Inquiries and correspondence in regard to account To make a one -time electronic payment go to:
service or billing: http: /vpvw.e- fleet.com
Call 1- 888 387 -5665, or ACH payments scheduled by 2:30 PM ET (on business days) are
credited to your account on the same day. There is a fee for each
Fax to 1 -800- 395 -0809, or ACH payment.
Mail to P.O. Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
ACCOUNT: CARMEL FIRE DEPARTMENT CLOSING DATE: 03 -31 -2012
FLEET SERVICES ACCOUNT NO: 0453 -00- 794629 -6
SERVICES
DELIVER TO:
DENISE SNYDER
CARMEL FIRE DEPARTMENT
2 CIVIC SQ
CARMEL IN 46032 -2584
Tax Summary
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX REPORTED TAX TAX TYPE TAX PRODUCT CLASS GALLONS GROSS COST TAX RATE
FEDERAL 356000972 -58.58 0.00 FEDERAL E85 320.040 1069.78 0.18300
FEDERAL TOTALS -56:58 0.00 320,0.0 1,068,76
IN 356000972 -66.17 0.00 STATE SALES E85 320.040 1 069 78 0.07000
lN. STATE TOTALS -66:17 0 00
ACCOUNT TOTALS 124.75 0.00
(c) WRIGHT EXPRESS CORPORATION 2012 PAGE 1
FLEET SERVICES STANDARD REPORT
INVOICE NUMBER: 29009166
ACCOUNT NAME: CARMEL FIRE DEPARTMENT
PAGE 1 OF 2
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD I BILL CLOSING DATE I PAYMENT DUE DATE AMOUNT DUE
0453-00-794629-6 8,100.00 31 03 -31 -2012 04 -26 -2012 967.03
CARD LOCATION DATE TIME DRIVER ODOMETER PRODUCT UNITS COST/ ITEM TOTAL
NO. NO. UNIT TOTAL AMOUNT
0001 MH 001 074 02 -29 -2012 11:03 SMITH, KEITH 14,500 E85 13.750 3.298 45.35 45.35
CARD SUBTOTALS 13.750 45.35
0002 MH 001 078 03 -06 -2012 14:32 HULETT, MARK 101,339 E85 9.700 3.299 32.00 32.00
MH 001 078 03 -08 -2012 22:28 HULETT, MARK 101,541 E85 12.700 3.358 42.65 42.65
MH 001 078 03 -20 -2012 16:16 HULETT, MARK 101,124 E85 13.800 3.359 46.35 46.35
CARD SUBTOTALS 36.200 121.00
0007 MH 001 074 03 -02 -2012 12:08 SMITH, KEITH 14,500 E85 19.390 3.300 63.98 63.98
MH 001 074 03 -09 -2012 11:53 SMITH, KEITH 14,500 E85 17.410 3.360 58.49 58.49
MH 001 074 03 -14 -2012 08:45 SMITH, KEITH 14,500 E85 21.380 3.358 71.80 71.80
MH 001 074 03 -16 -2012 11:58 SMITH, KEITH 14,500 E85 12.110 3.359 40.68 40.68
MH 001 078 03 -19 -2012 19:45 SMITH, KEITH 14,500 E85 15.550 3.359 52.24 52,24
MH 001 074 03 -23 -2012 11:53 SMITH, KEITH 14,500 E85 24.710 3.358 82.98 82.98
MH 001 074 03 -26 -2012 12:02 SMITH, KEITH 14,500 E85 17.590 3.360 59.10 59.10
CARD SUBTOTALS 128.140 429.27
4502 MH 001 074 03 -02 -2012 12:01 STEELE, JEFF 13,997 E85 22.740 3.299 75.02 75.02
MH001074 03 -06 -2012 13:17 STEELE, JEFF 14,198 E85 21.380 3.299 70.54 70.54
MH 001 074 03 -12 -2012 14:10 STEELE, JEFF 14,462 E85 24.570 3.359 82.54 82.54
MH 001 095 03 -18 -2012 13:04 STEELE, JEFF 14,699 E85 24.010 3.359 80.64 80.64
MH 001 074 03 -22 -2012 08:15 STEELE, JEFF 14,972 E85 25.070 3.358 84.19 84.19
MH 001 074 03 -26 -2012 15:10 STEELE, JEFF 15,233 E85 24.180 3.359 81.23 81.23
CARD SUBTOTALS 141.950 474.16
TOTAL PURCHASES 320.040 1,069.78
Y -T -D PURCHASES 580.310 1,897.18
SITES USED THIS MONTH NO. PURCHASES TOTAL AMOUNT
Location No. Brand Street City State Zip
MH 001 074 MEIJER 1426 W CARMEL DR CARMEL IN 46032 12 815.90
MH 001 078 MEIJER 5303 E SOUTHPORT RD INDIANAPOLIS IN 46237 4 173.24
MH 001 095 MEIJER 8225 E 96TH ST INDIANAPOLIS IN 46256 1 80.64
PRODUCTS: E85= ETHANL85
FLEET SERVICES
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VOUCHER NO. WARRANT NO.
ALLOWED 20
W? �p
IN SUM OF
P.O. Box 6293
Carol Stream, IL 60197
$967.03
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 10453 00-- 6 79646291 42 314.00 1 $967.03 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
APR
I
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund