208167 04/24/2012 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
0 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER
CARMEL, INDIANA 46032 PO BOX 183019 CHECK AMOUNT: $738.25
COLUMBUS OH 43218 -3019 CHECK NUMBER: 208167
CHECK DATE: 4/24/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065127193204 738.25 065 -127 -193
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www.shelifleetcard.accountonline.com
ACCOUNTNUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065- 127 -193 13 065127193204 SHEL B CENTER
P.O. BOX X 6 68 89081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
z 04 -05- 2012 04 -30 -2012 30 TELEPHONE: 1 -800.377.5150
FAX: 1-515- 226 -4045
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NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS /ADJUSTMENTS LATE FEE NEW BALANCE
774.43 .00 626.43 662.61 CR .00 738.25
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 04 -30 -2012
Card TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number 70619:16 ID CD CD TAX AMOUNT
PAYMENT -THANK YOU 626.43 CR
0001 0936336 633 W MAIN SR 32 WESTFIELD IN 16.082 8 UNL 2.94 63.35
16.082 GAL UNLEADED $63.35
TOTAL CARD 0001 16.082 2.94 63.35
0004 03 -23 14:18 0738237 1230 S RANGELINE RD CARMEL IN 23.772 8 UNL 4.35 95.09
23.772 GAL UNLEADED $95.09
0004 04 -02 1323 0802660 1230 S RANGELINE RD CARMEL IN 2 1. 500 8 UNL 3.93 86.00
21.500 GAL UNLEADED $86.00
TOTAL CARD 0004 45.272 8.28 181.09
0016 03 -09 1128 0067652 11109 AUGUSTA HWY WALTERSBORO SC 9.292 8 UNL 1.70 34 -00
9.292 GAL UNLEADED $34.00
0016 03 -09 14:18 0861369 1880 HIGHWAY 14 E LANDRUM SC 7.461 8 UNL 1.37 2610
7.461 GAL UNLEADED $26.10
0016 03 -09 1916 0219378 137 CONNECTOR ROAD 8 175 GEORGETOWN KY 13.603 8 UNL 2.49 49.23
13.603 GAL UNLEADED $49.23
TOTAL CARD 0016 30.356 5.56 109.33
0018 03 -13 1632 0672873 8924 E 116TH ST FISHERS IN 16.072 8 UNL 2.94 .62.99,
16.072 GAL UNLEADED $62.99
0018 03 -21 08:46 0010736 633 W MAIN SR 32 WESTFIELD IN 14.291 8 UNL 2.62 57.15
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 0014 GUG 1 7 2 120405 9366 8015 SH33 4979
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
t
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.
Include your name and account number on the front of your check or money order.
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.
This Account is Issued by Citibank, N.A.
PLOCOMM Rev 01/12
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www.shellfleetcard.accountonline.com
ACCOUNTNUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES
SHELL CARD CENTER
065- 127 -193 13 065127193204 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES, IA 50368 -9081
04 -05- 2012 04 -30 -2012 30 TELEPHONE: 1 -800377 -5150
FAX: 1315 226 -4045
Caid TRANS TRANSACTION LOCATION DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
14.291 GAL UNLEADED $57.15
TOTAL CARD 0018 30.363 5.56 120.14
0029 03 -15 10:27 0215483 808 W MAIN ST CARMEL IN 17.494 8 UNL 320 6821
17.494 GAL UNLEADED $68.21
0029 03 -23 11:20 0736801 1230 S RANGELINE RD CARMEL IN 17.662 8 UNL 3.23 70.65
17.662 GAL UNLEADED $70.65
0029 04 -03 12:21 0584524 7024 N KEYSTONE AVE INDIANAPOLIS IN 18.063 8 UNL 3 -31 74.24
18.063 GAL UNLEADED $74.24
TOTAL CARD 0029 53.219 9.74 213.10
0030 03 -28 1647 0770610 1230 S RANGELINE RD CARMEL IN 12.471 8 UNL 2.28 51.87 V
12.471 GAL UNLEADED $51.87
TOTAL CARD 0030 12.471 2.28 51.87
e 0032 03 -13 07:21 0628321 2181 OLD FORT PKWY 124 MURFREESBORO TN 9.960 8 UNL 1.82 35.55
9.960 GAL UNLEADED $35.55
TOTAL CARD 0032 9.960 1.82 35.55
GRAND TOTAL 197.723 36.18 774.43
s FEDERAL EXCISE TAX
197.7 GALLONS GASOLINE 36.18 CR
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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 0014 GUG 1 7 2 120405 9366 8015 SH33 4979
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
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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.
Include your name and account number on the front of your check or money order.
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.
This Account is Issued by Citibank, N.A.
PLOCOMM Rev 01/12
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/05/12 65127193204 gasoline $738.25
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 NO. WARRANT NO,
ALLOWED 20
Shell Fleet Plus
Processing Center
IN SUM OF
P.O. Box 183019
Columbus, OH 43218 -3019
$738.25
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 I 65127193204 I 42- 314.00 I $738.H I 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
Tuesday, April 17, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund