208579 05/10/2012 CITY OF CARMEL; INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WRIGHT EXPRESS FSC
CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $196.13
CAROL STREAM IL 60197 -6293
CHECK NUMBER: 208579
CHECK DATE: 5/10/2012
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1205 4231400 29281799 196.13 0496 -00- 138002 -1
I nvoi oe Statement
I NVOI CE NUM BER: 29281799
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
0496-00-13M _1 550.00 30 APR -30 2012 MAY -25 2012 196.13
DATE ACTIVITY DESCRIPTION CHARGES /DEBITS PAYMENTS /CREDITS
APR -13 -2012 PAYMENT THANK YOU 157.59
APR40 =2012 FUEL PURCHASES 196.13
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
MAY 7.2012 1
BY
PURCHASES RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
PREVIOUS BALANCE PAYMENTS (,)PURCHASES )DEBITS CREDITS LATE FE NEW BALANCE
157.59 157.59 196.13 0.00 0.00 0.00 196.13
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 ENSURE PROPER CREDIT—TEA F2 AT PERFORATION AND INCLI -DE BOTTOM_PORTIQN WITH YQUR PAYMENT.
VOUCHER NO. WARRANT N
ALLOWED 20
Circle K=Fleet Servrce
N �)N IN SUM OF
PO Box
Carol Steam, IL 60197 -6293
$973.52
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1205 29293740 42 314.00 $777.39 i hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 29281799 42 314.00 $196.13
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, May 07, 2012
4
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
04/30/12 29293740 Fire Dept $777.39
04/30/12 29281799 $196.13
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