211607 08/14/2012CITY OF CARMEL, INDIANA
ONE CIVIC SQUARE
CARMEL, INDIANA 46032
VENDOR: 366015
WRIGHT EXPRESS FSC
PO BOX 6293
CAROL STREAM IL 60197 -6293
Page 1 of 1
CHECK AMOUNT: $104.38
CHECK NUMBER: 211607
CHECK DATE: 8/14/2012
DEPARTMENT
ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 30137172 104.38 0496 -00- 138009 -6
0
1 nvoice Statement
INVOICE NUMBER: 30137172
ACCOUNT NAME: City of Carmel Utilities
PAGE 1 OF 1
ACCOUNT NUMBER
CREDIT LIMIT
DAYS THIS PERIOD
BILL CLOSING DATE
PAYMENT DUE DATE
AMOUNT DUE
0496-00 - 138009-6
500.00
31
JUL -31 -2012
AUG -24 -2012
104.38
DATE
ACTIVITY DESCRIPTION
CHARGES /DEBITS
PAYMENTS /CREDITS
JUL -31 -2012
FUEL
PURCHASES
0.00
104.38
104.38
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
0.00
PURCHASES, RETURNS AND PAYM ENTS MADE JUST PRIOR TO BI LL I NG DATE MAY NOT APPEAR UNTI L THE NEXT I NVOI CE/STATEM ENT.
PREVIOUS BALANCE
(- )PAYMENTS
( +)PURCHASES
( +)DEBITS
(- )CREDITS
(±)LATE FEE
( =)NEW BALANCE
0.00
0.00
104.38
0.00
0.00
0.00
104.38
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616
The Late Fee is determined by
applying a monthly rate of
Which is an EFFECTIVE ANNUAL
RATE of
To the balance subject to late
fee for this period which is
2.08 %
24.99 %
0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
TO ENSURE PROPER CREDIT,TEAR AT PERFORATION AND INCLUDE BOTTOM PORTIQN WITH YQUR PAYMENT.
Prescribed by State Board of Accounts
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
City Form No. 201 (Rev. 1995)
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
PO Box 6293
Date Due
Carol Stream, IL 60197 -6293
Invoice
Date
Invoice
Number
Description
(or note attached invoice(s) or bill(s))
Amount
07/31/12
30137172
Gasoline -MI Dept
$104.38
$296.11
07/31/12
07/31/12
30142708
30153803
Gasoline - Police Dept
Gasoline - Fire Dept
$630.85
07/31/12
30195776
Gasoline - Admin Dept
$287.18
$1,318.52
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
VOUCHER NO. WARRANT NO.
08/14/12
Wright Express, FSC
PO Box 6293
Carol Stream, IL 60197 -6293
$ $1,318.52
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or
DEPT. #
INVOICE NO. ACCT #/TITLE
ALLOWED 20
IN SUM OF $
Board Members
AMOUNT 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
3
twhich charge is made were ordered and
$296.1 teceived except
111
112
12n.=
314
/$104
30142708 314
30153803 314
30195776 314
Cost distribution ledger classification if
claim paid motor vehicle highway fund
.85
18
Invoice Statement
INVOICE NUMBER: 30137172
ACCOUNT NAME: City of Carmel Utilities
PAGE 1 OF 1
ACCOUNT NUMBER
CREDIT LIMIT
DAYS THIS PERIOD
BILL CLOSING DATE
PAYMENT DUE DATE
AMOUNT DUE
0496 -00 - 138009 -6
500.00
31
JUL -31 -2012
AUG -24 -2012
104.38
ACTIVITY DESCRIPTION
:::CHARGES/DEBITS
PAYMENTS /CREDITS
FUEL PURCHASES
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
PURCHASES, RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE
(- )PAYMENTS
( +)PURCHASES
( +)DEBITS
(- )CREDITS
( +)LATE FEE
( =)NEW BALANCE
0.00
0.00
104.38
0.00
0.00
0.00
104.38
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616
The Late Fee is determined by
applying a monthly rate of
Which is an EFFECTIVE ANNUAL
RATE of
To the balance subject to late
fee for this period which is
2.08 %
24.99 %
0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS
VOUCHER # 121950 WARRANT # ALLOWED
366015
WRIGHT EXPRESS FSC (CIRCLE k)
PO BOX 6293
CAROL STREAM, IL 60197
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
IN SUM OF$
Board members
PO # INV # ACCT # AMOUNT Audit Trail Code
30137172 01- 6500 -08
D
$104.38
Voucher Total $104.38
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
City Form No. 201 (Rev 1995)
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
366015
WRIGHT EXPRESS FSC (CIRCLE k)
PO BOX 6293
CAROL STREAM, IL 60197
Purchase Order No.
Terms
Due Date
8/20/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/20/2012 30137172 $104.38
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
Date
Officer