212475 09/11/2012 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WRIGHT EXPRESS FSC
CARMEL, INDIANA 46032 PO BOX 6293 CHECK AMOUNT: $1,393.41
CAROL STREAM IL 601976293 CHECK NUMBER: 212475
ON�
CHECK DATE: 9/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 30452454 1, 393 .41 0496-00-138012-0
Invoice Statement
INVOICE NUMBER: 30452454
NO 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 3,55 O.00 31 AUG-31-2012 SEP-26-2012 1 393.41
ACTIVITY DESCRIPTION CHARGESOESI S: PAYMENTS/CREDITS
PAYMENT- 630.85
THANK YOU
.::...::::::::::::
............
AU ::20. ... ...... .::::::::::.:::.:
.....
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.
" \
t�
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
630.85 630.85 1393.41 0.00 0.00 0.00 1393.41
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 m thly 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 TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYMENT
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City of Carmel Fire
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ACCOUNT NUMBER > >: 0496-00-138012-0 Circle K Fleet
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tN�f010E:NkTMB1"i :>: 30452454
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:8ILL. 5ENG'RATE`"`"> AUG-31-2012 FAX CHANGE OF ADDRESS REQUEST TO 1-800-395-0809.
Make check payable to:WRIGHT EXPRESS FSC.
F(vf(5i::AMOUNT.`EU < »> > ?>` 1,393.41 Use enclosed envelope or send to:
X.:.AMOUNT ENCLOS
isP.AYTvl E N'1'DUEAbA'1'E > SEP-26-2012
PAYMENTS RECEIVED AFTER THIS DATE SUBJECT TO LATE FEES. /\
�rllirllnnnlllrl�rlrrrlrll�nilrl�r�rnrllrinrll
WRIGHT EXPRESS FSC r
P.O. BOX 6293 r
CAROL STREAM IL 60197-6293
04960013801200000000139341 120926
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.wextools.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 1-866-544-1715 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 making a payment,you can
considered final and binding. also check your balance.
Card Issuer Payments scheduled by 3:00 PM ET(on business days)
The Circle K Fleet 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: hftp://www.e-fleet.com
- Call 1-866-544-1715,or ACH payments made 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.
-- -------- ---- -
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
No
AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE 1 OF 6
UME3 [:CA PLATIE:��IN
I A$$ ........
10001 Chief Smith 63225
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 14,500
08-03 14:51 545 S Range Line Carmel IN 1 driver Op 14,500 UNL 20.000 3.959 79.20 3.66- 75.54 8.31-
08-09 11:56 545 S Range Line Carmel IN 1 driver OP 14,500 UNL 22.070 3.899 86.09 4.04- 82.05 9.08-
08-12 11:52 3801 S Post Rd Indianapol IN 1 driver OP 14,500 UNL 12.340 3.789 46.78 2.26- 44.52 4.99-
08-16 12:37 545 S Range Line Carmel IN I driver OP 114,500 UNL 17.220 3.689 63.55 3.15- 60.40 6.85-
08-20 14:43 545 S Range Line Carmel IN 1 driver OP 14,500 UNL 15,200 3.689 56.09 2.78- 53.31 6.05-
08-22 11:26 545 S Range Line Carmel IN I driver Op 14,500 UNL 13.150 3.669 48.25 2.41- 45.84 5,21-
08-28 13:08 545 S Range Line Carmel IN 1 driver Op 14,500 UNL 15.960 3.859 61.59 2.92- 58.67
...................................... .....................—..........I.
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.... ..... 1115940. ..1, 6 21.2 3 TIM -
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YTO: ...................
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592,880
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PERIOD AVERAGE:PPG 3.809
YTD AVERAGE:PPG 3.661
TO ENSURE MORE A:=RA TE MILEAG E REPO F TING,VEHICLE MILEAGE TATISTICS AF E NOT
CAI,CULATED WHEN KEY :)DOME TER READ!NGS ART NOT WITHIN AN ACCEPT ABLE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
ETSM
PAN,
mum
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
No
AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE 2 OF 6
X.
10002 Asst.Chief Hoffman 1 74957
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES,
PREVIOUS ODOMETER 19,889
08-11 18:27 1360 N Green St Brownsburg IN 1 driver OF 21,979 UNL 25.690 3.719 95.55 4.70- 90.85 10.26-
08-25 17:32 1360 N Green St Brownsburg IN I driver OP 22,581 UNL 24.400 3.859 94.17 4.47- 89.70 9.97-
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PER1011.10TALs ....... 2�6W� ::50AWY.T. 5 20,23
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........... '128$4
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PERIOD AVERAGES:MPG,PPG,(,PM 53.74 3.788 0.07
YTD AVERAGES:MPG,PPG,CPIV 36.79 3.615 0.10
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
No
AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE 3 OF 5
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VC
I A�ARV W4�410LP-I AS$P-T..IDF-NTIFISK7 _7 .... LA ........
10003 1 Asst.Chief Haboush 74965
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 15,980
07-31 08:40 545 S Range Line Carmel IN 1 driver OP 16,482 UNL 21.110 3.521 74.34 3.86- 70.48 8.16-
..................... .............I...............................I.................................................... .... ........ . ................................................I...I. ........... ........I..........
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24 4.40 7434
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.... ......
PERIOD AVERAGES:MPG,PPG,OPM 23.78 3.522 0.15
YTD AVERAGES:MPG,PPG,CPM 29.36 3.536 0.12
TRANSACTION CODES:
OP=Outdoor Payment Terminal
ll=�—
MM-
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
No AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE4 OF 6
kPLATE<($T)
10004 1 1 EMS Chief Hulett 70614 r 1 7��
DATE TIME SITE ADDRESS PROMPT TRANI ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 3,351
07-31 07:05 545 S Range Line Carmel IN 1 driver OP 3,863 UNL 15.670 3.521 55.20 2.87- 52.33 6.06-
08-03 14:29 545 S Range Line Carmel IN I driver OP 3,907 UNL 18.170 3.632 66.00 3.33- 62.67 7.16-
08-06 15:41 545 S Range Line Carmel IN 1 driver OP 4,052 UNL 11.280 3.632 41.00 2.06- 38.94 4.44-
08-14 11:48 545 S Range Line Carmel IN 1 driver OP 4,702 UNL 14.670 3.679 54.00 2.68- 51.32 5.82-
08-16 05:58 545 S Range Line Carmel IN 1 driver OP 4,849 UNL 11.920 3.689 44.00 2.18- 41.82 4.74-
08-23 09:36 545 S Range Line Carmel IN 1 driver OP 5,320 UNL 14.990 3.669 55.01 2.74- 52.27 5.94-
........ .. ......
6.7 0
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X.X: .
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.......:459.090 1598.02
........ .......
........... .....
PERIOD AVERAGES:MPG,PPG,1,PM 22.71 3.636 0.16
YTD AVERAGE:PPG 3.481
TO ENSURE MORE A:;CUR A rE MILEAG REPO F TING,VEHICLE MILEAGE TATISTICS AF E NOT
CAL CULATED WHEN KEY DDOME TER READ I NGS ARE NOT WITHIN AN ACCEPT ABLE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
NO AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE 5 OF 6
I;CARD:NUMSEW:.......... ..:0ARD-VM80.$S1N0, MCRIPTION....
..............................
............. ...........................
10008 Chris Ellison 1 82907
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 7,316
08-21 17:26 8924 E 116th St Fishers IN 1 driver OP 18,865 UNL 20.310 3.579 72.70 3,72- 68.98 7.93-
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72:*': .....x. ::7.�.9..3...
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.YTDTOTALS =310...... 727. .
PERIOD AVERAGE:PPG 3.580
YTD AVERAGE:PPG 3.580
TO ENSURE MORE A:;CUR A TE MILEAG E REPO F TING,VEHICLE MILEAGE TATISTICS AF E NOT
CAL CULATED WHEN KEY DDOME TER READ NGS AR NOT WITHIIN AN ACCEPT ABLE RANGE.
I I I I
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
AUG-01-2012 TO AUG-31-2012
Purchase Activity Report PAGE OF 6
0012 FIRE IN
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 87,778
08-07 08:32 545 S Range Line Carmel IN 1 driver OP 88,046 UNL 22.570 3.632 82.00 4.13- 77.87 8.89-
08-09 14:10 545 S Range Line Carmel IN 1 driver OP 88,123 UNL 8.960 3.682 33.00 1.64- 31.36 3.56-
08-14 16:39 545 S Range Line Carmel IN 1 driver OP 88,321 UNL 20.170 3.679 74.23 3.69- 70.54 8.01-
08-24 08:07 545 S Range Line Carmel IN 1 driver OP 88,775 UNL 23.220 3.929 91.27 4.25- 87.02 9.60-
08-30 15:52 545 S Range Line Carmel IN 1 driver OP 89,032 UNL 24.580 3.719 91.43 4.50- 86.93 9.82-
";:'3:r:r'':'''i < i: ?:<i'3i2"< ,:;::;:5:i:ii:::;;';: .:':i:;:li:'> . ...377:93 <..: i�>18£21 ` .35372''.:239:88:2>::i
PERIOD.TOTALS.............. 999.:::>::G::>::s:: >: c:::�19,5Q0 ;>:> :s:s:s:..
............. .
.....
sisis nisi:si; i 161'38-;:<.;:.;:.;
14.9$0 4 4 5:93. .............. 5 93- 1 :0
7
PERIOD AVERAGES:MPG,PPG, PM 10.04 3.738 0.37
YTD AVERAGE:PPG ""' 3.557
'* TO ENSURE MORE A:;CURAFE MILEAG REPOF TING,VEHICLE MILEAGE 3TATISTICS AF E NOT
CAI CULATED WHEN KEY DDOME TER READINGS ARE NOT WITHIN AN ACCEP BLE RANGE.
TRANSACTION CODES:
OF=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
me 0496-00-138012-0
AUG-01-2012 TO AUG-31-2012
Financial Summary PAGE OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES&
QTY COST/FEE TOTAL FEES FUEL$ OTHER$ EXEMPTED TAX NET$ PURCHASES
ACCOUNT TOTALS Unleaded Regular 1,465.45 72.04- 1,393.41
4: 1 393.41
........ :. PER1C31?:: QC00.;.::....... .... 1,465,45. .::::<:.;:.:... ::::O.flO 72,Q >:: ... 1,3 .....::.:..:
...............:::
7`335:90:'
... ;;..YTD....:............... O.W..:;:.;..:;;::..::;:7734,73.................. . 0,00 398,8.3 ::::7,335.90::: :::: ,...........
........ ... . ...................4.. ........................
ACCOUNTS RECEIVA LE SUMMARY-Invoice 304i2454
PREVIOUS BALANCE 630.85
PAYMENTS 630.85-
PURCHASES 1,393.41
DEBITS 0.00
CREDITS 0.00
ANCILLARIES 0.00
AMOUNT DUE 1,393.41
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
AUG-01-2012 TO AUG-31-2012
Site Summary PAGE OF 2
BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL$ OTHER$ EXEMPT NET$
TRANS TAX
SHELL 545 S Range Line Rd Carmel IN 46032 18 310.910 1,156.25 56.89- 1,099.36
8924 E 116th St Fishers IN 46038 1 20.310 72.70 3.72- 68.98
1360 N Green St Brownsburg IN 46112 2 50.090 189.72 9.17- 180.55
3801 S Post Rd Indianapolis IN 46239 1 12.340 46.78 2.26- 44.52
..........—...:::::.:::;::;.: !I, p:.tc?1AiS.::::...::...........:................................ ....:....... ::
PARENT ACCOUNT: REPORT FOR:
City of Carmel Fire City of Carmel Fire
0496-00-138012-0
NO AUG-01-2012 TO AUG-31-2012
Tax Summary PAGE OF 2
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX$ REPORTED TAX$ TAX TYPE TAX PRODUCT CLASS UNITS GROSS$ TAX RATE
FEDERAL 356000972 JUN-18-2012 -72.04 Federal Excise Gasoline Unblended 393.650 1465.45 0.18300
.............................................
:zFEDEfALTf 7 <::::>::>:::>:>:z z>:;:<z>:z>:z>:::: .:>:Ec»:i>'s:zi»i>>i»:>>sisi»i»ii>»i 'sEri::::i;.;:i:.; ;. a;.;:.»:<si:>i»i»ii>»>s»i»i>i:»»i?>i'ssi»iaii:� ::i's'si's :..;
7 .04..... ..._............................................. ..... ... ::: 393;650: c>:>:>::: 14BS45.. : :::
IN 356000972 JUN-18-2012 -86.52 State Sales Gasoline Unblended 393.650 1465.45 0.07000
»>:::
-70.85 State Excise Gasoline Unblended 393.650 1465.45 0.18000
::: ::s; >;;:.
157.37 <:::>:.>::;:.
ACCOUNT TOTALS -72.04 -157.37
RIM
I nvoice eme 1t
INVOICE NUMBER: 30452454
N(R 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 3550.00 31 AUG-31-2012 SEP-262012 1393.41
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
AUG-20-2012 PAYMENT-THANK YOU 630.85
AUG-31.2012 FUEL PURCHASES 1,393.41
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
�}
�J sEp z o zo�2
By
PURCHASES,RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS I + PURCHASES (+)DEBITS I OCREDITS + LATE FE =NEW BALANCE
630.85 630.85 1393.41 0.00 0.00 0.00 1393.41
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 variod which is
2-08 % 24.99 % 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
TO FNSURF PROPFR CREDIT.TEAR AT PFRFORATION ANr)INCI I IF)F=Rf)TTf)M PnRTInnI wITU vnl IG cnvnacnlT
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wrights Express FSC
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197
$1,393.41
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#rrITLE AMOUNT Board Members
1120 I 30452454 I 42-314.00 I $1,393.41 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
SEA 10 20P
a
Fire Chief
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))
30452454 $1,393.41
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