212476 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: $5,521.87
CAROL STREAM IL 60197-6293
CHECK NUMBER: 212476
CHECK DATE: 9/1112012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 30468417 5, 521 . 87 0496-00-138007-0
nvoim Statement
INVOICE NUMBER: 30468417
r� ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAY�THIS RIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00.138007-0 9 000.00 AUG-31-2012 SEP-26 2012 5 521.87
"•DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
:T AUGr20-2012:- PAYMENT-THANK YOU rcry,, .,r; r 296.11
AUG 312012 ..' FUEL PURCHASES 5;545_.45
'AUG-31=2012 REBATE 23.58
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
-'
SE:P
i✓ 1 0 2012
By
PURCHASE$RETURNSAND PAYMENTS MADE JUST PRIOR TO BI LLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS (+)PURCHASES I CREDITS (,)LATE FE (=)NEW BALANCE
296.11 296.11 5,545-451 0.00 23.58 0.00 5,521:87
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.
T!1 C\ICV 11']C 1'fl"]I'1f1C1"1 I�rlrll,T Try'+ •�r�r—'.r.�r.�,.... ..... ...�. ..���__—�__ —_-- _
VOUCHER NO. WARRANT NO.
Wright Express FSC ALLOWED 20
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197-6293
$5,521.87
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
i
PO#/Dept. INVOICE NO. ACCT#/TITLE MOUNT Board Members
1110 I 30468417 I 42-314.00 I $5,521.87 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
Wednesday, September 05, 2012
Chief of Police
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))
09/05/12 30468417 monthly payment $5,521.87
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