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Home My WebLink About213817 10/22/2012 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER ?o CARMEL, INDIANA 46032 PO BOX 183019 CHECK AMOUNT: $675.87 COLUMBUS OH 43218-3019 CHECK NUMBER: 213817 CHECK DATE: 10/22/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065127193210 675 . 87 065-127-193 i www.shelifleetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: SHELL CARD CENTER 065-127-193 13 065127193210 P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,iA 50368-9081 10-05-2012 10-30-2012 30 TELEPHONE: 1.800.377-5150 FAX: 1.515-226-4045 NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE 709.05 .00 788.24 821.42 CR .00 675.87 PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 10-30-2012 Card TRANS kCTION TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 09-27 PAYMENT-THANK YOU 788.24 CA 0 0011 09-29 1320 0577759 115 CUFTY DRIVE MAD!SON IN 10.060 8 i!NL 1.91 33 76"N e 10.460 GAL UNLEADED $39.76 TOTAL CARD 0011 10.460 1.91 39.76 *" _ 0014 09-05 1949 0430298 10598 N COLLEGE AVE INDIANAPOLIS IN 14A52 8 UNL 2.64 56.38 14.452 GAL UNLEADED $56.38 _ 0014 09-13 16'57 0385591 1551 N ILLINOIS INDIANAPOLIS IN 14.752 8 UNL 2.70 59.01 ® 14.752 GAL UNLEADED $59.01 ® TOTAL CARD 0014 29.204 5.34 115.39 ® 0015 10-03 18:47 0589812 10080 US 31 COLUMBUS IN 14.031 8 UNL 2.57 54.71 14.031 GAL UNLEADED $54.71 ® TOTAL CARD 0015 14.031 2.57 54.71 *� 0016 09-20 21.06 0801522 1 E HIGGINS RD ELK GROVE VIL IL 12.240 8 UNL 2.24 51.79'/ 12.240 GAL UNLEADED $51.79 ® 0016 09-30 01.35 0634030 9510 E 126TH ST FISHERS IN 12.410 8 UNL 2.27 47.52 ® 12.410 GAL UNLEADED $47.52 TOTAL CARD 0016 24.650 4.51 99.31 " ®_ 0025 09-07 1107 0404574 1230 S RANGELINE RD CARMEL IN 14.610 8 UNL 2.67 56.85 ® 14.610 GAL UNLEADED S56.85 ®_ 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 0006 GUG 1 7 2 121005 9366 8015 SH33 5262 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS z ' Z 0005262 Page 1 of 2 FLET<!GUti 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 www.shelifleetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065-127-193 13 065127193210 SHELL CARD CENTER P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081 10-05-2012 10-30-2012 30 TELEPHONE: 1-800-377.5150 FAX: 1-515226-4045 Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 0025 09-26 1517 0381525 1821 E 151ST ST CARMEL IN 15.643 8 UNL 2.86 60.98' 15.643 GAL UNLEADED $60.98 TOTAL CARD 0025 30.253 5.53 117.83 ** 0027 09-26 08.55 0576538 545 S RANGE LINE RD CARMEL IN 11.330 8 UNL 2.07 44.19 11.330 GAL UNLEADED $44.19 0027 10-03 0715 0556225 1230 S RANGELINE RD CARMEL IN 12.640 8 UNL 2.31 48.02' 12.640 GAL UNLEADED $48.02 TOTAL CARD 0027 23.970 4.38 9221 *x 0029 09-09 0514 0412734 633 W MAIN SR 32 WESTFIELD IN 15.960 8 UNL 2.92 60.65 ° 15.960 GAL UNLEADED 560.65 0029 09-14 11.33 0506097 8924 E 116TH ST FISHERS IN 17310 8 UNL 3-17 69-07 17.310 GAL UNLEADED $69.07 ® 0029 09-18 13:42 0571547 7788 E 96TH ST FISHERS IN 15.571 8 UNL 2.85 60.12 ° 15.571 GAL UNLEADED S60.12 TOTAL CARD 0029 48.841 8.94 189.84 *' GRAND TOTAL 181.409 33.18 709.05 ® FEDERAL EXCISE TAX ® 181.4 GALLONS GASOLINE 33.18 CR ®_ 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 0006 GUG 1 7 2 121005 9366 8015 SH33 5262 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS I 7 0005262 Page 2 of 2 FLET2GUG 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. PIOCOMM Rev 01/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Shell Fleet Plus Processing Center IN SUM OF $ P.O. Box 183019 C I FOR vepaltment PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 I 65127193210 I 42-314.00 I $675.87 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 Thursday, October 18, 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)) 10/17/12 65127193210 monthly payment $675.87 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