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Home My WebLink About214562 11/20/2012 o, CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $728.79 CARMEL, INDIANA 46032 PO BOX 183019 COLUMBUS OH 43218-3019 CHECK NUMBER: 214562 CHECK DATE: 11/2012012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065129116211 728 . 79 GASOLINE i www.shellileetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES SHELL CARD CENTER 065-129-116 18 065129116211 P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081 11-05-2012 11-30-2012 31 TELEPHONE: 1.8003773150 FAX: 1-515-226-4045 NEW CHARGES FLEET FEE REVIOUS BALANCE I PAYMENTS/ADJUSTMENTS LATE FEE I NEW BALANCE 768.96 .00 657.09 69726 CR .00 728.79 A PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 11-30-2012 Card TRANS I TRANSACTION LOCATION/DESCRIPTION OIJANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 10-25 PAYMENT-THANK YOU 657.09 CR - 0001 11-04 1830 0766543 1230 S RANGELINE RD CARMEL IN 15.151 8 UNL 2.77 50.00,+/ 15.151 GAL UNLEADED 550.00 TOTAL CARD 0001 15.151 2.77 50.00 ** - 0002 10-12 1507 0699579 545 S RANGE LINE RD CARMEL IN 6.170 8 UNL 1.13 23.01 6.170 GAL UNLEADED 523.01 0002 10-25 21.26 0707588 1230 S RANGELINE RD CARMEL IN 6250 8 UNL 1.14 20.00 6-250 GAL UNLEADED 520.00 +++yyy TOTAL CARD 0002 12.420 227 43.01 x/ 0006 10-10 0948 0211045 2108 N EMERSON AVE INDIANAPOLIS IN 11.111 8 UNL 203 4200✓ 11-111 GAL UNLEADED $42-00 0006 10-17 2223 0677492 4887 KENTUCKY AVE INDIANAPOLIS IN 11.310 8 SUP 2.07 40.04 11.310 GAL SUPER 540.04 00(x3 10-19 14:22 0048033 3002 N ILLINOIS INDIANAPOLIS IN 7.761 8 SUP 142 27.01 7-761 GAL SUPER 527.01 0006 10-29 1340 0535732 2040 E WASHINGTON INDIANAPOLIS IN 10.201 8 UNL 1.87 35.00 10.201 GAL UNLEADED $35.00 / 0006 11-01 09.47 0667527 5020 E 62ND ST INDIANAPOLIS IN 8.741 8 UNL 1.60 30,00'.% e 8.741 GAL UNLEADED $30.00 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 0014 GUG 1 7 2 121105 9366 8015 SH33 5310 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0005310 Page 1 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. o 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.shell fleetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: SHELL CARD CENTER 065-129-116 18 065129116211 P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081 11-05-2012 11-30-2012 31 TELEPHONE: 1-800377.5150 FAX: 1-515-226-4045 Card TRANSACTION TRANS I TRANSACTION LOCATION I DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 0006 11-01 23:14 0379634 6998 E 21ST ST INDIANAPOLIS IN 8.600 8 UNL 1.57 28.03 8.600 GAL UNLEADED S28.03 TOTAL CARD 0006 57.724 10.56 20208 r: 0009 10-08 2216 0708156 1230 WEST SR 32 LEBANON IN 23.400 8 UNL 4.28 86.56` 23.400 GAL UNLEADED S86.56 0009 10-24 1844 0525162 2400 JONATHON MOORE PIKE COLUMBUS IN 11.370 8 UNL 2.08 37.51 11.370 GAL UNLEADED $37.51 0009 10-30 1632 0734129 1230 S RANGELINE RD CARMEL IN 16.181 8 UNL 2.96 5500 16.181 GAL UNLEADED S55.00 TOTAL CARD 0009 50.951 9.32 179.07 s 0011 10-05 1051 0570598 1230 S RANGELINE RD CARMEL IN 10.051 8 UNL 184 37.18 ®_ 10.051 GAL UNLEADED $37.18 TOTAL CARD 0011 10.051 1.94 37.18 ** 0014 10-06 19:44 0371674 1601 EAST STATE RD 44 SHELBYVILLE IN 15.991 8 UNL 2.93 62.35 15.991 GAL UNLEADED $62.35 _- 0014 10-12 19.15 0947861 11601 ALLISONVILLE RD FISHERS IN 11.870 8 UNL 2.17 44.29 11.870 GAL UNLEADED $44.29 0014 10-23 08:19 0796185 8924 E 116TH ST FISHERS IN 15.822 8 UNL 2.90 52.99 ®_ 15.822 GAL UNLEADED $52.99 0014 11-02 16.34 0410290 2224 N 600 WEST GREENFIELD IN 17.171 8 UNL 3.14 57.01 17.171 GAL UNLEADED SS7.01 ev 0014 11-03 16.41 0576561 5890 NATIONAL RD EAST RICHMOND IN 12.421 8 UNL 2.27 40.98 _ 12.421 GAL UNLEADED $40.98 TOTAL CARD 0014 73.275 13.41 257.62 GRAND TOTAL 219.572 40.17 76&96 ** v FEDERAL EXCISE TAX ® 219.5 GALLONS GASOLINE 40.17 CR Message Codes: 1-Electronic Sale with Authorization 4-Electronic Sale without Authorization 8-Electronic Sale at Purp 2-Keyed Sale with Authorization 5-Keyed Sale without Authorization 9-Manual Sale 6057 0014 GUG 1 7 2 121105 9366 8015 SH33 5310 ® NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS Z z 0005310 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. PLOCOMM Rev 01/12 VOUCHER NO. WARRANT NO. ALLOWED 20 Shell Fleet Plus Processing Center IN SUM OF $ P.O. Box 183019 Columbus, OH 43218-3019 $728.79 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 1065129116211 42-314.00 $728.70 I hereby certify that the attached invoice(s), or I 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 t Thursday, November 15, 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)) 11/05/12 65129116211 monthly payment $728.79 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