215457 12/12/2012 �.f CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WEX BANK
CARMEL, INDIANA 46032 PO Box 6293 CHECK AMOUNT: $2,843.10
CAROL STREAM IL 60197-6293 CHECK NUMBER: 215457
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CHECK DATE: 12/1212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 31344396 2 , 843 . 10 0496-00-138007-0
I nvoilm Statement
INVOICE NUMBER: 31344396
ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT 1 DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DAT AMOUNT DUE
0496-00-138007-0 9,000.00 30 NOV-30-20 DEC-26-2012 2,843.10
`CHARGES/DEBITS';_DATE,.'. ACTIVITY DESCRIPTION PAYMENTS/CREDITS
2-
NOV,116-2012;:,-*K:` PAYMENT THANK YOU
7,008.65
FUEL PURCHASES
`�NOV-36-�012---1;_:
REBATE 9.60
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
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PURCHASES,RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE N EXT INVOICE/STATEMENT.
PREVIOUS BALANCE I OPAYMENTS I (,)PURCHASES (,)DEBITS I OCREDITS I (,)LATE FE EI (=)NEW BALANCE
7,008.651 7,008.65 1 2,852.701 0.001 9.601 0.001 2,843.101
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 I NFORM ATI ON AND TERMS.
TO ENSURE PROPER CREDI T,TEAR AT PERFORATI ON AND—1 NCL UDE BOTTOM—PORTION WITH YOUR PAYM ENT.
VOUCHER NO. WARRANT NO.
WEX Bank ALLOWED 20
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197-6293
$2,843.10
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 31344396 I 42-314.00 I $2,843.10 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, December 06, 2012
...ice
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))
11/30/12 31344396 monthly payment $2,843.10
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