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Home My WebLink About215533 12/18/2012 „w CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 i ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $668.81 CARMEL, INDIANA 46032 PO BOX 183019 COLUMBUS OH 43218-3019 CHECK NUMBER: 215533 CHECK DATE: 12/1812012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065129116212 668 . 81 065-129-116 i www.shelifleetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065-129-116 15 065129116212 SHELL CARD CENTER P.O BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081 12-06-2012 12-31-2012 31 TELEPHONE: 1-800377.5150 FAX: 1315-226-4045 NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE 705.57 .00 728.79 765.55 CR .00 668.81 PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 12-31-2012 Card TRANS\CTION TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 11-23 PAYMENT-THANK YOU 728 79 CR ® 0001 12-04 11 16 0950089 1230 S RANGELINE RD CARMEL IN 10.231 8 UNL 1-87 33.97 ® I 10.231 GAL UNLEADED 533.97 TOTAL CARD 0001 10.231 1.87 33.97 ** ® 1 0002 11-08 11 17 0789149 1230 S RANGELINE RD CARMEL IN 23.133 8 UNL 4.23 80.48 23.133 GAL UNLEADED 530.:8 0002 11-13 1605 0819714 1230 S RANGELINE RD CARMEL IN 20.561 8 UNL 176 74.02✓ 20.561 GAL UNLEADED 574.02 0002 11-13 1621 0819797 1230 S RANGELINE RD CARMEL IN 25 430 8 UNL 4.65 91.55 25.430 GAL UNLEADED $91.55 0002 11-19 1820 0892372 1821 E 151ST ST CARMEL IN 22.153 8 UNL 4.05 75.30 22.153 GAL UNLEADED $75.30 TOTAL CARD 0002 91.277 16.69 321.35 �k 0006 11-14 1018 0564864 2040 E WASHINGTON INDIANAPOLIS IN 11.440 8 UNL 2.09 40.04 11.440 GAL UNLEADED $40.04 0006 11-15 1441 0536003 2705 BLOYD AVE INDIANAPOLIS IN 5780 8 UNL 1 06 20.00 5.780 GAL UNLEADED 520.00 0006 11-19 2201 0796193 6955 S EMERSON INDIANAPOLIS IN 7231 8 UNL 1.32 25.02 L 7.231 GAL UNLEADED S25.02 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 121206 9366 8015 SH33 5297 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS Z 0005297 Page 1 of 2 FLEI-2GUG 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.sheliffeetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065-129-116 15 065129116212 SHELL CARD CENTER P.O. BOX 689081 CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081 12-06-2012 12-31-2012 31 TELEPHONE: 1-800-377-5150 FAX: 1-515-726-4045 Card A TRANS MSG PROD EXEMPT TRANSACTION TRANSACTION LOCATION/DESCRIPTION QUANTITY Number DATE TIME ID CD CD TAX AMOUNT 0006 11-21 05:57 0636829 2166 E HADLEY PLAINFIELD IN 20 561 8 UNL 3.76 74.00 20.561 GAL UNLEADED $74.00 0006 11-29 09 55 0183905 8501 E WASHINGTON ST INDIANAPOLIS IN 9.272 8 UNL 1.70 32.00 9.272 GAL UNLEADED S32.00 0006 12-05 1827 0584722 2108 N EMERSON AVE INDIANAPOLIS IN 9.090 8 I UNL 1.66 30.00 9.090 GAL UNLEADED S30.00 TOTAL CARD 0006 63.374 11.59 221.06 0014 11-21 0900 0992511 9609 OLIO RD MCCORDSVILLE IN 1930 8 UNL 0-72 1411 3.930 GAL UNLEADED S14.11 ® 0014 11-22 10.56 0999904 9609OLIO RD MCCORDSVILLE IN 5.500 8 UNL 1.01 1977. -_ 5.500 GAL UNLEADED S19.77 0014 11-23 16:09 0648808 5890 NATIONAL RD EAST RICHMOND IN 12.513 8 UNL 2.29 45.06 12.513 GAL UNLEADED $45.06 ® 0014 11-26 2050 0346635 11601 ALLISONVILLE RD FISHERS IN 14.150 8 UNL 2.59 50.25 ® 14.150 GAL UNLEADED $50.25 ® TOTAL CARD 0014 36.093 6.61 129.19 *� ® GRAND TOTAL 200.975 36.76 705.57 ® FEDERAL EXCISE TAX ® ( 200.9 GALLONS GASOLINE 3616 CR ® TOTAL*FINANCE CHARGE' BILLED IN 2012 $0.00 ® 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 6057 0014 GUG 1 7 2 121206 9366 8015 SH33 5297 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS L Z 0005297 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: a 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 $668.81 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 I 65129116212 I 42-314.00 I $668.81 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 Friday, December 14, 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)) 12/06/12 65129116212 monthly payment $668.81 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