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Home My WebLink About215534 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1 ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $795.69 CARMEL, INDIANA 46032 PO BOX 183019 COLUMBUS OH 43218-3019 CHECK NUMBER: 215534 CHECK DATE: 12/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 065127193212 795 . 69 065-127-193 www.shelitleetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065-127-193 15 065127193212 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: 1-515-226-4045 NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE 840.02 .00 670.84 715.17 CR 00 795.69 PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 12-31-2012 Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Number DATE TIME ID CD CD TAX AMOUNT 11-23 PAYMENT-THANK YOU 670.84 CR 0003 12-05 15.59 0103689 8924E 116TH ST FISHERS IN 15 214 B UNL 2.78 53.25 _ 15.214 GAL UNLEADED $53.25 TOTAL CARD 0003 15.214 2.78 53.25 ® 1 0004 11-15 17.18 0251347 11601 ALLISONVILLE RD FISHERS IN 23.041 8 UNL 4.22 82.95 23.941 GAL UNLEADED $32.95 I ®_ 0004 11-21 2133 0979971 545 S RANGE LINE RD CARMEL IN 21.672 8 UNL 3.97 78.00 ® 21.672 GAL UNLEADED $78.00 0004 11-28 17 15 0022442 545 S RANGE LINE RD CARMEL IIJ 23.493 8 UNL 4.30 81.50 23.493 GAL UNLEADED $81.50 TOTAL CARD 0004 68.206 12.49 242.45 " 0006 11-12 0707 0338442 4180 W INA RD TUCSON AZ 17.101 8 UNL 3.13 55.75 17.101 GAL UNLEADED 555.75 ,��,,,/// ® TOTAL CARD 0006 17.101 3.13 55.75 / ® 0007 11-07 11 50 0163121 3170 OVERTON RD BIRMINGHAM AL 12.121 8 UNL 2.22 40.00✓ 12.121 GAL UNLEADED $40.00 ® 0007 11-16 1540 0641167 1801 MONTGOMERY HWY S IFIOOVER AL 12.812 8 UNP 2.34 41.00 12.812 GAL UNL PLUS $41.00 0007 11-17 1206 0795484 553 DUN 10V WAY BOWLING GREEN KY 11.630 8 UNL 2.13 38 37 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 5296 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0005296 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. •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.shellileetcard.accountonline.com ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO: 065-127-193 15 065127193212 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: 1-515-226-4045 Card -jBANaAQjKQN. TRANS TRANSACTION LOCATION I DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION Numbei DATE TIME ID CD CD TAX AMOUNT 11.630 GAL UNLEADED $38.37 TOTAL CARD 0007 36.563 I 6.69 119.37 ** 0025 11-22 1046 0921247 1821 E 151ST ST CARMEL IN 12.720 8 UNL I 2.33 45.54E 12.720 GAL UNLEADED S45.54 0025 11-27 19.37 0094078 7788 E 96TH ST FISHERS IN 14.492 8 UNL 2.65 51.16 14.492 GAL UNLEADED $51.16 TOTAL CARD 0025 27.212 4.98 96.70 ** 0027 11-18 02:11 0993139 9599 N MERIDIAN ST INDIANAPOLIS IN 14183 8 UNL 2.60 49.33 14.183 GAL UNLEADED $49.33 TOTAL CARD 0027 14.183 2.60 49.33 ** ®_ 0029 11-09 18.16 0398636 808 W MAIN ST CARMEL IN 17.051 8 UNL 3.12 59.68 ° 17.051 GAL UNLEADED S59.68 .� 0029 11-16 20 3C 0841761 1230 S RANGELINE RD CARMEL- IN '4.981 8 jNL 274 5272 14.981 GAL UNLEADED $52.72 TOTAL CARD 0029 32.032 5.86 112.40 *� 0030 11-?_1 11.54 0870295 1230 S RANGELINE RD CARMEL IN 16.122 8 UNL 2.95 59.04. 16.122 GAL UNLEADED $58.04 0030 12-02 1202 0228148 9510 E 126TH ST FISHERS IN 15 563 8 UNL 2.85 52.7' _® 15.563 GAL UNLEADED $52.73 _ TOTAL CARD 0030 31.685 5.80 110.77 *� GRAND TOTAL 242.196 44.33 840.02 ** ® FEDERAL EXCISE TAX 242.1 GALLONS GASOLINE 44 33 CA 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 5296 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS 0005296 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 $795.69 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 I 65127193212 I 42-314.00 I $795.69 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 65127193212 monthly payment $795.69 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