216331 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER
' CARMEL, INDIANA 46032 PO BOX 183019 CHECK AMOUNT: $698.03
COLUMBUS OH 43218-3019 CHECK NUMBER: 216331
grow c
CHECK DATE: 1/15/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065129116301 698 . 03 065-129-116
i
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INOUIRIES TO:
065.129-116 16 065129116301 SHELL CARD CENTER
P.O. DOX 689081 _
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50369-9081
01-06-2013 01-31-2013 31 TELEPHONE: 1.800377-5150
-- FAX: 1.515.226-4045
NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE
739.52 .00 668.81 710.30 CR .00 698.03
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 01-31-2013
Card TR NSACTION I TRANS MSG PROD EXEMPT j TRANSACTION
Number DATE TI1AE ID TRANSACTION LOCATION/DESCRIPTION Ol1ANTil`/ CD I CD TAX ( AMOUNT
I
12-20 ( PAYMENT-THANK YOU , IJ( � 668.81 CR
® I
® 0001 01-03 12.35 0139246 I 1230 S RANGELINE RD CARREL IN 8.111 I 8 J UNL I 1.48 2500
®_ 8.111 GAL UNLEADED
$25.00 1
! TOTAL CARD 0001 { 8.111 1.48 I 25.00 *%
® m1n 12-18 18.23 i 05576-'3.7 BOB W MAIN ST CARREL IN i 27.347 8 UNL 5.00 I 84,75✓
27.347 GAL UNLEADED 584.75 I
01002 12-25 2306 024x253 1821 E 151ST ST CARMEL IN 20.254 8 UNL 3,7 1 65,20
_® 20.254 GAL UNLEADED $65.20
TOTAL CARD 0002 47.601 8.71 149.95 �x
® OOCS 112-19 15.31 I Ou-3579 2040E WASHINGTON INDIANAPOLIS IN 10.483 8 �UNL 102 3103
® 1 I 10.483 GAL UNLEADED 531.03
® (Y-013 12-24 20 52 I 0224063 2045 N POST RD INDIANAPOLIS IN 7011 6 i UNL 1.45 25.
7.911 GAL UNLEADED SZS•00
® 00il3 01-05 1221 0730069 { 2108 N EMERSON AVE INDIANAPOLIS IN 8.690 8 UNL 1.59 28-M
® 8.690 GAL UNLEADED $28.00
1 TOTAL CARD 0006 i 27.084 4.96 84.03
® 0009 i f 12-C6 ` 14.54 0078570 545 S RANGE LINE RD CARMEL IN I 13.370 8 UNL 2.45 44.11 J
' 13.370 GAL UNLEADED $44-11
000° 12.09 1146 0518464 808 W MAIN S CARMEL IN J 23.400 I 8 I UNL 4.26 ; 81.41
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 130106 9366 8015 SH33 S417
.UOTICE:.SEE.REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
DD05417 Paue 1 o12 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:
e 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 01112
www.shellfleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INOUIRIES TO:
065-129-116 16 065129116301 SHELL CARD CENTER
P.C., BOX 659051
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,la 50369-9081
01-06-2013 01-31-2013 31 TELEPHONE: 1.800-377.5150
FAX: 1.515-226.4045
Card !TRAR2ACTION I TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY;MSG'FROD EXEMPT TRANSACTION
Number { DATE TIME ID { CD CD TAX AMOUNT
23.400 GAL UNLEADED 381.41 I
0009 01-01 21:12 0127670 1230 S RANGELINE RD CARMEL IN 11 6.141 8 UNL 1.49 25.24
8.141 GAL UNLEADED S25-24 J
TOTAL CARD 0009 I 44.911 8.22 150.76 /*1
0014 12-07 15:57 0445437 11601 ALLISONVILLE RD FISHERS IN 14,641 8 UNL 2.65 51.23V
i 14.641 GAL UNLEADED $51.23
0014 12-13 16:56 0497149 11601 ALLI&DWILLE RD FISHERS IN 14.140 8 UNL 2.59 f 4S.9.3�
i 14.140 GAL UNLEADED 546.96
0014 12-20 12:44 0205799 8924 E 116TH ST FISHERS IN 13.602 8 I UNL 2.49 I 44.33Y
®_ 13.602 GAL UNLEADED 544.33
0014 12-27 1029 0759787 5KO NATIONAL RD EAST RICHMOND IN � 11.1Gl � 8 j U�IL 2.59 ; 48.15
14.161 GAL UNLEADED 548.15
®.. 0014 12-30 12:11 0299735 123014ESTSR32LEBANON IN 14,620 8 JUNL 2.66 45,10
;� II ( 14.620 GAL UNLEADED S48.10 /
® 0014 1 01-01 12:08 0233395 %609 OLIO RD MCCORDSVILLE IN 14 981 8 I UNL 2-74 48.69
I 14.981 GAL UNLEADED $48.69
0014 01-05 16:26 0790642 5690 NATIONAL RD EAST RICHMOND IN 11820 I 8 i UNL 2.35 42.32
®r 12-820 GAL UNLEADED $42.32
TOTAL CARD 0014 98.965,, ' 18 12 329 78 x.
{ GRAND TOTAL 226.672 i 41.49 739.52 k*
I I
FEDERAL EXCISE TAX
226.0"GALLONS GASOLINE 41.49 CR
o f �
TOTAL*FINANCE CHARGE' BILLED IN 2012 i $0.00 f ;
®_ 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 130106 9366 8015 51133 5417
r
NOTICE:SEE REVERSE SIDE FOR IMPORTAt1T 1NFORAMATiON PLEASE KEEP THIS PORTION FOR YOUR RECORDS
Z
0005417 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 verity 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
$698.03
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 65129116301 I 42-314.00 I $698.03 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
Monday, January 14, 2013
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))
01/06/13 65129116301 gasoline $698.03
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