217417 02/13/2013 f CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
s ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $436.76
CARMEL, INDIANA 46032 PO BOX 183019
«p� COLUMBUS OH 43218-3019 CHECK NUMBER: 217417
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065129116302 436 . 76 065-129-116
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES
SHELL CARD CENTER
065-129-116 11 065129116302 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
02-03-2013 02-28-2013 28 TELEPHONE: 1-800377-5150
FAX: 1-515-2264045
NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE
462.07 .00 698.03 723.34 CR .00 436.76
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 02-2 8-2013
Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
01-17 PAYMENT-THANK YOU 698.03 C RR
° 0001 01-09 19:04 0190694 1230 S RANGELINE RD CARMEL IN 12.062 8 UNL 2.21 41.00 V/
12.062 GAL UNLEADED $41.00
0001 01-15 13.45 0220921 1230 S RANGELINE RD CARMEL IN 10.330 8 UNL 1.89 34.09
10.330 GAL UNLEADED $34.09
® 0001 01-30 19:45 0312314 1230 S RANGELINE RD CARMEL IN 7.782 8 UNL 1.42 28.00
® 7.782 GAL UNLEADED $28.00
TOTAL CARD 0001 30.174 5.52 103.09
® 0002 01-14 1845 0653121 808 W MAIN ST CARMEL IN 25.174 8 UNL 4.61 83.0
2S.174 GAL UNLEADED $83.05
-_ 0002 01-19 06:31 0455709 1821 E 151ST ST CARMEL IN 17.974 8 UNL 3.29 60.00
_ 17.974 GAL UNLEADED $60.00
e TOTAL CARD 0002 43.148 7.90 143.05 **
° 0006 01-08 18:32 0745257 2108 N EMERSON AVE INDIANAPOLIS IN 6.471 8 UNL 1.18 2201.
®_ 6.471 GAL UNLEADED $22.01
0006 01-10 10:32 0753186 2108 N EMERSON AVE INDIANAPOLIS IN 10.291 8 UNL 1.88 35.00
10.291 GAL UNLEADED $35.00
0006 01-21 22:16 0808881 2108 N EMERSON AVE INDIANAPOLIS IN 15.253 8 UNL 2.79 50.031/
15.253 GAL UNLEADED $50.03
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 130203 9366 8015 SH33 5432
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
z 0005432 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.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065-129-116 11 065129116302 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
02-03-2013 02-28-2013 28 TELEPHONE: 1-800-377-5150
FAX: 1-515-226-4045
Caid TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0006 32.015 5.85 107.04 **
0014 01-11 10:41 0752014 9599 N MERIDIAN ST INDIANAPOLIS IN 7.270 8 UNL 1.33 22.54
7.270 GAL UNLEADED $22.54
0014 01-21 11:23 0256792 1230 S RANGELINE RD CARMEL IN 16.220 8 UNL 2.97 54.50
16.220 GAL UNLEADED $54.50
0014 01-23 1707 0271726 1230 S RANGELINE RD CARMEL IN 9.481 8 UNL 1.74 31.85
9.481 GAL UNLEADED $31.85
TOTAL CARD 0014 32.971 6.04 108.89 *�
GRAND TOTAL 138.308 25.31 462.07 **
_ FEDERAL EXCISE TAX
° 138.3 GALLONS GASOLINE 25.31 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 130203 9366 8015 SH33 5432
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
OW5432 Page 2 of 2 FLET2GUG
Information About Your Account
Report a Lost or Stolen Card Immediately: Our Customer Service Representatii
days a week. I
Payment Instructions: We must receive your payment in proper form at our proce,
do,it will be credited as of that day. A payment received at the processing facility in
of the next day. Allow 5 to 7 days for payments by regular mail to reach us.There rri
payment we receive that is not in proper form or is not sent to the correct address.
regular mail is the address listed on the return envelope or on the front of the paymE
express courier,you must call us for the correct address at the Customer Service nu
Proper Form. For a payment sent by mail or courier to be in proper form,you musts
•Enclose a valid check or money order.No cash or foreign currency please. i
•Include your name and account number on the front of your check or money i
If you send an eligible check with the payment coupon,you authorize us to coi
we do,the checking account will be debited in the amount on the check. We nI
the check. Also,the check will be destroyed.
Optional Pay by Phone Service. You may use this optional service any time to ma
$14.95 to use this service. Call by 5 p.m.Eastern time to have your payment crediti
your payment will be credited as of the next day. We may process your payment elE
This Account is Issued by Citibank,N.A.
PLOCOMM Rev 01112
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))
02/03/13 065129116302 monthly payment $436.76
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
Processing Center
IN SUM OF $
P.O. Box 183019
Columbus, OH 43218-3019
$436.76
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1110 I 065129116302 I 42-314.00 I $436.76 I 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
Tuesday, February 12, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund