219194 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $1,093.60
CARMEL, INDIANA 46032 PO BOX 183019
COLUMBUS OH 43218-3019 CHECK NUMBER: 219194
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 65127193304 1, 093 . 60 GASOLINE
i
www.shellfleetcard.accountonline.coin
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065-127-193 19 065127193304 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
04-05-2013 04-30-2013 30 TELEPHONE: 1-800-377-5150
FAX: 1-515-226.4045
NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE
1,159.62 .00 1,115.52 1,181.54 CR .00 1,093.60
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 04-30-2013
Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
03-23 PAYMENT-THANK YOU 1.1 15 52 CR
® 04-05 DISCOUNT 930 CR
® 0003 03-08 2058 0121509 9510 E 126 iH ST FISHERS IN 17.403 8 UNL 3.18 6100
17.403 GAL UNLEADED $63.00
_® TOTAL CARD 0003 17.403 3.18 63.00
0004 03-08 1347 0669937 545 S RANGE LINE RD CARMEL IN 18150 8 UNL 3.32 6750
- 18.150 GAL UNLEADED 567.50
® 0004 03-12 11 14 0568592 1230 S RANGELINE RD CARMEL IN 22.911 B UNL 4.19 84.52
® 22.911 GAL UNLEADED $84.52
®_ 0004 03-21 1112 0624098 1230 S RANGELINE RD CARMEL IN 22.321 8 UNL 4.08 8703
® 22.321 GAL UNLEADED $87.03
® 0004 03-28 1846 0801274 545 S RANGE LINE RD CARMEL IN 22.145 8 UNL 4.05 83.00
® 22.145 GAL UNLEADED $83.00
TOTAL CARD 0004 85.527 15.64 322.05 "
0014 03-30 14 11 0700245 10598 N COLLEGE AVE INDIANAPOLIS IN 14.971 8 UNL 274 55.411./
®_ 14.971 GAL UNLEADED $55.41
® TOTAL CARD 0014 14.971 2.74 55.41 **
® 0016 03-08 1941 0697920 1230 WEST SR 32 LEBANON IN 14281 d UNL 2.61 49.97
® 14.281 GAL UNLEADED $49.97
®_ 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 130405 9366 8015 SH33 9859
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE ftEEP THIS PORTION FOR v011R RECORDS
Z 0009859 Page 1 of 4 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 format 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
i
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065-127-193 19 065127193304 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
04-05-2013 04-30-2013 30 TELEPHONE: 1.800-377-5150
FAX: 1-515-226-4045
Card TRANS%CTION TRANS TRANSACTION LOCATION/DESCRIPTION OUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
TOTAL CARD 0016 14.281 2.61 49.97
0017 03-14 1052 0891168 7788 E 96 FH ST FISHERS IN 24.062 8 UNL 4.40 92.4
24.062 GAL UNLEADED 592.40
TOTAL CARD 0017 24.062 4.40 92.40 **
0018 03-07 1704 0893750 1821 E 151 ST ST CARMEL IN 16.362 8 UNL 2.99 59.56
16.362 GAL UNLEADED $59.56
0018 03-18 1939 0926329 808 W MAIN ST CARMEL IN 15.011 8 UNL 2.75 59.46
15.011 GAL UNLEADED $59.46
0018 03-25 09.08 0647107 1230 S RANGELINE RD CARMEL IN 13.560 8 UNL 2.48 52.22
13.560 GAL UNLEADED $52.22
0018 04-03 01 30 0145938 1821 E 151 ST ST CARMEL IN 15 732 8 UNL 2.88 59.14
_ 15.732 GAL UNLEADED $59.14
_® TOTAL CARD 0018 60.665 11.10 230.38 */�y
® 0025 03-10 1226 0243527 106 MICHIGAN RD GREENSBURG IN 12.031 8 UNL 2.20 44.53%/
12.031 GAL UNLEADED $44.53
- TOTAL CARP 4925 12.031 229 44.53
�® 1 0027 03-11 17.05 0405738 11601 ALLISONVILL.E RD FISHERS IN 7.781 8 UNL 1.42 30.02
7.781 GAL UNLEADED $30.02
_® 0027 03-29 1332 0000554 7788 E 961-H ST FISHERS IN 6.811 8 UNL 1.25 25.06
® 6.811 GAL UNLEADED $25.06
TOTAL CARD 0027 14.592 2.67 55.08
0029 03-12 15:30 0571117 1230 S RANGELINE RD CARMEL IN 17.500 8 UNL 3.20 64.56
17.500 GAL UNLEADED 564.56
0029 03-21 20:41 0370320 633 W MAIN SR 32 WES TFIELD IN 17.381 8 UNL 3.18 68.29
_ 17.381 GAL UNLEADED $68.29
0029 03-30 11 19 0114694 1821 E 151 ST ST CARMEL IN 17.400 8 UNL 3.18 61.25
_ 17.400 GAL UNLEADED $61.25
TOTAL CARD 0029 52.281 9.56 194.10
®_ 0030 03-29 12.01 0999516 7788 E 96TH ST FISHERS IN 14.320 8 UNL 2.62 52.70
® 14.320 GAL UNLEADED $52.70
® TOTAL CARD 0030 14.320 2.62 52.70 **
® GRAND TOTAL 310.133 56.72 1,159.62
FEDERAL EXCISE 1AX
® 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 130405 9366 8015 SH33 9859
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
Z 0009859 Page 2 of 4 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 01112
i
www.shelitleetcard.accountonline.com
ACCOUNT NUMBER 1OTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065-127-193 19 065127193304 P 0- BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
04-05-2013 04-30-2013 30 TELEPHONE: 1-800-377-5150
FAX: 1-515-226-4045
Card TRANS6CTION TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE IIME ID CD CD TAX AMOUNT
310.1 GALLONS GASOLINE 5612 CR
d 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 130405 9366 8015 SH33 9859
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
z --
Z 0009859 Page 3 of 4 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
i
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065-127-193 19 065127193304 SHELL CARD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
04-05-13 04-30-13 30 TELEPHONE: 1-800-377-5150
FAX: 1-515-226-4045
DISCOUNT LOCATION ADDRESS DISC TIER PRODUCT DISC DISC UNITS DOLLAR DISC
TYPE TYPE BASIS DESCR % CENTS PORCH SALES AMOUNT
PROGRAM TDCPG036 C U ALL FUELS 310 133 9.30
SUB-TOTAL 9.30
TOTAL I 9.30
I
TOTAL DISCOUNT 9.30
DISC TYPE: %-Percent of Dollar Sales, C-Cents per Unit TIER BASIS: U-Units Purchased; D-Dollar Sales
-= 6057 0014 GUG 1 7 2 130405 9366 8015 SH33 9859
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOIIR RECORDS
z
z 0009859 Page 4 of 4 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
$1,093.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1110 I 65127193304 I 42-314.00 I $1,093.60 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, April 18, 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))
04/05/13 65127193304 gasoline $1,093.60
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