220040 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WEX BANK
CARMEL, INDIANA 46032 PO Box 6293 CHECK AMOUNT: $51.42
CAROL STREAM IL 60197$293 CHECK NUMBER: 220040
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 32823281 51 .42 0496-00-138009-6
Invoice Statement
INVOICE NUMBER: 32823281
® ACCOUNT NAME: City of Carmel Utilities
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496.00.138009-0 900.00 30 APR-30-2013 MAY-24-2013 51.42
ACTIVITY DESCRIPTION G}0.Fa?E�SiL... 3f S PAYMENTSICREDITS
FUEL PURCHASES
CARD REPLACEMENT FEE
REMINDER
REMINDER PL
DE EASE
BE SURE TO CLOD
IN ERE REMITTANCE E STU
B
WITH PAYMENT. MAIL O S
L THE ADDRESS SHOWN IN TH
E
RIGHT RTI
PO ON OF E REMITTANCE TTANCE ST
UB.
i
V
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1W
W
PURCHASES,RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICE/STATEMENT.
PREVIOUS BALANCE PAYMENTS +PURCHASES +DEBITS CREDITS + ATE FEE =NEW BALANCE
0.00 0.00 49.42 2.00 0.00 0.00 51.42
CALL CUSTOMER SERVICE TO PAY BY PHONE
�EDERAL TAX ID: 841425616 The Late Fee is determined by Whi h is an EFFECTIVE ANNUAL I To the balance subject to late
v..�----.,s�,�.___ �__..,,r+• "1+^---.••�apratvino,a.mon'hlxrate�f...�"""'*+.-= '"""'` fee for this riod,which is
PARENT ACCOUNT: REPORT FOR:
City of Carmel Utilities City of Carmel Utilities
0496-00-138009-6
APR-01-2013 TO APR-30-2013
1!- up Activity Repoldt PAGE 1 OF 2
CARD;NUMW '.*`.- 0 ARM-EMBOS
Cx e H 10 Ca 0 a SO
V :>:>:::>:;;:;:;::»::>;:::::<::.:::::>;:;:::r<::
..-..---..-....�........ ..
0031 ..
78410 1
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-D PREVIOUS ODOMETER INFO CODE UNIT $ TAX TAX CODES
04-24 06:59 545 S Range Line Carmel IN 1 driver OP 59,950 UNL 14.090 3.689 52.00 2.58- 49.42 5.61-
PERIOD...OTAILS
TT .... ..
...........
PERIOD AVERAGE:PPG 3.691 .... . . ............
YTD AVERAGE:PPG 3.691
-- TO ENSURE MORE A:;cuRArEMILEAGz-REPO TING,VEHICLE MILEAGE 3TATISTICS AF E NOT
CAI CULATED WHEN KEY:)DOME TER READ NGS AR I:NOT WITHIN AN ACCEP 13LE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENTACCOUNT: REPORTFOR:
City of Carmel Utilities City of Carmel Utilities
0496-00-138009-6
190 APR-01-2013 TO APR-30-2013
Financial Summary PAGE 1 OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES&
QTY COST/FEE TOTAL FEES FUEL$ OTHER$ EXEMPTED TAX NET$ PURCHASES_
ACCOUNT TOTALS Card Replacement Fee 2.00
Unleaded Regular 52.00 2.58- 49.42
......
q Y w:fX
ACCOUNTS RECEIVABLE SUMMARY-Invoice 32823281
PREVIOUS BALANCE 0.00
PAYMENTS 0.00
PURCHASES 49,42
DEBITS 2.00
CREDITS 0.00
ANCILLARIES 0.00
-------------
AMOUNT DUE 51.42
PARENT ACCOUNT: REPORT FOR:
City of Carmel Utilities City of Carmel Utilities
0496-00-138009-6
No APR-01-2013 TO APR-30-2013
Site Summary PAGE I OF 2
BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL$ OTHER$ EXEMPT NET$
TRANS TAX
SHELL 545 S Range Line Rd Carmel IN 46032 1 14.090 52.00 2.58- 49.42
xx .. ....
x
. ..........
PARENT ACCOUNT: REPORT FOR:
City of Carmel Utilities City of Carmel Utilities
0496-00-138009-6
190 APR-01-2013 TO APR-30-2013
Tax Summa PAGE OF 2
TAX JURISDICTION ID EXPIRATION EXEMPTED TAX$ REPORTED TAX$ TAX TYPE TAX PRODUCT CLASS UNITS GROSS$ TAX RATE
FEDERAL 356000972 JUN-18-2012 -2.58 Federal Excise Gasoline..;. ......::.:::.::.:.::::�: ::.:: c:;: ::::;;::::,.;;::::::::.::::::::. -::::::.::::::..�..: :.............................
. .. a Unblende 14.090 52.00
:.:
-:: RALsTC1T .:.'S; ;:o:;;:.:.::;:o:>;;>:;::.::•;;:;;:::.:.:::::::::<.::;::.;:.;;::::. .;;::..�:::.::.:::::.:�:: 0.1
1=4>t...... .......a�s......::::..:.:::.;::.:_.,..::........ ................:,.:...........:.::.....::..,:::::.:.:.:.::..:. ::::.::::::.: ..........:.::::.:.::.:..:,::::..:.....:•.:::::::.:::::::::::. ................................:..::::................................. . 8300
IN 356000972 JUN-18-2012 -3.07 State Sales Gasoline Unblended 14.090 52.00 0.07000
:.: o:;;;..,::•.::::.::•:::..::•:::.::::::...:.... -2.54 State Excise Gaso'
line Unblended 14.090
5
..:. .:. .::.: ::.:..: . 2.00
tN.ST1�TE..i'GT'�4L5........::..::.::...:.: .. .....:..::.:.::..::::.::::.......:::::..::.;.....:.::.::.:............. :::..::.:....::.::.:............ . .:..:::.;::::::.....::......:::.::::::.:.�.:,.:.........:...:::.:::::.::::::...::::.................................. . 0.ls000
...........:.....
ACCOUNT TOTALS -2.58 -5.61
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
366015
WEX BANK Purchase Order No.
PO Box 6293 Terms
Carol Stream, IL 60197 Due Date 5/15/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/15/2013 32823281 $51.42
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
Date Officer
VOUCHER # 135491 WARRANT # ALLOWED
366015 IN SUM OF $
WEX BANK
PO Box 6293
Carol Stream, IL 60197
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
32823281 01-7500-08 $51.42
Voucher Total $51.42
Cost distribution ledger classification if
claim paid under vehicle highway fund