220916 06/18/2013 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: $709.85
COLUMBUS OH 43218-3019 CHECK NUMBER: 220916
CHECK DATE: 6/1812013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065127193306 709 . 85 065-127-193
www.shelitleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065-127-193 14 065127193306 P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
06-05-2013 06-30-2013 30 TELEPHONE: 1.800-377-5150
FAX: 1-515-226-4045
NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE
745.38 .00 1,148.49 1,184.02 CR .00 709.85
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 06-30-2013
Card TRANSACTION TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
05-24 PAYMENT-THANK YOU 1,148.49 CR
0003 05-26 1023 0459578 7788 E 96TH ST FISHERS IN 18.000 8 UNL 3.29 67.14
18.000 GAL UNLEADED S67.14 /
0003 06-02 1044 0515007 7788 E 96TH ST FISHERS IN 17.251 8 UNL 3.16 68.99 /
17.251 GAL UNLEADED $68.99
TOTAL CARD 0003 35.251 6.45 136.13 xx
0004 05-26 1746 0387639 6416 E STATE ROAD 334 WHITESTOWN IN 18.304 8 UNL 3.35 71.02
18.304 GAL UNLEADED $71.02
0 TOTAL CARD 0004 18.304 3.35 71.02../
0013 05-12 13.49 0154245 1230 WEST SR 32 LEBANON IN 14.412 8 UNL 2.64 54.32 /
14.412 GAL UNLEADED S54.32
TOTAL CARD 0013 14.412 2.64 54.32 /x
0014 05-22 1551 0229500 1505 W MCLAIN SCOTTSBURG IN 15.612 8 UNL 2.86 59.00 Y
15.612 GAL UNLEADED $59.00
TOTAL CARD 0014 15.612 2.86 59.00 xx
0016 05-11 19 34 0752550 9510 E 126TH ST FISHERS IN 12.742 8 UNL 2.33 48.41
12.742 GAL UNLEADED $48.41
TOTAL CARD 0016 12.742 2.33 48.41 xx
0018 05-10 0843 0934760 11601 ALLISONVILLE RD FISHERS IN 16 312 8 UNL 2.99 58.40
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 130605 9366 8015 SH33 5166
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
Z
0005166 Page 1 of 2 FLET2GUG
Information About Your Account
Report a Lost or Stolen Card Immediately. You may call Customer Service 24 hours a day,7 days a week.
When Your Payment Will Be Credited. If we receive your payment in proper form at our processing facility by 5 p.m.local time there,it will be credited as of that day.A payment received there
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 regular mail is the address on the front of the payment coupon.
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,gift cards,or foreign currency please.
•Include your name and the last four digits of your account number.
Payment Other Than By Mail.
Phone. Call the phone number on Page 1 of your statement to make a payment.We may process your payment electronically after we verily your identity. You will be charged 514.95 to use this
service. The payment cutoff time for Phone Payments is midnight Eastern time. This means that we will credit your account as of the calendar day,based on Eastern time,that we receive your
payment request.
If you send an eligible check with this 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.
This Account is Issued by Citibank,N.A.
PLOCOMM Rev 04/13
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
SHELL CARD CENTER
065-127-193 14 065127193306 P O. BOX 689081
CLOSING DATE DUE DATE °'CYCLE DAYS DES MOINES,IA 50368-9081
06-05-2013 06-30-2013 30 TELEPHONE: 1-800-377-5150
FAX: 1-515-2260045
Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
16.312 GAL UNLEADED $58.40
0018 05-24 15.24 0237271 1230 WEST SR 32 LEBANON IN 16.192 8 UNL 2.96 62.65
16.192 GAL UNLEADED $62.65
0018 05-30 0749 0707497 1821 E 151ST ST CARMEL IN 14.452 8 UNL 2.64 56.35
14.452 GAL UNLEADED $56.35
TOTAL CARD 0018 46.956 8.59 177.40 *if`
0027 05-24 0604 0881078 9510 E 126TH ST FISHERS IN 6.660 8 UNL 122 25.11'
6.660 GAL UNLEADED 525.11
0027 05-30 0025 0940130 9510 E 126TH ST FISHERS IN 2.570 8 UNL 0.47 10.02✓
2.570 GAL UNLEADED 510.02 //
0027 05-30 1021 0090159 1230 S RANGELINE RD CARMEL IN 10.771 8 UNL 1.97 42.03./
10.771 GAL UNLEADED $42.03
TOTAL CARD 0027 20.001 3.66 77.16 �*
0029 05-24 0901 0051920 1230 S RANGELINE RD CARMEL IN 15.542 8 UNL 2.84 60.60
15.542 GAL UNLEADED $60.60
� rx
TOTAL CARD 0029 15.542 2.84 60.60
_® 0030 06-02 1304 0516336 7788 E 96TH ST FISHERS IN 15.331 8 UNL 2.81 61.34
15.331 GAL UNLEADED $61.34
s TOTAL CARD 0030 15.331 2.81 61.34 �*
GRAND TOTAL 194.151 35.53 745.38 *�
_ FEDERAL EXCISE TAX
194.1 GALLONS GASOLINE 35.53 CR
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 130605 9366 8015 SH33 5166
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
Z 0005166 Page 2 of 2 FLET2GUG
Z
Information About Your Account
Report a Lost or Stolen Card Immediately. You may call Customer Service 24 hours a day,7 days a week.
When Your Payment Will Be Credited. If we receive your payment in proper form at our processing facility by 5 p.m.local time there,it will be credited as of that day. A payment received there
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 regular mail is the address on the front of the payment coupon.
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,gift cards,or foreign currency please.
•Include your name and the last four digits of your account number.
Payment Other Than By Mail.
Phone. Call the phone number on Page 1 of your statement to make a payment.We may process your payment electronically after we verify your identity. You will be charged$14.95 to use this
service. The payment cutoff time for Phone Payments is midnight Eastern time. This means that we will credit your account as of the calendar day,based on Eastern time,that we receive your
payment request.
If you send an eligible check with this 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.
This Account is Issued by Citibank,N A.
PLOCOMM Rev 04/13
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))
06/05/13 65127193306 monthly payment $709.85
I 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
$709.85
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 65127193306 I 42-314.00 I $709.85 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, June 14, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund