221855 07/17/2013 CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $124.37
CARMEL, INDIANA 46032 PO BOX 6293
4 oM.io CAROL STREAM IL 60197$293 CHECK NUMBER: 221855
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 33416830 124 . 37 0496-00-138007-0
Invoice Statement
INVOICE NUMBER: 33416830
NO ACCOUNT NAME: City of Carmel Police
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMIT DAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00-138007-0 20,00 30 JUN-00-2013 JUL-26-2013 156.84
AFtr ::::::::::;;;;:: ACTIVITY DESCRIPTION L#^i;?iF26£SfL7E8E75: PAYMENTS/CREDITS
PAYMENT THANK JliA1=21=2413:::::::: YOU
>::>::::::.>:_:::>::>::»::>::: . >::>::» 479.95
ll]N--28=2013: _ FUEL PURCHASES `z 424
REMINDER
BALANCE INCLUDES PAST DUE AMOUNT IF PAYMENT HAS
BEEN MADE PLEAS D THIS
E DISREGARD NOTICE.PAST DUE
ACCOUNTS ARE SUBJECT TO SERVICE INTERRUPTION
.::::::
PURCHASES,RETURNS AND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
CURRENT PERIO ONE BILLING PERIOD PAST DU TWO BILLING PERIODS PAST DUO THREE+BILLING PERIODS PAST DUE1 TOTAL DUE
134.37 22.47 0.00 0.00 156.84
PREVIOUS BALANCE PAYMENTS (+)PURCHASES (+)DEBITS CREDITS +LATE FEE =NEW BALANCE
502.42 479.95 124.37 0.00 0.00 10.00 156.84
CALL CUSTOMER SERVICE TO PAY BY PHONE
FEDERAL TAX ID: 841425616 The Late Fee is determined by Which is an EFFECTIVE ANNUAL To the balance subject to late
applying a monthly rate of RATE of fee for this period which is
2.08 % 24.99 % 22.47
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS.
- - -- -- -- - -. ------TO-ENSURE-PROPER CREDIT.-TEAR-AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYMFNT-
Balance Subject to Late Fee Mail
The late fee will be calculated by determining the total balance Be sure to include bottom portion of invoice with your payment.
due on the date your account becomes delinquent,as follows: Write your account number or invoice number on the check to help
adding the total amount due on your Account on the payment due avoid delays in payment processing if the check and remit stub
date together with any purchases posted to your Account from become separated.
the end of the last billing cycle through the payment due date and Allow 10 business days prior to the due date for mailing to help
subtracting from that amount any payments and/or credits entered avoid late fees.Mail payments to:
during that period.The total balance due will then be multiplied
by the applicable periodic rate to determine your late fee.In the Fleet Services
event that the calculated late fee is less than ten dollars($10.00), PO Box 6293
a minimum late fee of ten dollars($10.00)will be charged. Carol Stream,IL 60197-6293
Your Account will be delinquent if you do not pay it in full within Online
26 calendar days of the billing date appearing on your invoice. Authorized users can elect to receive an email notification when an
Certain customers,based upon our credit review,may be required invoice is ready for online viewing and payment.Log in or register to
to make payment in less than 26 calendar days on a cycle that we set up an online account at www.wextools.com.
may establish for you.In addition,certain customers may elect a Online payments scheduled by 3:00 PM ET(on business days)
shorter billing or payment cycle as offered by us, are credited to your account on the same day.There is no fee for
If your payment due date falls on a non-business day,payment is online payments.
due on the business day before the payment due date.Delinquent Phone
Accounts will be subject to late fees,suspension,or termination Call Customer Service at 1-866-544-1715 and select the menu
of credit privileges,without notice.All charges must be paid in
full regardless of disputes.Charges must be disputed in writing option for Billing Inquiries.In addition to making a payment,you can
no later than sixty(60)days from the billing date or they will be also check your balance.
considered final and binding. Payments scheduled by 3:00 PM ET(on business days)
Card Issuer are credited to your account on the same day.
The Circle K Fleet Card is issued by,and all card transactions are Be prepared with your fleet card account number and a sample
funded by and payable to,WEX Bank,under a Business Charge check to enter your bank account number and routing number.
Account Agreement with the cardholder named on the reverse. There is no fee for phone payments.
Customer Service Automated Clearing House(ACH)
To make a one-time electronic payment go to:
For account Inquiries and correspondence in regard to account hftp://Www.e-Reet.com
service or billing:
• Call 1-866-544-1715,or ACH payments made by 2:30 PM ET(on business days)are
credited to your account on the same day.There is a fee for each
• Fax to 1-800-395-0809, or ACH payment.
• Mail to P.O.Box 639, Portland, ME 04104
Be sure to include your account number on all correspondence.
Payment Options
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
No JUN-01-2013 TO JUN-30-2013
Purchase Activity Report PAGE I OF 4
MC KIPTIOW:i PLATE:
INSHICLE:
X X
10144 132VA6 I Police
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD PREVIOUS ODOMETER INFO CODE - UNIT TAX TAX CODES
06-24 07:08 706 Northwestern West Lafay IN 1 Driver OP 57,223 UNL 16.728 3.558 59.53 3.06- 56.47 6.51-
.......... . ......
.... ........
.......... .... .....
........... ......
TALS
... ....... ... 06 56:47.:;.;:::::::.;:........i:.
PERIOD AVERAGE:PPG
3.559
YTD AVERAGE:PPG 3.559
TO ENSURE MORE A:=RA TE MILEAG E REPO F TING,VEHICLE MILEAGE TATISTICS AF E NOT
CAI CULATED WHEN KEY DDOME TER READ NGS ARE NOT WITHIN AN ACCEPT ABLE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
JUN-01-2013 TO JUN-30-2013
Purchase Activity Report PAGE 2 OF 4
VEHICLE IAWP--T IFFENTIFIEW....i....."
ItAIM
PLATSOT) ....777777777-1
10146 822 1 Police
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 10,115
06-12 08:58 545 S Range Line Carmel IN I Driver OF 10,971 SUP 4.680 4.469 20.95 0.86- 20.09 2.10-
':— ,,.. .... . ..........
PERIOD ......... ......
. ...... ...
..........
.. . . .. .. ...... ...... .
........... . ....
.............
........... :67,96
........ ........ 04t
.. ....... ..... ......
PERIOD AVERAGE:PPG 4.476
YTD AVERAGE:PPG 4.099
TO ENSURE MORE A:=RA FE MILEAGE REPO F TING,VEHICI E MILEAGE TATISTICS APE NOT
CA[CULATED WHEN KEY DDOME TER READ NGS AR NOT WITHIN AN ACCEP BLE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
JUN-01-2013 TO JUN-30-2013
Purchase Activity Report PAGE 3 OF 4
77
..... .. ... . .........
.. ..................:77FF��w:,...
10029 11139 ...... . . Unassigned
DATE TIME SITE ADDRESS PROMPT TRAN ODOM. PROD UNITS COST/ FUEL$ OTHER EXEMPT NET$ REPORTED EXC.
MM-DD INFO CODE UNIT $ TAX TAX CODES
PREVIOUS ODOMETER 10,199
06-08 22:10 606 N Main St North Webs IN 1 Driver OP 11,375 UNL 12.056 4.149 50.02,;7 2.21- 47.81 5.16-
............
42*
......... ........– .......
.......... .......
916::
. ............. ........
......... .34
..... ..........
PERIOD AVERAGE:PPG 4.149
YTD AVERAGE:PPG 3.705
TO ENSURE MORE A'CUR MILEAGE REPORTING,VEHICI E MILEAGE 3TATISTICS AF E NOT
CAI.CULATED WHEN KEY DDOME TER READ NGS ARE NOT WITHIN AN ACCEPT 6,BLE RANGE.
TRANSACTION CODES:
OP=Outdoor Payment Terminal
um
99—N-
KTFNM
Lou@
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PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
He JUN-01-2013 TO JUN-30-2013
Site Summary PAGE OF 2
BRAND ADDRESS CITY STATE ZIP NO. FUEL UNITS FUEL$ OTHER$ EXEMPT NET$
TRANS TAX
BP PRODUCTS NA 706 Northwestern Ave West Lafayette IN 47906 1 16.728 59.53 3.06- 56.47
DAIRY MART 606 N Main St North Webster IN 46555 1 12.056 50.02 2.21- 47.81
SHELL 545 S Range Line Rd Carmel IN 46032 1 4.680 20.95 0.86- 20.09
.. .... ........
ERIOD:IOTA »:»::::`:::<:::s::»:>:;> »»>:1:.:::::;>.:;:;;..» i3»»>::»>::<:; ::
LS.........
3 33.4&4;': :<:::I:I>:I:>:::730:50.;:::::::;:::;:;:Q,00::: >::>: 6:13 ............124:31::;
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PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
se JUN-01-2013 TO JUN-30-2013
Tax Summary 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 -6.13 Federal Excise Gasoline Unblended 33.470 130.50 0.18300
..
;:c:<::; :;..
IN 356000972 JUN-18-2012 -7.75 State Sales Gasoline Unblended 33.470 130.50 0.07000
6.02 State Excise Gasoline Unblended 33.470 130.50 0.18000
..... ...:.:.:.. ::::..:...:..:::::..:::::::: :::::::::::: ...
1���
ACCOUNT TOTALS -6.13 -13.77
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PARENT ACCOUNT: REPORT FOR:
City of Carmel Police City of Carmel Police
0496-00-138007-0
® JUN-01-2013 TO JUN-30-2013
Financial Summary PAGE OF 2
DEPARTMENT DESCRIPTION FEES PURCHASES TOTAL FEES 8
QTY COST/FEE TOTAL FEES FUEL$ OTHER$ EXEMPTED TAX NET$ PURCHASES
Police Unleaded Regular 59.53 3.06- 56.47
Unleaded Super 20.95 0.86- 20.09
>:.;:.;»::<>>:i:: ;`<i'`'7i:;»>:I> »»> »:>sa,.,,,:..:..,.»`<: »:>`:I>:>: ::y
0.00......... ..:.:::::::;:80.48.:::::::::::::.: .: .0,00.::::::::::::::::: 3.92..
.58..... 76.56.
0.40- >::::'::>6&8:-::::::::.;::::>::;:;::::>33s:7d::::::..::::>::::>:::': !' 6.74
UNASSIGNED Unleaded Regular 50.02 2.21- 47.81
...
. ':: :>:::a :.:;:;: �1:> . .....
............... .. .......... ::.:::c ::::;;::�., ........
..:::::::::.:::::::..
. 000 4 .. - ..
ACCOUNT TOTALS Unleaded Regular 109.55 5.27- 104.28
Unleaded Super 20.95 0.86- 20.09
ERIQC? :::::
1
............. .. ................................. .......... i:l ... :. :::::.:::.>::>::::: :.::::::::i::;:..
.:.:.........>:::
,62 5::..:::::::::::::.::.. .4P. 52,20:; .:.:::.....;.... .95:>:::::
�.
ACCOUNTS RECEIVA LE SUMMARY-Invoice 334 6830
PREVIOUS BALANCE 502.42
PAYMENTS 479.95-
PURCHASES 124.37
DEBITS 0.00
CREDITS 0.00
ANCILLARIES 0.00
LATE FEES 10.00
AMOUNT DUE 156.84
GEM
NO
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VOUCHER NO. WARRANT NO.
ALLOWED 20
WEX Bank
IN SUM OF $
P.O. Box 6293
Carol Stream, IL 60197-6293
$450.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1110 33421072 42-314.00 $325.63
I hereby certify that the attached invoice(s), or
_
bill(s) is (are) true and correct and that the
1110 33416830 42-314.00 $124.37
materials or services itemized thereon for
which charge is made were ordered and
received except
Wednesday, July 10, 2013
oe
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))
06/30/13 33421072 gasoline $325.63
06/30/13 33416830 gasoline $124.37
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