223357 08/26/2013 CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $1,065.68
CARMEL, INDIANA 46032 PO BOX 183019
COLUMBUS OH 43218-3019 CHECK NUMBER: 223357
CHECK DATE: 8/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 065127193308 1, 065 . 68 065-127-193
www.shelitleeteard.iccountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES
065-127-193 20 065127193308 SHELL CAARD RD CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
08-06-2013 08-31-2013 32 TELEPHONE: 1.8003773150
FAX: 1615-226-4045
NEW CHARGES FLEET FEE REVIOUS BALANCE PAYMENTS/ADJUSTMENTS LATE FEE NEW BALANCE
1,131.98 .00 1,002.50 1,068.80 OR .00 1,065.68
A
PAYMENT OF NEW BALANCE MUST BE RECEIVED BY 08-31-2013
Card TRAN kCTION TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
07-19 PAYMENT-THANK YOU 1,002.50 CR
® 08-06 DISCOUNT 9.33 CR
0003 07-22 16:39 0661454 11601 ALLISONVILLE RD FISHERS IN 18.101 8 UNL 3.31 66.25✓
18.101 GAL UNLEADED $66.25
TOTAL CARD 0003 18.101 3.31 66.25 "*
0009 08-05 0959 0568568 1230 S RANGELINE RD CARMEL IN 13.900 8 UNL 2.54 51.43
�= 13.900 GAL UNLEADED $51.43
® TOTAL CARD 0009 13.900 2.54 51.43 r�
0014 07-28 1100 0521682 1230 S RANGELINE RD CARMEL IN 13.752 8 UNL 2.52 47.02
® 13.752 GAL UNLEADED $47.02
■® 0014 08-01 08:46 0797712 1601 EAST STATE RD 44 SHELBYVILLE IN 16.223 8 UNL 2.97 61.00\/
•� 16.223 GAL UNLEADED $61.00
® TOTAL CARD 0014 29.975 5.49 108.02
0015 07-23 12:21 0477695 1230 S RANGELINE RD CARMEL IN 14.470 8 UNL 2.65 49.20
�® 14.470 GAL UNLEADED $49.20
® TOTAL CARD 0015 14.470 2.65 49.20 �*
0016 07-25 1710 0529859 9510 E 126TH ST FISHERS IN 16.302 8 UNL 2.98 57.71
16.302 GAL UNLEADED $57.71
TOTAL CARD 0016 16.302 2.98 57.71 **
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
�r
6057 0014 GUG 1 7 2 130806 9366 8015 SH33 9678
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
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 04113
www.shelifleetcard.accountonline.com
ACCOUNT NUMBER TOTAL TRANSACTIONS INVOICE NUMBER SEND INQUIRIES TO:
065-127-193 20 065127193308 P.O. BOX CENTER
P.O. BOX 689081
CLOSING DATE DUE DATE CYCLE DAYS DES MOINES,IA 50368-9081
08-06-2013 08-31-2013 32 TELEPHONE: 1-800-377-5150
FAX: 1-515-226.4045
Card TRANS TRANSACTION LOCATION/DESCRIPTION QUANTITY MSG PROD EXEMPT TRANSACTION
Number DATE TIME ID CD CD TAX AMOUNT
0018 07-24 1132 0789677 8924 E 116TH ST FISHERS IN 16.782 8 UNL 3.07 61.07
16.782 GAL UNLEADED $61.07
0018 08-04 1656 0313270 1821 E 151ST ST CARMEL IN 15.980 8 UNL 2.92 58.81
15.980 GAL UNLEADED $58.81
TOTAL CARD 0018 32.762 5.99 119.88 *%
0023 07-18 16:25 0604850 721 E81STAVE MERRILLVILLE IN 14.891 8 UNL 2.73 61.07V/
14.891 GAL UNLEADED $61.07
TOTAL CARD 0023 14.891 2.73 61.07 *�
0025 07-08 12:40 0448449 808 W MAIN ST CARMEL IN 14.673 8 UNL 2.69 49.8"�//
14.673 GAL UNLEADED $49.89
TOTAL CARD 0025 14.673 2.69 49.89 /*
0027 07-14 21:43 0419937 9510 E 126TH ST FISHERS IN 12.310 8 UNL 2.25 45.55/
12.310 GAL UNLEADED $45.55
0027 07-25 0422 0263079 14554 HERRIMAN BLVD NOBLESVILLE IN 13.691 8 UNL 2.51 49.55r/
13.691 GAL UNLEADED $49.55
0027 08-02 0008 0758755 11601 ALLISONVILLE RD FISHERS IN 13.780 8 UNL 2.52 51.54 J
13.780 GAL UNLEADED $51.54
TOTAL CARD 0027 39.781 7.28 146.64 **
_ 0029 07-10 11:33 0341768 1230 S RANGELINE RD CARMEL IN 17.280 8 UNL 3.16 57.01
_ 17.280 GAL UNLEADED $57.01
° 0029 07-16 13:50 0142844 1821 E 151ST ST CARMEL IN 17.991 8 UNL 329 67.27
_® 17.991 GAL UNLEADED $67.27
0029 07-27 00:16 0680843 9599 N MERIDIAN ST INDIANAPOLIS IN 15.680 8 UNL 2.87 53.77
15.680 GAL UNLEADED $53.77
0029 07-31 1048 0540369 1230 S RANGELINE RD CARMEL IN 16.721 8 UNL 3.06 63.04
° 16.721 GAL UNLEADED 563.04
0029 08-05 1210 0569392 1230 S RANGELINE RD CARMEL IN 17.921 8 UNL 3.28 66.29
17.921 GAL UNLEADED $66.29
TOTAL CARD 0029 85.593 15.66 307.38 �*
0 0030 07-17 2039 0872481 7788 E 96TH ST FISHERS IN 14.730 8 UNL 2.70 55.40✓
® 14.730 GAL UNLEADED S55.40
0030 07-23 1925 0923045 7788 E 96TH ST FISHERS IN 16.110 8 UNL 2.95 59.1
16.110 GAL UNLEADED $59.11
® TOTAL CARD 0030 30.840 5.65 114.51 **
° 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 130806 9366 8015 SH33 9678
NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE KEEP THIS PORTION FOR YOUR RECORDS
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o • - • VILOW421 •. e- • • -
• Lower your fuel costs with ongoing rebates on fuel purchases.
•Save money with no monthly, annual or per card fees.
N •Help eliminate unauthorized card usage with individual driver prompts.
g •Track purchases by driver, vehicles, department and more.
• Restrict purchases to fuel only, as needed.
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N •Manage your account online 24/7 at www.shelIfIeetcard.accountonIine.com
•Get additional cards at no cost! Request cards online or call us at 1-800-377-5150.
Thank you for choosing the Shell Fleet Plus Card! S2l_xrAO512C
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 614.95 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.
Ta s Account is Issued by Citibank,N.A.
PLOCOMM Rev 04 13
VOUCHER NO. WARRANT NO.
Shell Fleet Plus ALLOWED 20
Processing Center IN SUM OF $
P.O. Box 183019
Columbus, OH 43218-3019
$1,065.68
ON ACCOUNT OF APPROPRIATION FOR ,
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 65127193308 I 42-314.00 I $1,065.68 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
Wednesday, August 21, 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))
08/06/13 65127193308 monthly payment $1,065.68
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