226185 11/19/2013 e+ CITY OF CARMEL, INDIANA VENDOR: 00351794 Page 1 of 1
ONE CIVIC SQUARE SHELL CREDIT CARD CENTER CHECK AMOUNT: $660.56
o CARMEL, INDIANA 46032 PO BOX 183019
COLUMBUS OH 43218-3019 CHECK NUMBER: 226185
CHECK DATE: 11119/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 651271933112 660 . 56 065-127-193
Account Statement
Commercial Account
x�� Customer Service: oAnmEL POLICE DEPARTMENT shellfleeteardacoountonlinecom
Shell Fleet Plus Card Account Inquiries: Account Number: 0651271931
1-800-377-6150 Fax 1-866-533-5302 Invoice Number: 0000b00065127193311
Csummary of Account Activity rPayment Information
Previous Balance $1,314.80 Current .Due $660.56
Payments Past Due Amount + $0.00
Credits Minimum Payment Due $660.56
Purchases +$698.5
Debits +$0,0— Payment Due Date 11/30/13
Late Fees +$0.00 tredit Line $3,700
�lew Balance $660.56
Credit Available $2,989
Total Transactions 14
Closing Date 11/05/13
end Notice of Billing Errors and Customer Service Inquiries to: .Next Closing Date 12/06/13
SHELL
P.O.Box 6406,Sioux Falls,SID 57117-6406
Everything you need tu know about your account ishere: account number, payments, contact information and more.
Please see the enclosed sample for additional information on how to read your statement.
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e
-o TRANSACTIONS
LLj Trans Trans Trans Msg Prod
cz Date Time m Location/Description ouamnv cmue Code Exempt Tax Amount
PAYMENTS,CREDITS,FEES AND ADJUSTMENTS
10/25 PAYMENT-THANK YOU
e
PURCHASES AND DEBITS
CARD NUMBER 000u
10/25 09:31 0451104 8501 E WASHINGTON ST INDIANAPOLIS IN 17.744 8 UNIL $3.�5 $58.52
17.744 GAL UNLEADED $58.52 ? 1
CARD NUMBER 0003 TOTAL 1 17744 $3.25 1 S58.52
CARD NUMBER mmr
0086728 10598 N COLLEGE AVE INDIANAPOLIS IN —! ---�3.(T3—[ $57.02
10/08 17:21 16.532 1 8
16.532 GAL UNLEADED $57.02
10/24 09:02 0041590 1230 S RANGELINE RD CARMEL IN 17.530 8 UNIL $3.21 $58.71
17.530 GAL UNLEADED $58.71
11/04 13:09 0031401 1 808 W MAIN ST CARMEL IN 5000 8 UNIL $0.92 $15.45
5.000 GAL UNLEADED $15.45
CARD NUMBER 0007 TOTAL $7.16 $131.18
���«�e�u�RxEwmE-,vR�poRwmTnwmvm^/mm _�-__,uoo�or� -_ --- - _- - '� This Account /�
~^
4, Pie se de ach and return lower portion with your payment to insure proper credit. Retain upper portion for your records, 41
Information About Your Account Payment Other Than By Mail.
When Your Payment Will Be Credited.If we receive your payment in Phone.Call the phone number on Page 1 of your statement to make
proper form at our processing facility by 5 p.m.local time there,it will a payment.We may process your payment electronically after we
be credited as of that day.A payment received there in proper form verify your identity.You will be charged$14.95 to use this service.
after that time will be credited as of the next day.Allow 5 to 7 days for The payment cutoff time for Phone Payments is midnight Eastern
payments by regular mail to reach us.There may be a delay of up to time.This means that we will credit your account as of the calendar
5 days in crediting a payment we receive that is not in proper form or day,based on Eastern time,that we receive your payment request.
is not sent to the correct address.The correct address for regular mail If you send an eligible check with this payment coupon,you authorize
is the address on the front of the payment coupon. us to complete your payment by electronic debit.if we do,the checking
Proper Form.For a payment sent by mail or courier to be in proper account will be debited In the amount on the check.We may do this as
form,you must: soon as the day we receive the check.Also,the check will be destroyed.
Enclose a valid check or money order.No cash,gift cards, Report a Lost or Stolen Card Immediately.You may call Customer
or foreign currency please. Service 24 hours a day,7 days a week.
Include your name and the last four digits of your account number.
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0
T04563-H2-9366-8015-0001-OOL--O---04/01/91-272-56-P--0--0-0-0-SHFLEET2---03/31/10-SH33-October 6,2013---
PLOCOMM OCT13
Page 2 of 4
Account: **** **** **** 7193
TRANSACTIONS (cont)
Trans Trans Trans Msg Prod
Date_ Time ID Location/Descript ion-__.-.- --_------------ Quantity Code Code Exempt Tax---,-Amount
CARD NUMBER 0008___ ^� w
10/07 ' 09:36 0941815 1 1230 S RANGELINE RD CARMEL IN �- - i8 1
! 10.192 8 UNL $1.87 $33.33
{ I i 10.192 GAL UNLEADED $33.33 1
10/16 14:37 , 0939348 1 808 W MAIN ST CARMEL IN 16.132 ( 8 UNL 1 $2.95 i $54.35
i 16.132 GAL UNLEADED $54.35 I f
10/23 1 12:07 0195578 ! 14554 HERRIMAN BLVD NOBLESVILLE IN 7.350 8 j UNL $1.35 ' $24.19
I i 7.350 GAL UNLEADED $24.19 I ! I
10/25 11:04 0998310 1 101 N CROSS POINTE BLVD EVANSVILLE IN 15.514 8 UNL i $2.84 $55.82
9 15.514 GAL UNLEADED $55.82
11/01 i 21:55 0100040 1 1821 E 151ST ST CARMEL IN i 17.602 8 UNL j $3.22 $58.44
t i 17.602 GAL UNLEADED $58.44
___ NUMBER 0008 TOTAL ` 66.790 i $12,23 j $226.13
CARD NUMBER 0015
10/31 j 13:44 0012856 1 808 W MAIN ST CARMEL IN -- - I 13.170 I 8 UNL ! $2.41 ! $44.78
(( i 13.170 GAL UNLEADED $44.78
CARD NUMBER 0015 TOTAL` ,13.1170 rj_.- _l._._�_�___ $2.41 $44.78
CARD NUMBER 0016
10/25 19:02 0470955 9510 E 126TH ST FISHERS IN 14.953 i 8 }UNL $2.74 $48.30
i ( 14.953 GAL UNLEADED $48.30 ! I
f i CARD NUMBER 0016 TOTAL 14.953 i $2.74 ii $48.30
CARD NUMBER 0018
�+ 10/10 15:19 0848226 9599 N MERIDIAN ST INDIANAPOLIS IN - 1 16.911 j��UNL T $3.O9 T $58.16
-0 16.911 GAL UNLEADED $58.16
C3 10/31 ( 13:09 0449215 8924 E 116TH ST FISHERS IN 16.664 ! 8 i UNL IIII $3.05 $56.46
! III i
! 16.664 GAL UNLEADED $56.46 t i
CARD NUMBER 0018 TOTAL 33.575 $6.14 $114.62
CARD NUMBER 0033
10/14 1 17:06 f 0352401 f545 S RANGE LINE RD CARMEL IN -- 22.065 I-8 UNL $4.04 j $75.00
4 ' t 22.065 GAL UNLEADED $75.00 9
! E CARD NUMBER 0033 TOTAL 22.065 j $4.04 I $75.00
GRAND TOTAL 207.359 E $37.97 $698.53
1 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
TAX EXEMPTION SUMMARY
Description Amount
FEDERAL EXCISE TAX
207.3 GALLONS GASOLINE _ - -$37:97
- - Page 3 of 4 1-800-377-5150- shellfleetcard:accountonline:corn- -
**** **** ****
Account: 7193
E3 clear & concise,
Your new SIRaIRemento
Clear: Statements show you exactly how much you've spent, how much you owe, and your
i
available credit.
Concise: The information is "bucketed" into sections that make it simple to find what you're
looking for and is written in normal, everyday language.
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Account Number/ Account Statement
CommBtpalAaoam Payment Information
Contact Information Customer Service: NHM9ua
5611FleltPlusCard o 6 � Shows what you owe,
i Account Inquiries: Account Number.9888998998899889
Summary of 101a°o999a999 F==I' m Invg eNUmbO: 9999999999999999999 due dates and minimum
Account Activity Summa of Account Activity Paymentlntormatlon payment information
A�'T nick complete Pre'ou9 Balance _ s9,9%,999.99 _ Cu-1 Due $9 s9s,999 ee
q Paylr erns—_ -K-9wM99 Pasl Due Ammo- Transactions
+ $9.988.889.89
view of your account— U US M mPaymsn ao _ 58£K9699d9-.- _
Deblte '—X59,999,999.99 Payment Due Data MM/DD/YY Lists your purchase
all in one place lle FeeB. - +59.999,999.99
NEW 9elence � 59,999,989.98 Credit Line 59,998,999 activity, including
--i - - ---_-- --
TolalrrarXmctiona 9.ee9.9a9 GedllAVailaW9 ----- --5s_e9e_9as ' dates, locations, .
--- -
Arstounl Over Cred 1 L ne _ S9 8.19,998 _
Sand NOBCe oI&14ng Enos and CrR er Service ln9wwSX Clpynp Dale _—NIMIDDIYY �1
— q/uantit of gallons,
PO ROY 0889,aw ST 153920099 NeXI ClDStn9 OBIS MMlDD/YY quantity g
t and type of fuel
0 D TRANSACTIONS \ Payments,Credits
Tmna T— Ir— Ma8 Prod ,
-Year-to-Date m1a Tlma ID Laa b90a 1P1I Ouemily Coda Cada Ex p,T,, Amoum
ru y PAYMENTS,Cq DITS,PEESANDA T=" '
Summary 9 MMND i PAYMENT-TNANX YOU 1 EP,0P999G 92 Fees and Adjustments
MDD� �CREDIT AWUSTYENT TOYCUR ACCOUNT ' E9,B9B 89999 A record of payments
IW
A summary of MAWD: OVAUY RE WARD I EPA99.B9900.
total gallons this MAD°' I °'�°°°"T ! i E9,p99999D0. you've made and credit
PURCHASES ANDDEaRS adjustments affecting '
statement period SUM W NUM8e98808 NAME1
CAgD NUMBEq 0001 _
f MMIDO II as 89 —123Z6-7 YW r234MAINSTREETANFERE,US1 B2CB0 B`T 'UP SBB09,900.09T 69,99 oio your account
and year-to-date � n,,,cAD DIS.cADBD 7j� ,
I CARD NUMBER 000I TWAL W880 1 ( y �, Srg./-B_0-ABO.BB L SB9�_09�.99
CAM MBERWG2 ' Remit Coupon
MMIDC esea 23469] 1234 MAIN STREET ANYWHERE.USA ®908 E REG.1 Ee,BW,BBB.B9 E9,BBB BB999
Tax Exemption zT.B93 OAL UN BADBD Identifies payment
CPRD NUMBER 0000 TOTAL E00000 I I I E0p00A0090 � 3¢,9%,BeB.9B '
Summar\/ OALSUBACCTB9BB99B9NAME1 000.W8 i __-s.�^^^^^^^?^ ,a�e,�9, due date, new balance,
7 _ __-__._- — -._—� 1.
A summary of the any past due amount,
NOTICE:SEE REVERSE SUE FOR IMPORTANT INFORMATION Pa9s I M X B0 M 90 TNb AWgln1 h haw0 by CtWrrtR N.A.
tax exemption ,mA6a. minimum payment
credits by state, city. �eroa„� due, and an area to
Your Aarount Number 99999999 9999 9999 IIIIIIIIII'II�II�IIIIIIIIIIII�lII�lII V'II'I ,
county, and federal ShdlNee% °o, Invoice Number Q909 ooGoe9ese9se write in the amount
I
for qualified tax Payment Due Date Month DD.YYYY
--�, New Balance S9,9B9,999.99 of your payment
exempt accounts Pagl. ue APanaunt' 59,999,998.89
m y ID 59999.99999 Discount Summary
Statement Enclosed
'E�Deed $ Represents merchant
mD ro >gda ” funded and program
•"'9999 An ky P Y bl
Ac�unt'."""" •
` M. P�d °F mmo EaamPIT discounts. Merchant
0„m.,VH Coda Coda XX,CX1"(X
TAANSAC T,amt)
Tana Tlnx ID Laa,lorypaudPlbn 's9 funded discounts
De ^-inzs glyll. rnluur qulldrllhdhih
PM,CNASESAND DNPITS(F-1 are broken down by ,
9UBAOCT 99998888 �'!'
CARD NUMB1U50aa1 ,pO,IN STREET AN'M'RERE•USA S 0.Al li E>3OO each merchant when
MWDD 9B.B9�123n"d1 S"S TAX E 1.89
! AccsssoRY 5 21.99 i e 11AAAAAAAA CCAD
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NAG 9"' 1 applicable
• I 1'" 1234 MAIN STAE'T ANYWI=EFiE.DSA
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,•,µpp'I C. 129<50T l-„ISCWNT 550.00 i Account:••«••••. T1�,�,
8 I 1� 1� A L VNLEAD£D - 1 !!T'— h,e 9JJ'
CARD NIMBEN 0001 TOTALy_,�.- D/SCO(/NT SUMMARY
_ j1'fi6� Locetl
Cµ[I NUMBER ma2�� gTgEET ANVWRERE.USAF. 5 36.51 —� 1 'C"00n
1EM66T f'd MAIN OED REGU 1s.609 5 ' MERCNANTOI8000NI Dhc TM %aWCI
EGVOD i BB13 11.165 OiS Deacr
Pay WUN STREET ANVW Ep�wR S 02.00 4 236 M41N STREET ANY.y,¢RE.VSA Ewa 0 % Cwec Unlb
0 MMTC 80.69 1996967 'SB.SOB gAL UNLE?D_ DARCNUMB£Raesa NAM£2�988.999 11• 1=34 MAIN STREET C %srM D-se,S OIaaWN
111 VSA C L UNL e1°° Amoans
n I II TOTAL B„OAOOT 88899989 1999.999 i —' ERE,USA I U SUP I EO.��l 999,989.99p
PfiAND TOTAL: � � 234 MAIN BTREE A £USAF S_^e TOTAL C U ' DSL 500 I 998.933.909 j I EB.999,9 e9
_�,,,,.�y..•---- 236 MAM _ �.0�� 999999 18 $9.939.999.99
~A-E1W'On10$el¢WIIhOUt AUlhOr1 ._..-.4BTgEtTANYYR,�P.US4 ' U UNL �__ _ I I E9.999.999.90
,-_°'. T.BpOBOrtiC sale WAh AUIhar""' _S.Keyed SBIe WIIMut AUI-baur- � C i U SUP t II f001N 989.999.9 l_____ _-J iB BBB_B%90
Message Coble: P Ryyed Sale wi9l AUtttOrbAUOa •TOr/y yFFCHntB1T .- EO.OIa •}
O - `_�' _I 999.999999 E9999.99g_9y
_sn,r,n.........-._.- ,+•-•°'c-'•`�.. r-�- FCOFAM UIBCQIITI -_i_�_.._ f ......L_ 59.999.99999
-
30,8es,,S9S.99
9 VEAfl TO DATE SUMMARY WP,B99.9BB - 59,889,980.98
Total Gelb PurcFeced FN$element_ _'898.998.800 TD9 00p1_�""` -^:.____ YITSTp^TAlf % D I hl NELS OCUN l
TofAl Gelwrc Puronacod'n Y`/YY - -..�_ � %TI_C_-,ALL FU -' S9,BBO,y98.B9
TOTAL SUBTOTAL E15 L 0.025p 59.999.999.99
TAX EXEMPTION SUMMARY NOODMMOnwUNT+ { - se.B9B,B8B.9B
Oaecnptpn TOTAL DISCDUNI - E9.999.999.99
Disc Type:.%.1--of Dw1p E9,999,ggg.gg
(STATE NAME)STPTEMOTOP FUELTA% Bahr,C Cents 38900,888.88
BBB 00BBGALLONS GASOLINE L Per Vml Tar Des s' SB BBB,OBB.gg
990 989 B GALLON$DIESEL FU6 % a U Vmk Pu.Mesad,D-a..,E.. 19-999.
(STATE NAME)STATE MOTOR FLEL TP% --- - ,,,,,._
- �� � 999.99
888.999,9 GALLONS GASOLINE -'
9%.BBB.BGALIANIS NTsa'EL _ For Illustration purposes ordy. SH f=2 TE HTR I
Page 4 of 4 1-800-377-5150 shellfleetcard.accountonline.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shell Fleet Plus
Processing Center IN SUM OF $
P.O. Box 183019
Columbus, OH 43218-3019
$660.56
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#(TITLE AMOUNT Board Members
1110 I 65127193311 I 42-314.00 I $660.56 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, November 14, 2013
i
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))
11/13/13 65127193311 monthly payment $660.56
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