227902 1/14/2014 Af CITY OF CARMEL, INDIANA VENDOR: 366015 Page 1 of 1
ONE CIVIC SQUARE WEX BANK CHECK AMOUNT: $205.26
CARMEL, INDIANA 46032 PO BOX 6293
CAROL STREAM IL 60197-6293 CHECK NUMBER: 227902
CHECK DATE: 1/14/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4231400 35320056 205 . 26 0490-00-138002-1
I nvoi ce Ratement
INVOICE NUMBER: 35320056
�a ACCOUNT NAME: City of Carmel Admin.
PAGE 1 OF 1
ACCOUNT NUMBER CREDIT LIMITDAYS THIS PERIOD BILL CLOSING DATE PAYMENT DUE DATE AMOUNT DUE
0496-00-138002-1 1,550.00
31 DEC-31-2013 JAN-24 2014 205.26
DATE ACTIVITY DESCRIPTION CHARGES/DEBITS PAYMENTS/CREDITS
DEC-06-2013 PAYMENT-THANK YOU 214.69
DEC-31"-2013 FUEL PURCHASES 205:26
REMINDER
REMINDER PLEASE BE SURE TO INCLUDE REMITTANCE STUB
WITH PAYMENT. MAIL TO THE ADDRESS SHOWN IN THE
RIGHT PORTION OF THE REMITTANCE STUB.
Submitted To
JAN 62014
Clea Treasurer
PURCHASES,RETURNSAND PAYMENTS MADE JUST PRIOR TO BILLING DATE MAY NOT APPEAR UNTIL THE NEXT INVOICEISTATEMENT.
PREVIOUS BALANCE ()PAYMENTS (,)PURCHASES (,)DEBITS CREDITS (,)LATE FE (=)NEW BALANCE
214.69 214.69 205.26 0.00 0.00 0.00 205.26
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
2.249 % 26.99 % 0.00
SEE REVERSE SIDE FOR IMPORTANT INFORMATION AND TERMS
TO ENSURE PROPER CREDIT.TEAR AT PERFORATION AND INCLUDE BOTTOM PORTION WITH YOUR PAYMENT_
VOUCHER NO. WARRANT NO.
ALLOWED 20
,Fre--e�t Serviced/�
IN SUM OF $
hO Box 6293
Carol Stream, IL 60197-6293
$205.26
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
120_5_ I 35320056 I 42-314.00 I $205.26
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
9 received except
r'
i
i
MonoW, January 13, 2014
I D
Director, Administrati �n
Title
I
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))
12/31/13 35320056 $205.26
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