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234490 07/08/14
`'' y9q"''� CITY OF CARMEL, INDIANA VENDOR: 367001 ;4 ® ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $"""""""195.12" ;. a° CARMEL, INDIANA 46032 PO BOX 5219 CHECK NUMBER: 234490 -�"�,C�oN2�'` CAROL STREAM IL 60197-5219 CHECK DATE: 07/08/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 195.12 7003731100072984 Please Direct Inquiries To:1-800-220-8594 CAMM01 COSTCO �ELE ccstNuirirabertsw lE3atazice .......,:..Paynte Flue. Amouti'asfiDue;Date 7003.7 1]_pD4 ,29 4.... ..... $195 f ... ...$:0©..... ..: ....:. ...._._:.$QfJ...::: . ..... 07121/2014.::.......: Idling Dam Credtt!Itte: Ariatlab(a Credfk 061�G12..... . $5,0 0.. 88 . .........: ... . . . U . a N TDD/Hearing Impaired:1-800-365-0186 $ STATEMENT OF YOUR ACCOUNT s ........---.._.._...._......_..__.......... 1=1N...... f f3G1*:SLiIfAAAARY. ::......... : :....,::.. 0 . .. . ... ..__.... Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire Description Number Balance Rate APR Periodic Rate RATE Due 0 a Reg 00014 $12.59 0.00000% 00.00% $.00 00.00% $195.12 $.00 07/26/2014 ACCOUNT DETAIL ............... .._._........_............................._................................................................._............................._.........._..................................._.........._......................._................._..........._........._................._...._.._................ :::lratasact4ar�:.:.::::._;-:_.__:=:::;:>: ::>:- fnvoica ...::.:.. .....:.:tlaer... .P«D »;::.;<.ransactiotr bate..:...:.. t usar...... ..:.:. . .. : .:..:_......::::::._ Number ..:.....: iE?. Ettmbai`:.:. 1lmbtir2t..:....::. :.::............................................................................._.....................................:.....................................................:___....................................... ..................................................._................ 06/05/2014 COSTCO WHOLESALE-346 037261 00016 $195.12 00016 SUBTOTAL: $195.12 06/14/2014 PAYMENT-THANK YOU 00001 $378.06- /0 -0. 42390,3? a �- VVED JUL L - 3 2014 BY:TR EFF Return the below portion with payment.For billing errors or questions please refer to the back of the statement. Page 1 of 2 I Important Notice:Promptly review this statement and notify Capital One Commercial ink of any errors or unauthorized Purchases.If you do not notify Capital One Commercial within 60 days of errors or unauthorized purchases,this statement will be presumed to be correct. Write to Capital One Commercial at P.O.Box 4160,Carol Stream, IL 60197-4160. You may telephone Capital One Commercial at 1-800-210-8115,but it will not preserve your rights. Notify Capital One Commercial in writing of the cancellation of a credit card or authorized user. cbs7col COSTCO WEIOLESALE ACCOUNT SUMMARY BALANCE SUMMARY ....................................................................................................................... Outstanding DAY-9-PAST....."DUE AST-dD.UJE*;-!�:E�';W on B ;%C.URREKT.-* Transact $378.06 ..................................................................................................................... +New $.00 $.00 $.00 Purchase(s)/Debit(s) $195.12 ..................................... .................................... ........................................... ....................................... +New Fees $.00 '4.911VAYS-'.� U =:6.0.05.� AYS; Emi; ;:120' 4.9.'DAYSITAST.� U ............................ ................ ................. +Finance Charges $.00 $.00 $.00 $.00 Payment(s) $378.06 .............. ........ ...................... but. PAST; 1 .7. ............................ ............. Credits) $.00 ............................................... $.00 $.00 =New Balance $195.12 O O C) O Page 2 of 2 $El 1:11:111 El E Important Notice:Promptly review this statement and notify Capital One Commercial in writing of any errors or unauthorized purchases.If you do not notify Capital One Commercial within 60 days of errors or unauthorized purchases,this statement will be presumed to be correct. Write to Capital One Commercial at P.O.Box 4160,Carol Stream, IL 60197-4160. You may telephone Capital One Commercial at 1-800-210-8115,but it will not preserve your rights. Notify Capital One Commercial in writing of the cancellation of a credit card or authorized user. 22CAP720298(02/13) TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS AND NUMBERS ONLY! Compan Name om Email Address ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ Street Number if an Street Name or the words TO BOX" Unit or PO BOX Number C�❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ State Z ❑❑❑❑ +usiness Phone ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 (Costco) Purchase Order No. 367001 Capital One.Commercial Terms P.O. Box 5219 Date Due Carol Stream, IL 60197-5219 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 6/26/14 7003731100072984 General program supplies $ 195.12 Total $ 195.12 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 X20_ Clerk-Treasurer Voucher No. Warrant No. (Costco) 367001 Capital One Commercial } Allowed 20 P.O. Box 5219 Carol Stream, IL 60197-5219 � In Sum of$ $ 195.12 I ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#orBoard Members Dept# INVOICE NO. ACCT#/TITL AMOUNT 1096-60 7003731100072984 4239039 $ 195.12 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 3-Jul 2014 Signature $ 195.12 i Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I