240857 01/07/15 (9)
CITY OF CARMEL, INDIANA VENDOR: 00352108
ONE CIVIC SQUARE WAL-MART COMMUNITY CHECK AMOUNT: S*******118.00*
CARMEL, INDIANA 46032 PO BOX 530934 CHECK NUMBER: 240857
ATLANTA GA 30353-0934 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239099 STREET 118.00 OTHER MISCELLANOUS
Save money.Live better.
Walmaff CITY OF CARMEL STREET DEPT Visit us at walmart.com/credit
Community Card Account Number: 6032 2020 0013 5815 Customer Service: 1-877-294-1086
Summa
'of"Account 1c6%Lai
j!2L6fAnfoin4ti6ri;
Previous Balance $0.00 New Balance $118.00
+purchases/Debits $118.00 Total Minimum Payment Due $118.00
New Balance $118.00 Payment Dug Date 01/11/2015
Credit Limit $1,000
Available Credit $882
Statement Closing Date 12/16/2014
Days in Billing Cycle 30
ljrafiggeti.or=Summa'
Tran Post
Date Date Reference Number Description of Transaction or Credit Amount
12/02 12/02 P92730OP301HXRESV WALMART 001601 CARMEL IN $118.00
TOTAL FOR AUTHORIZED BUYER NO 05 $118.00
Li
Annual Percentage Balance Subject to Late Charge
Rate Late Charge
0.00% $0.00 $0.00
PAYMENT DUE BY.5 P.M.(ET)ON THE DUE DATE.
NOTICE:We may convert your payment into an electronic debit. See reverse for details, Billing Rights and other important
information.
5404 0003 BEH 3 7 16 141216 PAGE 1 of 3 9273 2000 N122 010X5404 33797
7
Customer Service;For account information,call the number on the front of this statement.For Hearing or Speech disabilities,use a TRS.Unless
your name is listed on this statement,your access to information on the account may be limited.You may also mail questions(but not payments)to:
P.O.Box 965022,Orlando,FL 32896-5022.Please include your account number on any correspondence you send to us.
Payments;Send payments to the address listed on the remit portion of this statement or pay online.
ara» Notice:See below foryour Billing Rights and other important information.Telephoning about billing errors will not preserve your rights under federal law. 1
To preserve your rights,please write to our Billing Inquiries Address,P.O.Box 965023,Orlando,FL 32896-5023.
Purchases,returns,and payments made just prbrto billing date may notappear until next month's statement When you provide a check as payment,you
authorize us eitherto use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check
transaction.When we use information from yourcheckto make an electronic fund transferjunds may be withdrawn from youraccountas soon asthesame
day we receive your payment,andyou will not receive yourcheck back from your financial institution.You maychoose notto have your payment collected
electronically by sending your payment(with the payment stub),in your own envelope—not the enclosed window envelope,addressed to:
P.O.Box 960095,Orlando,FL 32896-0095 and not the Payment Address.
Information About Payments:You may at any time pay,in whole or Payments
in part, the total unpaid balance without any additional charge for All Purchases charged to this Account made during a monthly billing period
prepayment.Payments received after 5:00 p.m.(ET)on any day will be and any service fees will be shown on the Statement for that period and
credited as of the next day.Credit to your Account may be delayed up to payment of the entire balance(the"New Balance')is due in full promptly.
five days if pa rent(a)is not received at the Payment Address,(b)is not When there is a New Balance shown on your Statement,you agree to pay
made in U.S.dollars drawn on a U.S.financial institution located in the U.S., the entire New Balance by 5:00 p.m.(ET)on the Payment Due Date shown
(c)isnotaccompaniedbytheremittance coupon attached toyourstatement, on the Statement.
® (d)contains morethanone payment orremittance coupon,(e)is not received Bankruptcy Notice: If you file bankruptcy you must send us notice,
in the remittance envelope provided or(f)includes staples,paperclips,tape, including account number and all information related to the proceeding
a folded check,or correspondence of any type.Conditional Payments:All to the following address: Retail Finance Credit Services, LLC, Attn:
written communications concernin disputed amounts,including any check
or other payment instrument that:ki)indicates that the payment constitutes Bankruptcy Dept.,P.O.Box 965060,Orlando,FL 32896-5060.
"payment in full'or is tendered as full satisfaction of a disputed amount:or Your account is owned and serviced by Retail Finance Credit
(ii) is tendered with other conditions or limitations ("Disputed Services,LLC.
Payments"), must be mailed or delivered to us at P.O. Box 965023,
Orlando,FL 32896-5023.
Credits To Your Account:An amount shown in parentheses or preceded
by a minus(-)sign is a credit or credit balance unless otherwise indicated.
= Credits will be applied to your previous balance immediately upon receipt,
but will not satisfy any required payment that may be due.
Credit Reports And Account information:If you believe that we have
reported inaccurate information about you to a credit bureau, please
contact us at P.O. Box 965024, Orlando, FL 32896-5024. In doing so,
® please identify the inaccurate information and tell us why you believe lt is
incorrect.If you have a copy of the credit report that includes the inaccurate
information,please include a copy of that report.We may report information
about your account to credit bureaus.Late payments,missed payments,
or other defaults on your account may be reflected in your credit report.
L................................................... ..................................
..- ---. . ..- 01DX5404-1-07122114
0003 0004
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER#:05000
ACCOUNT M 6032 2020 0013 5815 P.O.M
INVOICEM 004751 DATE OF SALE M 120214 STORE M 00001601
TRANSACTION#:4751 AUTHORIZATION#:002107 REGISTER#: 10
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
090616764 B&D 9X13 2.000 EA 59.0000 118.00
CONVECTION
SUB$118.00 TAX$0.00 TOTAL INVOICE $118.00
CREDITS TOTAL $0.00
BALANCE DUE $118.00
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Nf'
I
5404 0003 BEH 3 7 16 141216 PAGE 2 of 3 9273 2000 M122 010X5404 33797
0004 0004
s®
0
5404 0003 BEH 3 7 16 141216 PAGE 3 of 3 9273 2000 N122 010X5404 33797
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))
12/31/14 004751 $118.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wal-Mart Community
IN SUM OF $
P. O. Box 530934
Atlanta, GA 30353-0934
$118.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
2201 I 004751 I 42-390.991 $118.00 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
UaU4dnesd4
Atmat t nmmlceinner
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund