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241933 02/10/15 �/ 4Qp� CITY OF CARMEL, INDIANA VENDOR: 367001 a ® ; ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $ 214.95 ,_�; CARMEL, INDIANA 46032 PO Box 5219 CHECK NUMBER: 241933 vy_`_� CAROL STREAM IL 60197-5219 CHECK DATE: 02/10/15 /[TpN� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 XXX2984 214.95 7003731100072984 Please Direct Inquiries To:1-800-220-8594 COSMA COSTCO WE/OLESALE ..........................6r. . ..... New t3alar♦ce. Payment f3ue ............ Amount Past R.ue. ...._... ..7003 73 � 0007.2984.....;: .,.. . :$2t4 95. :: . . ..... :_ . . . $:0©.. $00......:: .. .. . 02/20/2015. - Hill�ng:Date ..:.: .... . Cred�t.Lrne. ;. . .. Ava�labTe Gredfi 0 :. --.: :1 .__.. .. .: 01/25�20t 5 $5,000 $4, 85 05 .. V- a . TDD/Hearing Impaired:1-800-365-0186 $ STATEMENT OF YOUR ACCOUNT E; 0 FINIAT+iCEGItARG�St1NIMAI�Y :. Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire o Description Number Balance Rate APR Periodic Rate RATE Due co Q Reg 1 00014 $13.87 0.00000% 00.00% $.00 00.00% $214.95 $.00 02/26/2015 ACCOUNT DETAIL TranSac#lon TratfiaottEn IrtvQiCB User P I,� Tf`allsac�roR Date 15est:rtpttott Numb tD Ntunbt3r Atnaunt .. .. .... . . ........ 01/07/2015 COSTCO WHOLESALE-346 061146 00005 $214.95 00005 SUBTOTAL: $214.95 01/10/2015 PAYMENT-THANK YOU 00001 $5.99- 0 FEB - 3 2015 s e r• Return the below portion with payment.For billing errors or questions please refer to the back of the statement. Page 1 of 2 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. COSTCO tM�1F-SALE ACCOUNT SUMMARY BALANCE SUMMARY Outstanding g UH-HEUT 1.;W.DAYSP1�ST DUE . .::-3D 54 C1AYS .AS pC1�..:: Transaction $5.99 g +New N $.00 $.00 $.00 Purchase(s)/Debit(s) $214.95 O u GQ- ! DAY,�.EA��T.DII�.:.: .....EQ4?-TITOWAY.S:F�1.�T:[3�1E. .i;�Q.1g9 DIA��.�i.P./ku�E +New Fees $.00 +Finance Charges $.00 $.00 $.00 $.00 Payment(s) $5.99 0 1 47S OiY$FAS��lil 18i# DAYSAS7 fxi Credit(s) $.00 0 $.00 $.00 =New Balance $214.95 G 0 0 v 0 m v v Page 2 of 2 i 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(02113) TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS AND NUMBERS ONLY! fF _ I� r— 1L L-1 r;nnP:"Po 2O"" Unit or PO BOX Number _ sat.. ziL_ LL_l.- — JL��—'i-- 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 1/25/15 7003731100072984 Program supplies $ 214.95 Total $ 214.96 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 Voucher No. Warrant No. (Costco) 367001 Capital One Commercial Allowed 20 P.O. Box 5219 Carol Stream, IL 60197-5219 In Sum of$ $ 214.95 ON ACCOUNT OF APPROPRIATION FOR 108 ESE , r PO#or I Board Members Dept# INVOICE NO. ACCT#/TITL AMOUNT 1081-5 7003731100072984 4239039 $ 214.95 y 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 i which charge is made were ordered and received except I I February 5, 2015 i Signature $ 214.95 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i I i i is I —