243906 04/08/15 ,4y u!..F�q,�F` CITY OF CARMEL, INDIANA VENDOR: 367001
'j �!i• ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $*******565.90'
CARMEL, INDIANA 46032 PO Box 5219 CHECK NUMBER: 243906
��'��roii�O' CAROL STREAM IL 60197-5219 CHECK DATE: 04/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 2984 565.90 7003731100072984
Please Direct Inquiries To:1-800-220-8594 CosYCo COSTCO
Wfl'OLESALE
Account Numbt r Now Ralatw+ce Payment fae`; Amount Past Rue Due I)afie
.7 0.03 71 i D007 2984 $565 90...:. . ..:.. :. $ 56 OD 04E20/2D15_:.
S Billing Date Cxedit t me Available Credit
_
:..:. ..._ .,....._........... ... . . . .. . .. $41403/26/2015 5,O0
........... ... . . . : .
.. . .. ...... . . .
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V
a
' TDD/Hearing Impaired:1-800-365-0186
s
STATEMENT OF YOUR ACCOUNT
0
.: ........................................................................................................................................................................................................................._.......................................................
.::::,:::::::::::::::::::::::::::::::::::.::::.::::::::::............::::::::::::.::::::::::::::::::::.:::::::::::. :::::::::,::::::::::::::::::::::,:::::::::::::::::::::::,:::::::::::::::::,:::::::::::::::::::::::::::,:,::::::
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F[DANCE.CH....RC1 .��UMNiAI�'ff.........................................................................................................................................................................................................:................................................................................
0
o 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
Q Reg 00014 0.00000% 00.00% $.00 00.00% $277.56 $277.56 03/26/2015
Reg 00014 $20.60 0.00000% 00.00% $.00 00.00% $288.34 $.00 04/26/2015
ACCOUNT DETAIL
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ransac .anransac .orr a€€............................ii'>}>Ro ce :'er .:::. ..s€ i =;i s ti
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ate.....................................etc..........o..............................................................................................................Nu...._be............................_.................................._b...._be....................__..........._l�mount.::::.::,:::::.
................................................................................................................................................................................................................................................................................................................
........................................._...........................................................................................
...................................................................................................................._.............................-.........................................._..............................................
........
02/25/2015 COSTCO WHOLESALE-346 052957 00016 $277.56
03/12/2015 COSTCO WHOLESALE-346 025788 00016 $288.34
zm-
00016 SUBTOTAL: $565.90
03/13/2015 PAYMENT-THANK YOU 00001 $117.87-
APR 0 2015
Return the below portion with payment.For billing errors or questioqgIlLelse 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.
cosCOSTCO
WVHMESALE
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
C` 1`... ..
_ .n vs A r:nt� ....:..W W.oAvs nS�:nuE:
S Transaction $117.87
0
+New
0 $277.56 $.00 $.00 Purchase(s)/Debit(s) $565.90
0
0 .. ...... .. ......... .._. .. ...
:. $.00
i&A-$9 D/4YN P t 41 1�9 DA1f5 FASTT U 1.20. AY PAS +New Fees
:.......... ......... ...... ... +Finance Charges $.00
$.00 $.00 $.00 Payment(s) $117.87
0
51.#7$C}A�CS`�,�5`"�11 1$b+O/IL�ICS /1ST11 .; Credit(s) $.00
0 ........
0
$.00 $.00 =New Balance $565.90
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—— Page 2 of 2
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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(02/13)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS
AND NUMBERS ONLY!
r:�ary"dame
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6:r__,t,.n;er(II^m'1 S;reoi Penne or the word='PO 13OX" JI n 10 n_r)X
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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
3/26/15 7003731100072984 Program supplies $ 565.90
Total $ 565.90
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.
(Costco),
367001 Capital One Commercial Allowed 20 .
P.O. Box 5219
Carol Stream, IL 60197-5219
In Sum of$ . .
$ - 565.90-,
ON ACCOUNT OF APPROPRIATION FOR '
109 Monon Center �!
Dept#
ept# INVOICE NO. ACCT#/TITL AMOUNT (I Board Members
D
1096-60 7003731100072984 4239039_ ,.$ - _565.90 I'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
�"
�whicK charge is made were ordered and
l received.except
t .
April 3, 2015 -
j Signature
$ , 565.90. f Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund