246031 06/03/15 \�� CITY OF CARMEL, INDIANA VENDOR: 00352108
ONE CIVIC SQUARE WAL-MART COMMUNITY CHECK AMOUNT: $*******103.83*
?�; CARMEL, INDIANA 46032 PO BOX 530934 CHECK NUMBER: 246031
94j,�'ON..�� ATLANTA GA 30353-0934 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 STREET 103.83 6032-2020-0013-5815
W 1mart Fro
Save money.Live better. t4
Walmart' 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 -
Summary of Account Activity Bayment lnformatwn w NMu y rr
. �..._ -. v.
Previous Balance $444.70 New Balance $103.83
Payments $444.70 Total Minimum Payment Due $103.83
Other Credits $19.98 Payment Due Date 06/11/2015
+Purchases/Debits $123.81
New Balance $103.83
Credit Limit $1,000
Available Credit $896
Statement Closing Date 05/16/2015
Days in Billing Cycle 30
Transaction Summary
Post.
Date Date Reference Number Description of Transaction or Credit Amount
04/23 04/23 P9273003L01J2HZBB WALMART001601 CARMEL IN $50.96
04/23 04/23 P9273003L01J2HZBK WALMART001601 CARMEL IN $72.85
04/23 04/23 P9273003P01J2HZB0 WALMART001601 CARMEL IN ($19.98)
TOTAL FOR AUTHORIZED BUYER NO 05 $103.83
04/18 04/18 P9273003EOOYR33X3 PAYMENT-THANK YOU ($444.70)
Late
_ 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 150515 PAGE 1 of 3 9273 2000 N1ZZ 01DX5404 261355
�II
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 mall 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.
Notice;See below for your Billing Rights and other important information.Telephoning about billing errors will not preserve your rights under federal law.
To preserve your rights,please write to our Billing Inquiries Address,P.O.Box 965023,Orlando,FL 32896-5023.
Purchases,returns,and payments madejust priorto billing date may not appear until next month's statement.When you provide a checkas payment,you
authorize us either to 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 yourcheck to make an electronic fund transfer,funds may be withdrawn from youraccount as soon asthe same
daywe receiveyour payment,andyouwill not receiveyourcheck backfrom yourfinancial institution.You maychoose notto have your paymentcollected
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 Ume pay,in whole or Payments
In part, the total unpaid balance without any additional charge for Ail 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 payment(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, .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)is notaccompanied bythe remittance coupon attached to yourstatement, on the Statement.
(d)contains more than one payment orremittance coupon,(e)is not received
in the remittance envelope provided or(f)includes staples,paper clips,tape, Bankruptcy Notice: you file bankruptcy you must send notice,
a folded check,or correspondence of any type.Conditional Payments:All including account number
er and all Information related vthe proceeding ceeding
written communications ooncernin disputed amounts,including any check to the following address: Retail Finance Credit Services, LLC, Attn:
or other payment instrument that:Vii)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
n)- is--tendered with—other conditions or limitations--("Disputed Services,LLC.
ayments"), must be mailed or delivered to us at P.O. Box 965023,
Orlando,FL 32896-5023. - -
Credits To YourAccount,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 yourprevious balance immediately upon receipt,
t. 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 it 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,
C or other defaults on your account may be reflected in your credit report.
s
01 DX5404-1-07127114
0003 0004
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER M 05000
ACCOUNT M 6032 2020 0013 5815 P.O.#:
INVOICEM 008556 DATE OF SALE M 042315 STORE#:00001601
TRANSACTION M 8556 AUTHORIZATION#:023105 REGISTER#: 17
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
083690496 HP 932 BLACK 1.000 EA 19.9800 19.98
087139051 HP 933 COMBO 1.000 EA 30.9800 30.98
CREATIV
SUB$50.96 TAX$0.00 TOTAL INVOICE $50.96
CREDITS TOTAL $0.00
BALANCE DUE $50.96
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER#;05000
ACCOUNT M 6032 2020 0013 5815 P.O.M
INVOICEM 008650 DATE OF SALE#: 042315 STORE#:00001601
N
TRANSACTION#:8650 AUTHORIZATION#:023717 REGISTER M 17
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
068869074 DL POMTAN 9.4OZ HL 1.000 EA 0.9800 0.98
083690639 HP 932XL BLACK 1.000 EA 31.9800 31.98
091124026 BTY 12BR 59GT 3.000 EA 12.9700 38.91
092282216 DL LHS PINK INNER 1.000 EA 0.9800 0.98
SUB$72.85 TAX$0.00 TOTAL INVOICE $72.85
CREDITS TOTAL $0.00
BALANCE DUE $72.85
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER M 05000 ✓.
ACCOUNT M 6032 2020 0013 5815 P.O.#:
INVOICEM 000236 DATE OF SALE M 042315 STORE#:00001601
TRANSACTION M 236 AUTHORIZATION#: REGISTER M 91
REFUND
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
MERCHANDISE/CONS 1.000 EA 19.9800- 19.98-
UMABLES
SUB$19.98- TAX$0.00 TOTAL INVOICE $19.98-
CREDITS TOTAL $0.00
BALANCE DUE $19.98-
5404 0003 BEH 3 7 16-150515 PAGE 2 of 3 9273 2D00 N122 GIDX5404 261355
VOUCHER NO. WARRANT NO.
Wal-Mart Community ALLOWED 20
IN SUM OF$
P. O. Box 530934
Atlanta, GA 30353-0934
$103.83
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 000236 42-389.00 ($19.98) 1 hereby certify that the attached invoice(s), or
2201 008650 42-389.00 $72.85 bill(s) is (are) true and correct and that the
2201 008556 42-389.00 $50.96
materials or services itemized thereon for
which charge is made were ordered and
received except
hi h,111 Th ay 5
Ste ommissioerer
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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))
04/23/15 000236 ($19.98)
04/23/15 008650 $72.85
04/23/15 008556 $50.96
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