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246965 06/30/15 � Coq CITY OF CARMEL, INDIANA VENDOR: 00350958 ONE CIVIC SQUARE SAMS CLUB DIRECT CHECK AMOUNT: S"""' 635.28` CARMEL, INDIANA 46032 P 0 BOX 530930 CHECK NUMBER: 246965 ' iroH�o:r ATLANTA GA 30353-0930 CHECK DATE: 06/30/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1203 4359003 635.28 0402702401159 SAWS COMMERCIAL PAYMENT STUB SAfUi S CLUB DIRECT CREDIT Pagel of 3 Account: 0402 70240115 9 Statement Date:06/20/15 Page: 1 of 3 Account:0402 70240115 9 CITY OF CARMEL ATTN:ACCOUNTS PAYABLE TWO CIVIC SQUARE CARMEL,IN 46032-2584 PLEASE INDICATE ADDRESS CHANGES IllrrnlllJill gill llllllll//Null/llllrlulllrr[oil 11llJill IIII CITY OF CARMEL 5431 ATTN: ACCOUNTS PAYABLE G206 LATLANTA, T ADDRESS TWO CIVIC SQUARE B DIRECT CARMEL, IN 46032-2584 0930 GA 30353-0930 Customer Service Online at wwx.samsclubcredit.corn This accountis already registered - rd See our Online Admin to get a User 10 & Password ,• se y �� CyU�<DATE`a710�8%:1`5.': > �t1� Payments Received /Cls"I", = 05M-145265 (114.44) PAYMENT RECEIVED:-THANICY011 Current Month's Invoices (Details Enclosed) Date Invoice Original Due Date Club Reference Date Invoice A Duent Amount Please Indicate by[] Invoices Paid e 05129/15 004525 450.78 07/08/15 8168 05292015 05/29/15 004525 0 450.78 06103115 004781 8.28 07/08/15 8168 06032015 06!03!15 004781 El 8.28 e 69.00 07/08/15 8168 06/03/15 004778 0 69.00 06103115 004778 06/18/15 004860 107.22 07108/15 8168 61815 06/18/15 004860 0 107.22 Past Duel voices IQ � � Date Invoice Originai�Due°Date Club Reference Date Invoice Amount Due Amount_ // Please Indicate by n invoices Paid 04129/15 006497 147.07 \/06108115 8168 42915 04/29/15 006497 147.07 05/04115 002681 46.61 06/08/15 6316 05042015 05104/15 002681 46.61 05f14115 000000 498.00 06/08/15 6279 12355 05/14/15 000000 498.00 I r—Current Invoices: $635.28 Send payments to;, PLEASE PAY THIS Past'Due•Invoices: $691.68 P.O.Box 530930 AMOUNT Ailanta,Gl1303 10930 $1326.96 ,Unapplitici Payments& /(N � \ DUE BY 07/08/15 $0.00 For biliinglgenera jfnqu�es: Credits gj ese. P.O.Boz�87�26.�� Dayton 6l,S401-8726 PLEASE RETURN THIS STUB WITH For Customer Service: YOUR PAYMENT Call 1-800-362-6196 ��s a8 AMOUNT ENCLOSED Credit Line $10000.00 Purchases,returns and payments made just prior to the statement date may not appear until next Retain left hand portion for your records,send right hand portion noting Items paid by a 10 month's statement. Payments received at the credited with your payment.If not sending stub,note account number,Invoice number and amounts as oress f the date received.Ifpayment cated above y 5 pm will a de at a being paid on your check. location other than such address,credit may be delayed. 1 oil i� -Continue- 5966 0001 001 07' PAGE 1 of 3 COLR654A 5431 SAWS CLUB ®ORECT CROM EDITRCIAL Account: 0402 70240115 9 Statement Date:06/20/15 Page:2 of 3 SAM'S CLUB DIRECT P.O. BOX 530930 ATLANTA, GA 30353-0930 CITY OF CARMEL Date of Sale: 05/29/15 Account: 0402 70240115 9 Invoice: 004525 Club/Name: 8168 P.O.: 05292015 e Buyer: NANCY HECK S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE 000011469 TOOTSIE POPS 5.00 EA 9.18 45.90 005260647 MT APPLESAUCE VRTY 14.00 EA 9.45 132,30 021556221 100%WELCHS AP/OR/GR 21.00 EA 12.98 272.58 _ Sublotal: 450.78 Tax: 0.00 Balance Due:_ 450.78 SAM'S CLUB DIRECT R.,O. BOX 530930 ATL-ANTA, GA 30353-0930 CITY OF CARMEL Date of Sale: 06/03/15 Account: 0402 70240115 9 Invoice: 004781 Club/Name: 8168 P.O.: 06032015 Buyer: NANCY HECK S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE 003019798 BANANAS31-B 6.00 EA 1.38 8.28 Subtotal: 8.28 Tax: 0.00 Balance Due: 8.28 e SAM'S CLUB DIRECT P.O. BOX 530930 ATLANTA, GA 30353?0,930 CITY,OF CARMEL Date of Sale: 06/03/15 Account: 0402 70240115 9 lnvoice: 004778 Club/Name: 8168 P.O.: Buyer: NANCY HECK S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE 003019798 BANANAS31-B 50.00 EA 1.38 69.00 Subtotal: 69.00 Tax: 0.00 Balance Due: 69.00 t. SAM'S CLUB DIRECT !'?O-BOX 530930 rUG ATLANTA, GA 30353-0930 CITY OF CARMEL Date of Sale: 06/18/15 Account: 0402 70240115 9 Invoice: 004860 Club/Name: 8168 P.O.: 61815 Buyer: NANCY HECK H S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE 003896780 DUM DUM POPS 2.00 EA 8.27 16.54 003920882 TWIZZLER STRAWBERRY 2.00 EA 7.58 15.16 A0 -Gontinue- v�/o 5%0001 001 07 PAGE 2 of 3 COLR654A 5431 SAWS CLUB DIRECT CREDITRCIAL Account: 0402 70240115 9 Statement Date:06/20/15 Page: 3 of 3 S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE 004733937 AIRHEADS ASSTD FLVRS 2.00 EA 9.13 18.26 005944226 DUBBLE BUBBLE B GUM 2.00 EA 6.88 13.76 020723834 BOB'S SWEET STRIPES 1.00 EA 6.98 6.98 020824879 SKITTLE S/STARBURST 2.00 EA 10.98 21.96 026378657 LAFFY TAFFY 145 CT 2.00 EA 7.28 14.56 e Subtotal: 107.22 Tax: 0.00 Balance Due: 107.22 s F. I ,s S5966 0001001 <!�: PAGE 3 of 3 CDLR654A 5431 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)) 05/29/15 004525 $450.78 06/03/15 004778 $69.00 06/03/15 004781 $8.28 06/18/15 004860 $107.22 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Sam's Club IN SUM OF$ P. O. Box 530930 Atlanta, GA 30353-0930 $635.28 ON ACCOUNT OF APPROPRIATION FOR Community Relations PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1203 004525 43-590.03 $450.78 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1203 004778 43-590.03 $69.00 materials or services itemized thereon for 1203 004781 43-590.03 $8.28 which charge is made were ordered and 1203 004860 43-590.03 $107.22 received except Monday,June 29, 2015 �G- Director, Community Relations/Economic Development Title Cost distribution ledger classification if claim paid motor vehicle highway fund