251347 11/04/15 a ui,C9q,M
t CITY OF CARMEL, INDIANA VENDOR: 367001
ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $********78.82*
:. CARMEL, INDIANA 46032 PO BOX 5219 CHECK NUMBER: 251347
CAROL STREAM IL 60197-5219 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350100 PARKS 78.82 7003-7311-0007-4683
COSTC0
VV/$M E�gE COSTCO
Please Direct Inquires To: 1-800-220-8594
Account Number New Balance Payment Due Amount Past Due . 'Due Date
7003-7311-0007-4683 $78.82 $.00 $.00 11/20/2015
0
Billing Date Credit Line Available Credit
g 10/26/2015 $2,000 $1,921.18
0
Manage your account online at www.hrscommercial.com
STATEMENT OF YOUR ACCOUNT
s
0
FINANCE CHARGE SUMMARY
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
o Reg 00014 $5.25 0.00000% 00.00% $.00 00.00% $78.82 $.00 11/26/2015
ACCOUNT DETAIL
Transaction. Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
10/23/2015 COSTCO WHOLESALE-346 079217 0003 $78.82
® 0003 SUBTOTAL: $78.82
Return the below portion with payment.For billing errors or questions please refer to the back of this 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.
SB008
cesmo
COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
CURRENT 1-29 DAYS PAST DUE 30-59 DAYS PAST DUE Transaction $000
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $7882
N
+New Fees $00
0 60-89 DAYS PAST DUE 90-119 DAYS PAST DUE 120-149 DAYS PAST DUE +Finance charges $.00
0
o $.00 $.00 $.00 Payment(s) $00
0
0
aU -Credit(s) $00
150-179 DAYS PAST DUE 180+DAYS PAST DUE
Q =New Balance $7882
o $.00 $.00
0
0
c
c
0
0
C,
PAGE: 2 of 2
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))
10/23/15 I 079217 I Cleaning Products I $78.82
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.
ALLOWED 20
Capital One Commercial
IN SUM OF $
P.O. Box 5219
Carol Stream, IL 60197-5219
$78.82
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 079217 I 43-501.00 I $78.82 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
Tuesday, November 03, 2015
Director, Brookaig dolf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund