251285 11/04/15 r Cqq
JY tp� CITY OF CARMEL, INDIANA VENDOR: 00352108
ONE CIVIC SQUARE WAL-MART COMMUNITY CHECK AMOUNT: $*"""*""221.14*
=a CARMEL, INDIANA 46032 PO BOX 530934 CHECK NUMBER: 251285
y,�TON�. ATLANTA GA 30353-0934 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239011 STREET 221.14 6032-2020-0013-5815
Walmart =9° 0
Save money.Live better.
Walmaff
CITY OF CARMEL STREET DEPT Visit us at walmart.com/credit
Community Card Account Number: 6032202000135815 Customer Service:1-877-294-1086
Summary of Account Activity y - � Y _ Payment lriformatron � _ z
Previous Balance $0.00, New Balance L f $221.14
+Purchases/Debits .$221.14 Total Minimum Payment Due $221.14
New Balance $221.14 Payment Due Date 11/11/2015
Credit Limit $1,000
Available Credit $778
Statement Closing Date 10/16/2015
Days in Billing Cycle 30
Tranummary
S
Tran Post
Date Date Reference Number Description of Transaction or Credit Amount
09/15 09/17 P9273008501QENFH6 WALMART001501 CARMEL IN $122.37
09/16 09/17 P9273008701QT7JP7 WALMART001601 CARMEL IN $40.64
09/18 09/18 P9273008801 DFK98N WALMART001601 CARMEL IN $20.25
09129 09/29 P9273008K01 1-16SPTS WALMART001601 CARMEL IN $37.88
TOTAL FOR AUTHORIZED BUYER NO 05 $221.14
�-111�-d
Late,C h uirnryi
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 DAM
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 151016 PAGE 1 of 3 9273 2000 NIZZ 010X5404 55562
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 mail 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.
r• Notice:See below foryour Billing Rights and other important information.Telephoning about billing errors will not preserveyour 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 dale may notappear until next month's statement.When you provide a checkas payment,you
authorize us either to use information tom.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 your check tomake anelectronic fund transfer,funds me be withdrawn from your account as soon as the same
day wereceiveyourpayment,and you will not receiveyourcheckback from yourfinancial institution.You maychoose notto haveyour payment collected
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 time pay,in whole or Payments
in part, the total unpaid balance without any additional charge for All 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 topayment of the entire balance(the"New Balancel 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.S.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 not accompanied bythe remittance coupon attached to your statement, on the Statement.
(d)contains more than one payment or remittance coupon,(e)is not received Bankruptcy Notice: If you file bankruptcy you must send us notice,
in the remittance envelope provided or(f)includes staples,paper clips,tape, including account number and all information related to the proceeding
a folded check,or correspondence of any type.Conditional Payments:All to the following address: Retail Finance Credit Services, LLC, Attn:
written communications conceming disputed amounts,including any check Bankruptcy Dept.,P.O.Box 965060,Orlando,FL 32896-5060.
or other payment Instrument that:(i)Indicates that the payment constitutes your account is owned and serviced b Retail Finance Credit
'payment in full"or is tendered as full satisfaction of a disputed amount:or y
(ii) is tendered-with other-conditions-or limitations ('Disputed -Services,LLC. - --
Payments"), must be mailed or delivered to us at P.O. Box 965023,
Orlando,FL 32896-5023. - - - -
Credits To Your Account: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 your Previous balance immediately upon receipt,
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,
or other defaults on your account may be reflected in your credit report.
r.
r•
d_
0003 0004
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER M 05000 r
ACCOUNT M 6032 2020 0013 5816 P.O.M
INVOICEM 004427 DATE OF SALE M 091515 STORE M 00001601
TRANSACTION#:4427 AUTHORIZATION M 015396 REGISTER M 8
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
039990854 SB HD DISHWAND 2 3.000 EA 2.9800 8.94
RF
078289853 REYNOLDS 75'FOIL 2.000 EA 3.4800 6.96
091124024 BTY 12BR SAS 940T 7.000 EA 12.9700 90.79
093992150 DAWN ORIGINAL 2.000 EA 7.8400 15.68
75FO
SUB$122.37 TAX$0.00 TOTAL INVOICE $122.37
CREDITS TOTAL $0.00
BALANCE DUE $122.37
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER M 05000
i N
ACCOUNT#:6032 2020 0013 5815 P.O.M
INVOICEM 009941 DATE OF SALE M 091615 STORE#:00001601
TRANSACTION#:9941 AUTHORIZATION M 016718 REGISTER M 14
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
070566620 ECB 1.000 EA 1.9400 1.94
TAPERUNNERPERM
070566522 ECB 1.000 EA 1.9400 1.94
TAPERUNNERREFILL
089553049 ELM FOAMTRIFLD LG 2.000 EA 9.9700 19.94
BL
093231785 METALIC 4 COLORS 2.000 EA 3.9700 7.94
CAR
093367840 CM 12PK WHT LGL PD 1.000 EA 8.8800 8.88
SUB$40.64 TAX$0.00 TOTAL INVOICE $40.64
CREDITS TOTAL $0.00
BALANCE DUE $40.64
- ---`- - -
-CITY-OF-CARMEL-STREET
DEPT AUTHORIZED BUYER M 05000
ACCOUNT M 6032 2020 0013 5816 P.O.M
INVOICEM.001332 -- - DATE OF SALE#: 099815 STORE M 00001601
TRANSACTION#:1332 AUTHORIZATION M 018314 REGISTER M 97
S.K.0 DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
060468632 4X6(100+) 135.000 EA 0.1500 20.25
SUB$20.26 TAX$0.00 TOTAL INVOICE $20.25
CREDITS TOTAL $0.00
BALANCE DUE $20.25
CITY OF CARMEL STREET
DEPT AUTHORIZED BUYER M 05000
ACCOUNT#:6032 2020 0013 6815 P.O.M
INVOICEM 005843 DATE OF SALE M 092915 STORE M 00001601
TRANSACTION M 5843 AUTHORIZATION M 029654 REGISTER M 6
S:K.0- - DESCRIPTION QUANTITY UNIT PRICE - EXT.-PRICE
043457021 LARGE SQUARE 1.000 EA 2.9700 2.97
VOTIVE
044639809 IM 8OZ 12PK KIDS 2.000 EA 2.0000 4.00
053416557 YORK MINIATURES 1.000 EA 5.2800 5.28
053483081 ROLD GOLD FF 1.000 EA 2.9800 2.98
TWISTS
054010726 ROLD-GOLD-TINY - -- -`1.000- -- --EA _ - -- -2.9800 -- 2:98---
TWIST
077852841 BEVNAP 300T WHITE 2.000 EA 0.9700 1.94
091420971 101N TAPERED BOWL 3.000 EA 3.9700 11.91
094964339 61N SCALLOPD RIM 6.000 EA 0.9700 5.82
BWL
SUB$37.88 TAX$0.00 TOTAL INVOICE $37.88
CREDITS TOTAL $0.00
BALANCE DUE $37.88
5404 0003 BEH 3 7 16 151016 PACE 2 of 3 9273 2000 N122 DIDX5404 55562
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wal-Mart Community
IN SUM OF$
P. O. Box 530934
Atlanta, GA 30353-0934
$221.14
I
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
&0-3 'R 3�);-o 6y l 3 $L G
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 004427 42-390.11 $122.37 1 hereby certify that the attached invoice(s), or
2201 009941 42-390.11 $40.64
bill(s) is (are)true and correct and that the
2201 001332 42-390.11 $20.25
materials or services itemized thereon for
2201 1 005843 1 42-390.11 $37.88
which charge is made were ordered and
received except
i
j,&AdEhursdj2, ,qtA4t2
M_
c7tT1BYJ1��t9floe
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
09/15/15 004427 $122.37
09/16/15 009941 $40.64
09/18/15 001332 $20.25
09/29/15 005843 . $37.88
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