252238 12/08/15 CITY OF CARMEL, INDIANA VENDOR: 367001
A I ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: S*"****'222.71
CARMEL, INDIANA 46032 PO BOX 5219 CHECK NUMBER: 252238
CAROL STREAM IL 60197-5219 CHECK DATE: 12/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 COSTCO-PARKS 222.71 7003-7311-0007-2984
COSTCO
Please Direct Inquires To: 1-800-220-8594
Account Number New Balance Payment Due Amount Past Due Due Date.
7003-7311-0007-2984 $222.71 $.00 $.00 12/21/2015
Billing Date :Credit Line Available Credit
11/26/2015 $5,000 $4,777.29
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a Manage your account online at www.hrscommercial.com
0
STATEMENT OF YOUR ACCOUNT
s
FINANCE CHARGE SUMMARY
o 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
0
Reg 00014 $14.37 0.00000% 00.00% $.00 00.00% $222.71 $.00 12/26/2015
ACCOUNT DETAIL
Transaction Transaction Invoice User - P.O. Transaction
Date Description Number ID Number,' Amount
11/06/2015 COSTCO WHOLESALE-346 070675 0016 $222.71
® 0016 SUBTOTAL: $222.71
®
RECEIVED
® DEC - 9 2015
® BY:
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.
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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
i
Carol Stream, IL 60197-5219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
11/26/15 7003731100072984 Supplies for bingo $ 222.71
i
Total $ 222.71
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
120
Clerk-Treasurer
i
Voucher No. Warrant No.
(Costco) Allowed 20
367001 Capital One Commercial
P.O. Box 5219
Carol Stream, IL 60197-5219 In Sum of$
$ 222.71
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
7enter �J
--7311—00 1 and Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
222 71 I hereby certify that the attached invoices , or
1096-60 7003731100072984 4239039 $ 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
December 3, 2015
Signature
Accounts Payable Coordinator
$ 222'71 Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund