303891 10/10/16 CITY OF u/ CARMEL, INDIANA VENDOR: 367001'
.�� I• ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $*******200.07*
x• a CARMEL, INDIANA 46032 PO BOX 5219 CHECK NUMBER: 303891
CAROL STREAM IL 60197.5219 CHECK DATE: 10/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 700373110007 40.72 GENERAL PROGRAM SUPPL
1096 4239039 700373110007 159.35 GENERAL PROGRAM SUPPL
Voucher No. Warrant No.
(Costco)
367001 Capital One Commercial Allowed 20
P.O. Box 5219
Carol Stream, IL 60197-5219
In Sum of$
$ 200.07
ON ACCOUNT OF APPROPRIATION FOR
108 ESE /109 Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-7 7003731100072984 4239039 $ 40.72 1 hereby certify that the attached invoice(s), or
1096-70 7003731100072984 4239039 $ 159.35 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
October 4, 2016
Signature
$ 200.07 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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
Carol Stream, IL 60197-5219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
9/26/16 7003731100072964 General Program Supplies $ 40.72
9/26/16 7003731100072964 General Program Supplies $ 159.35
Total $ 200.07
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
r n�
COSTCO
Please Direct Inquires To: 1-800-220-8594
Past Dde-
6, B Pa�rrlient-Due Amount".N alandbi -DaW
00. 10/21'/201
FN;1 0007,,L29E47,_--z,-;W
#7109ROU'IS-� $
$.'60
Billing Date, Available'
Credit Line,
2 'Credit-
.2- �016
0,91 612
$15,000 $4,"799.93,
a
Manage your account online at www.hrscommercial.com
C?
3
0 STATEMENT OF YOUR ACCOUNT
FINANCE CHARGE SUMMARY
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
_y
Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
Description Number Balance Rate APR Periodic Rate RATE Due
00
Reg 00014 $12.91 0.00000% 00.00% $.00 00.00% $200.07 $.00 10/26/2016
ACCOUNT DETAIL
Transaction Transaction Invoice 'User ',P.O. Transaction
Date Description Numbef ID: 'Number
Amount-
09/1612016 COSTCO WHOLESALE-346 040059 0005 $40.72
0005 SUBTOTAL: $40.72
09/15/2016 COSTCO WHOLESALE-346 011420 0018 $159.35
0018 SUBTOTAL: $159.35
09/10/2016 PAYMENT-THANK YOU 0001 -$165.66,
=-ECEIVEID,
OCT 0 3 2016
BY:
Return the below portion with payment.For billinq 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.
saooe
cos� COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
a.:., Outstanding
"CURRENT n; 1-29 DAYS PAST DUE 30-59 DAYS PAST DUE" Transaction $165.66
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $200.07
N +New Fees $.00
6049-DAYS PAST;DUE 96A%DAYS PAST DUE' 120 149'DAYS PA$T DUE"; +Finance Charges $.00
0
g $.00 $,00 $.00 Payment(s) $165.66
0
UCredit(s) $.00
150 179 DAYSPAST DUE 180+_DAAYS-PAST DUE
c =New Balance $200.07
s $.00 $.00
0
0
0
0
n
0
0
v
0
0
m
m
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