182077 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 00350958 Page 1 of 1
Ls e, F ONE CIVIC SQUARE SAMS CLUB DIRECT
i
CARMEL, INDIANA 46032 P 0 BOX 530930 CHECK AMOUNT: $131.11
ATLANTA GA 30353 -0930 CHECK NUMBER: 182077
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 040270240115 131.11 009414
SAM'S CLUB DIRECT CREDIT
Account: 0402 70240115 9 Statement Date: 01/20/10 Page: 1 of 2
1111•111111 111111. 111111. 11.111111111nI,I
CITY OF CARMEL 4165
ATTN: ACCOUNTS PAYABLE
TWO CIVIC SQUARE
IA CARMEL, IN 46032 -2584
r
N
0
MEM
urrent Month's Invoices (Details E o s N.
Cr: a �ce Or iginal Due Date Club R e te n S
ci u�
N--40. Amount +s'
01/12/10 009414 131.11 02/08/10 8168 0112
ma
m.
Past Due Invoices
Date Invoice Original Due Date Club Reference
o Amount
11/20/09 001323 35.72 01/08/10 8168 11202009
LI 12/17/09 006677 69.10 11/08/10 6316
Irlitir
Currentlnvoices: $131.11 d Send payments to
Pastue l voices: $104.82 P.0 Box 3 93
/4';',"-,::�'i Atlanta 30353 30
Urvii died 'P yments 4
�C ad c t i S $0.00 ar Send inquinal i nis) to:
g a P.O. Boxxs8726:
Dayton OH 4.1 -8726
iii For Customer Service:
F.. .i Call 1- 800 362 -6196
Credit Line $10000.00
Retain left hand portion for your records, send right hand portion noting items paid by a 0
with your payment. If not sending stub, note account number, invoice number and amounts
being paid on your check.
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5966 0025 001 07 k; PAGE 1 of 2
SAM'S CLUB DIRECT CO
Account: 0402 70240115 9 Statement Date: 01/20/10 Page: 2 of 2
SAM'S CLUB DIRECT
P.O. BOX 530930
ATLANTA, GA 30353 -0930
CITY OF CARMEL Date of Sle: 01/12/10
Account 0402 70240115 9 Invoice: 009414
Club /Name: 8168 P.O.: 0112
Buyer: GARY CARTER
W S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
000665591 GRANULATED SUGAR 1.00 EA 6.23 6.23
004822824 COFFEE CREAMER 3.00 EA 5.30 15.90
021567135 FOLGER DECAF PKTS 1.00 EA 19.83 19.83
021568260 FOLGERS COFFEE PKTS 5.00 EA 17.83 89.15
Subtotal: 131.11 Tax: 0.00 Balance Due: 131.11
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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))
Total \`3�
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.
C
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
FEB -12010
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund