184299 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC &ECK AMOUNT: $43.86
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197 -5219 CHECK NUMBER: 184299
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 GOLF 43.86 7003731100074683
Please Direct Inquiries To: 1- 800 220 -8594 cbsyco COSTCO
WFiOILESSALE
Account Number New Balance Payment Due Amount Past Due Due Date
7003 7311 0007 -4683 $43.86 $43.86 $.00 04/20/2010
Billing Date Credit Line Available Credit
03/26/2010 $2,000 $1,956.14
This communication serves as official notice that all calls to /from our offices may be monitored and /or recorded for quality
assurance purposes.
TDD /Hearing Impaired: 800 365 -0186
STATEMENT OF YOUR ACCOUNT
FINANCE CHARGE SUMMARY
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire e
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 $1.57 0.00000% 00.00% $.00 00.00% $43.86 543.86 03/26/2010
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
02126/2010 COSTCO WHOLESALE -347 049002 00003 $43.86
00003 SUBTOTAL: $43.86
03/04/2010 PAYMENT THANK YOU 00001 $10.35
Online Account Access lets you take control of your Account anytime, anywhere. Registration is easy, secure and waiting for you at
www.hrscommercial.com. v
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Return the below portion with payment. For billing errors or questions please refer to the back of the statement. Page 1 of 2
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Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or
unauthorized purchases. If you do not notify HSBC Business Solutions within 60 days of errors or unauthorized purchases,
this statement will be presumed to be correct.
Write to HSBC Business Solutions at PO. Box 4160, Carol Stream, IL 60197 -4160.
You may telephone HSBC Business Solutions at 1- 800 210 -8115, but it will not preserve your rights.
Notify HSBC Business Solutions in writing of the cancellation of a credit card or authorized user.
c bsyco COSTCO
WN�LESALE v
ACCOUNT SUMMARY BALANCE SUMMARY
CURRENT 1 -29 DAYS PAST DUE 30 -59 DAYS PAST DUE Outstanding e
Transaction $10.35
+New
$43.86 $.00 $.00 Purchase(s)/Debit(s) $43.86
60 89 DAYS PAST DUE 90 119 DAYS PAST DUE 120 149 DAYS PAST DUE +New Fees $.00
Finance Charges $.00
$.00 $.00 $.00 Payment(s) $10.35
150 -179 DAYS PAST DUE 180+ DAYS PAST DUE
Credit(s) $.00
$.00 $.00 New Balance $43.86
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Page 2 of 2
C
#347 NW INDIANAPOLIS
9010 MICHIGAN ROAD
INDI/2.72 IN 462
MEM11791434 5
RESALE ON
E 87924 EA 3.29
E 5623 4.49
E 60357 PPER 6.49
E 172246 POTS 4.99
747111 ET 11.88
28456 EFIL 12.72
RE AL 43.86
NON RESALE TOTAL .00
TOTAL -Xfl:'A
VF Costco Wholesale 43.86
XXXXXXXXXXXX4683 SWIPED
02/26/10 20:11
Se9 004483 APP 049002
Costco Wholesale ResP:. AA
Tran ID 005717154000
Merchant ID 99034711
APPROVED PURCHASE
AMOUNT: $43.86
0347 009 0000000024 0394
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD m 6
CASHIER: Mary Kay'C REG# 9
f k*T4'10JiL 20:11 0347 09 0394 24
Thank You!
Please Come Again!
r,
'VOUCHER NO. WARRANT NO.
ALLOWED 20
HSBC Business Solutions
IN SUM OF
P.O. Box 5219
Carol Stream, IL 60197 -5219
$43.86
ON ACCOUNT OF APPROPRIATION FOR
B rooksh ire-Go1f Club
PO# I Dept. INVOICEN ACCT /TITLE AMOUNT Board Members
1207 7003- 7311 -0007- 42- 390.40 $4186 I hereby certify that the attached invoice(s), or
r 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
Monday, April 05, 2010
Director, Brooksh Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev_ 199'
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))
03/26/10 7311- 0007 -4683M Food Beverage $43.8
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
2a
Clerk- Treasurer