185420 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 00350958 Page 1 of 1
ONE CIVIC SQUARE SAMS CLUB DIRECT
CARMEL, INDIANA 46032 P 0 a0x 530930 CHECK AMOUNT: $119.36
ATLANTA GA 30353 -0930
CHECK NUMBER: 185420
CHECK DATE: 5117!2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 002618 119.36 0402702401159
5�
SAM'S. CLUB DIRECT CREDIT
Account; 0402 70240115 9 Statement Date: 04/20110 Page: 1 of 2
CITY OF CARMEL 3600
ATTN: ACCOUNTS PAYABLE
TWO CIVIC SQUARE
CARMEL, IN 46032 -2564
0
Payllnents Received
03/22/10 0182989 39' 51;) PAYMENT RECEIVED -THANK YOU
Current Month's Invoices (Details Enclosed)
Date Invoice Original Due Date Club Reference
Amount
03/29/10 002618 119.36 05/08/10 8168 32910
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Current Invoices: $119.36 Send payments lo:
Past Due Invoices: $&00 P.O. Box 530930
Unapplied Payments Atlanta GA 30353 -0930
Credits: 0:00. p!7 0 jM Send Inquiries (not payments) t
P.O. Box 8726
est Dayton OH 45401 -8726
For Customer Service:
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
with your payment. If not sending stub, note account number, Invoice number and amounts
being paid on your check.
antinue-
�596 0027 001 07 PA G of 2
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SAM'S CLUB DIRECT CREDITR
Accounf: 0402 70240115 9 Statement Date: 04/20/10 Page: 2 of 2
SAM'S CLUB DIRECT
P.O. BOX 530930
ATLANTA, GA 30353 -0930
CITY OF CARMEL Date of Sale: 03/29/10
Account: 0402 70240115 9 Invoice: 002618
Club /Name: 8168 P.O.: 32910
e
Buyer:; GARY CARTER
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
000665591 GRANULATED SUGAR 1.00 EA 6.38 6.38
021567135 FOLGER DECAF PKTS 3.00 EA 19.83 59.49
021568260 FOLGERS COFFEE PKTS 3.00 EA 17.83 53.49
Subtotal: 119.36 Tax: 0.00 Balance Due: 1 19.36
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*7 '5966 0027 001 PAGE 2 of 2 COLR654A 3600
Prescribed by Stale Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 261 (Rev. 1995)
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))
10 N
Total
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.&
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
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
6�517-jlq I 3l 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
MAY 10 2010
.,9 w
2
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund