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187436 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00350958 Page 1 of 1 ONE CIVIC SQUARE SAMS CLUB DIRECT CARMEL, INDIANA 46032 P 0 BOX 530930 CHECK AMOUNT: $182.42 'y ATLANTA GA 30353 -0930 CHECK NUMBER: 187436 CHECK DATE: 7/712010 DEPARTMENT ACCOUNT PO NUMBER INVOIC NU MBER AMOUNT DESCRIPTION 1120 4239099 9849 68.20 OTHER MISCELLANOUS 851 5023990 9849 114.22 OTHER EXPENSES SAM'S CLUB DIRECT CREDIT Account: 0402 70240115 9 Statement Date: 06/21/10 Page: 1 of 2 CITY OF CARMEL 3451 ATTN: ACCOUNTS PAYABLE TWO CIVIC SQUARE i CARMEL, IN 46032 -2584 v+ 0 %Current Month's Invoices (Details Enc sed Date Involce Original Due Date Club R terencre Amount e 06/11/10 009849 182.42 07/08/10 8168 061110 e Past Due Invoices Date Invoice Original Due Date Club Reference Amount 04/20110 009218 218.73 06/08/10 8168 042010 04/29/10 001980 54.74 06/08/10 6316 1105689 05/13/10 005584 23.52 ,06/08/10 8168 051310 Curre $182.42 Send payments toff Past /Due•lnvoices: $296.99 P.O. Box 530930 U�apilied Payments Atlanta GAt30353 0930 Credits'.p�, $0.00 Send inqu de t ents) to: C\6d P.O. Box 87-26 Dayton 0445401 -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. -Continue 5966 0029 001 0T PAGE 1 of 2 I i SAINTS CLUB DIRECT CREDIT Account: 0402 70240115 9 Statement Date: 06/21110 Page: 2 of 2 I I SAM'S CLUB DIRECT P.O. BOX 530930 ATLANTA, GA 30353 -0930 I CITY OF CARMEL Date of Sale: 06111110 Account: 0402 70240115 9 Invoice: 009849 Gub /Name: 8168 P.O.: 061110 Buyer: 1 GARY CARTER e 1 i S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE 000665591 GRANULATED SUGAR 1.00 EA 5.34 5.34 004822824 COFFEE CREAMER 3.00 EA 5.30 15.90 005369078 CHARMIN ULTRA 4.00 EA 17.05 68.20 021567135 FOLGER DECAF PKTS 2.00 EA 19.76 39.52 021568260 FOLGERS COFFEE PKTS 3.00 EA 17.82 53.46 Subtotal: 182.42 Tax: 0.00 Balance Due: 182.42 I I I i I m I T I i I I I I 1 1 I I I I I I 1 1 I I I 1 I H I 1 i I I *P-f 59b6'0029 001 07 COLR654A 3451 V I VOUCHER NO. WARRANT N ALLOWED 20 Sams Ctjab IN SUM OF P.O. Box 530930 Atlanta, GA 30353 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 42 390.99 $68.20 1 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 9111 2 7 91 81 jz� Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by Slate 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)) $68.20 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