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187835 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC s'.�• CARMEL, INDIANA 46032 PO BOX 5219 HECK AMOUNT: $340.41 CAROL STREAM IL 60197 -5219 CHECK NUMBER: 187835 CHECK DATE: 7/2112010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4239039 PARKS 235.47 GENERAL PROGRAM SUPPL 1095 4239040 PARKS 104.94 FOOD BEVERAGES Please Direct Inquiries To: 1- 800 220 -8594 C YCO. COSTCO Wi/OLESALE io Account Number New Balance Payment Due Amount Past Due Due Date 7003 7311 0007 -2984 $340.41 $.00 $.00 07/21/2010 Billing Date Credit Line Available Credit 06/26/2010 $5,000 $4,659.59 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 C FINANCE CHARGE SUMMARY a Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire Description Number Balance Rate APR Periodic Rate RATE Due e ZZ Reg 00014 $22.54 0.00000% 00.00% $.00 00.00% $340.41 $.00 07/26/2010 0 ACCOUNT DETAIL Transaction Transaction Invoice User P.O. Transaction Date Description Number ID Number Amount 0 06/08/2010 COSTCO ON LINE 847 129323530211 00001 $135.86 0 00001 SUBTOTAL: $135.86 0 06/23/2010 COSTCO WHOLESALE -346 077360 00005 $54.25 0 06/24/2010 COSTCO WHOLESALE -346 057003 00005 $54.25 00005 SUBTOTAL: $108.50 06/08/2010 COSTCO WHOLESALE -346 000116 00013 $104.94 0 00013 SUBTOTAL: $104.94 N 06/03/2010 RETURNED MERCHANDISE 3920425 00001 $8.89- 06/03/2010 RETURNED MERCHANDISE 3921002 00001 $8.89- 06/15/2010 RETURNED MERCHANDISE 3956411 00001 $8.89- 06/26/2010 PAYMENT THANK YOU 00001 $484.99 Online Account Access lets you take control of your Account anylime, anywhere Registratipmis easy, secure and waiting for you at www.hrscommercial.com. AL 2010 L....................... Return the below portion with payment. For billing errors or questions please refer to the back of the statement. Pagel of 2 i 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 P.O. 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. COSTCO Wilff! FCA1 E r_ ACCOUNT SUMMARY BALANCE SUMMARY e CURRENT 1 -29 DAYS PAST DUE 30 -59 DAYS PAST DUE Transaction $502.77 +New $.00 $.00 $.00 Purchase(s)/Debit(s) $349.30 v 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) $484.99 150 -179 DAYS PAST DUE 180+ DAYS PAST DUE Credit(s) $26.67 $.00 $.00 New Balance $340.41 e a 0 0 JUL U 7 2016 a N 0 N Page 2 of 2 Costco receipt ge I of 1 LO:�A i S 0 SL "PP `;F �FROFr �1f "I" ij,: EM:R A, r,"AR 7.f (9) CM HC What's New Appliances Auto Baby Beauty Bed Bath BookslCDsIDVDs Computers Decor Electronics Floral Food Furniture Funeral Gifts Tickets Hardware Health Housewares Instruments Jewelry Office Products Outdoor Pet Sports Toys Games View All LOGOUT Search. In All Your Receipt Thank you for shopping costco.com. Your order is in process. JUNO 201.0 Li Your order number is: 203532392 Order Date: 61812010 Please print this page for your records, Billing Address Payment Method Carmel Clay Parks Recreation Member Number: 111785098197 Costco Credit Card: 1411 E. 116TH ST CARMEL, IN 46032 Shipping Tiffany Buckingham Monon Center 1235 CENTRAL PARK DR E CARMEL, IN 46032-4421 Your Order Qty Description Ship Method Price Item Total 1 TRINITY 6-tier Chrome Shelving Standard $99,99 $99.99 Item 341584 Subtotal. $99.99 Shipping Handling: $26-98 99 Tax: $8.89 Order Total: $135.86 Please print this page for your records. An e-mail confirmation will be sent for your order. If you have any questions, please go to customer service. Shop Confident!y Membership: We will refund your membership fee in full at any time if you are dissatisfied. Merchandise: We guarantee your satisfaction on every product we sell with a full refund. Exceptions: Televisions, projectors, computers, cameras, camcorders, iPod/MP3 players and cellular phones must be returned within 90 days of purchase for a refund. I How to Return: Simply return your purchase to any one of our Costco warehouses worldwide for a refund (including shipping and handling). If you are unable to return your order at one of our warehouses, please contact customer service or call our customer service center at 1-800-955-2292 for assistance. To expedite the processing of your return, please reference your order number, CUSTOMER SERVICE ORDER STATUS I REBATES I CREDIT CARDS I COSTCO CONNECTION MAGAZINE P,ivncy ami �:orkd to E, l Vlr.111­1�fll https://www.costco.com/Checkout/Reccipt.aspx?mode=BC&topnav=BC&whse=B 6/8/2010 costco F und 1 08 Fund 109 General eneral Ge n program program program Food supplies supplies supplies Beverage V# 361108 Invoice 42390391 4239039 4239039 4239040 1 1082 -3 10824 1082 -99 1095 -1 06/08/10 2392 f 126.97 06/08/10 2775 104.94 06/24/10 57003 54.25 06/23/10 77360 54.25 54.25 126.97 54.25 104.94 340.41 costco Fund 108 Fund 109 TOTAL General General General program program program Food supplies supplies supplies Beverage V#361108 Invoice 4239039 4239039 4239039 4239040 1082 -3 1082 -4 1082 -99 1 1095 -1 1 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 Purchase Order No. (Costco) Terms 361108 HSBC Business Solutions Date Due P.O. Box 5219 Carol Stream, IL 60197 -5219 Invoice Invoice Description Amount or note attached invoice(s) or bills PO Date Number 54.25 6/26110 7003731100472984 General Program supplies 126.97 6126110 7003731100072984 General Program sup lies 54.25 6126110 7003731100072984 General Pro ram su plies 104.94 6126110 700373110007298 Food Beverage Total 340.41 1 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. (Costco) 361108 HSBC Business Solutions Allowed 20 P.O. Box 5219 Carol Stream, IL 60197 -5219 In Sum of$ 340.41 ON ACCOUNT OF APPROPRIATION FOR i 108 ESE 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1082 -3 7003731100072984 4239039 54.25 1 hereby certify that the attached invoice(s), or 1082 -4 7003731100072984 4239039 126.97 bill(s) is (are) true and correct and that the 1082 -99 7003731100072984 4239039 54.25 materials or services itemized thereon for 1095 -1 7003731100072984 4239040 104.94 which charge is made were ordered and received except 15 -Jul 2010 Signature 340.41 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund