189810 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCp
CARMEL, INDIANA 46032 PO BOX 5219 CHECK AMOUNT: $392.51
CAROL STREAM IL 60197 -5219
CHECK NUMBER: 189810
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 PARKS 168.98 7003731100072984
1095 4239040 PARKS 223.53 7003731100072984
COSTCO
Please Direct Inquiries To: 1- 800 220 -8594
WHOLESALE
Account Number New Balance Payment Due Amount Past Due Due Date
7003 7311 0007 -2984 $392.51 $.00 $.00 09/20/2010
Billing Date Credit Line Available Credit
08/26/2010 $5,000 $4,607.49
This communication serves as official notice that all calls to /from our offices may be monitored and /or recorded for qualitya
assurance purposes.
TDD /Hearing Impaired: 800 365 -0186
STATEMENT OF YOUR ACCOUNT C
FINANCE CHARGE SUMMARY
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
Reg 00014 $24.02 0.00000% 00.00% $.00 00.00% $392.51 $.00 09/26/2010
e
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
0
08/11/2010 COSTCO ON LINE 847 104590660211 00001 $116.62
08/13/2010 COSTCO ON LINE 847 104590660211 00001 $64.19 0
00001 SUBTOTAL: $180.81 0
08/05/2010 COSTCO WHOLESALE -346 002870 00013 $223.53 0
00013 SUBTOTAL: $223.53
08/18/2010 RETURNED MERCHANDISE 4164503 00001 $11.83- o
08/20/2010 PAYMENT THANK YOU 00001 $437.95- N
N
9WT-12
SEP032010
9y:
Return the below portion with payment. For billing errors or questions please refer to the back of the statement. Page 1 of 2
r
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.
Il�rl� I���C I��i �6� ►91►�
Jlk
Cl N, .0 N
6110 f::ASTA361H STREET
CASTLETONr IN 46250
h'iEMBER #,11176792129 06
RE;iAI.E: Citd
4 1 7 .45 1
E '11 `i� I /TLLJ 69.96
3@1
E '11; :3 :i MUSKETEERS `;0.55
3 17:45' d'
E '11 j Sx!�ARBURSI 152.47
F: '11(f1. M:I:LK:Y WAY ".;0.55
a
RE:`.'M -1_ TOTAL 223.53
NON TOTAL 00
'1.01 ki.. i �ftli►x1s�:K
VF C;cie, #c:o Wholesale 2'3.53
(SW)'F'ED
08/05/1("
0028
cosi co ResR AA
Tran 11111: C :2'171693000
Merchani 11) X191)39611
AF'f ROV1;:D PURCHASE
f'�MOl1t IT $;223.
0:' °16 0!)6 0000000011 0131
l:.Hf'ih!GfE
.00
TOTAL NI,1f1Bi :R OF I TENS SOLI) 13
CASH31F, F'L1TLLIP H RFC# 6
(.16 0316 06 0137 i 1
1"' 1- i =t IV I< Y O IJ
I-:- 1._ E_i C; M F
Costco receipt Page I of 2
Nl r r „y 0”! 4 H r4 ,-_..,1 R U.' A'1.':'1QUN"T I
COSWO
cm T 1`7,
What's New Appliances Auto Baby Beauty Bed Bath Books/CDs/DVDs 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.
Your order number is: 206609540
Order Date: 8111/2010
Please print this page for your records.
Billing Address Payment Method
Carmel Clay Parks Recreation Member Number: 111785098197 Costco Credit Card: A� AUG 1 3 2010
1411 E. 116TH ST
CARMEL, IN 46032
Shipping BY.
Natalie Love
Orchard Park ESE
10404 ORCHARD PARK DR S
INDIANAPOLIS, IN 46280-1538
Your Order
Qty Description Ship Method Price Item Total
1 Seville Classics Utility Carl
Item 338721 Standard $59.99 $59.99
1 Black
Item 350263 Standard $108.99 $108.99
Subtotal: $1
Shipping Handling: $0.00
Tax: $11.83
Order Total: $180.81
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.
Purchase
Description 1&6
P.O. 12 VE T LL.L_ P F
G.L.
Bud t
Shop Confidently Line low,
Purchaser
Dek
Membership: We will refund your membership fee in full at any time if you are dissatisfied. A PPr 0 v 0 J Date,__
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.
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 cuslorner 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.
httPs://Www.costco.com/Checkout/Receipt.aspx?mode=BC&topnav=BC&whse= BC&plD 8/11/2010
Co stco F und 1 08 :Fund 109
General
program Food
.supplies Beve
V# 361108 Anvoice 42390 4 2390401
10$1 -6 11095 -1
07/01/10 2 0470138 91
08105/10; 28 223
08/11/10 206609540 168
168.98 223.53 392.51
Costco I Fund 108 Fund 109 TOTAL
.General
program Food
!s upplie s _I iBe verage
V #3611 08 Inv oice 4239039 4239040
i1095-1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; k ind of service, where price perform .e dates service rendered, by
whom, rates per day, number of hours, rate N
Payee Purchase Order No
(Costco) Terms
361108 HSBC Business Solutions Date Due
P.O. Box 5219
Carol Stream, IL 60197 -5219
Invoice Invoice
Description PO Amount
Date Number (or note attached invoice(s) or bill(s)) 168.98
8126110 7003731100072984 General Program supplies 223.53
$126110 7003731100072984 Concessions
Total 392.51
Y hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 1C 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
392.51
ON ACCOUNT OF APPROPRIATION FOR
108 ESE 109 Monon Center
P0# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
Dept
1081 -6 7003731100072954 4239039 168.98 1 hereby certify that the attached invoice(s), or
1095 -1 7003731100072984 4239040 223.53 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
9 -Sep 2010
&vl U rn
Signature
392.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund