191662 11/10/2010 «a, CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
0 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC &ECK AMOUNT: $38.46
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197 -5219 CHECK NUMBER: 191662
CHECK DATE: 1111012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1.081 4239039 PARKS 38.46 7003- 7311 -0007 -2984
Please Direct Inquiries To: 1- 800 220 -8594
0 2SYCO. COSTCO
WHOLESALE
Account Number New Balance Payment Due Amount Past Due Due Date
7003 7311 0007 -2984 $38.46 $.00 $.00 11/20/2010
Billing Date Credit Line Available Credit
10/26/2010 $5,000 $4,961.54
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
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 $2.56 0.00000% 00.00% $.00 00.00% $38.46 $.00 11/26/2010
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
10/06/2010 COSTCO WHOLESALE -346 012162 00005 $38.46
00005 SUBTOTAL: $38.46
10/15/2010 PAYMENT THANK YOU 00001 5454.61-
0 4 2010
BY.
Return the below portion with payment. For billing errors or questions please refer to the back of the statement. Page 1 of 2
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.
C OS COSTCO
WHIIXES"E
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
CURRENT 1 29 DAYS PAST DUE 30 59 DAYS PAST DUE Transaction $454.61
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $38.46
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) $454.61
150 -179 DAYS PAST DUE 180+ DAYS PAST DUE Credit(s) $.00
$.00 $.00 New Balance $38.46
Page 2 of 2
s 11 F� ED El
Ne address or phone number?
Please chaCK box and complete reverse side.
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.
STMT222C (10/07)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS
AND NUMBERS ONLY!
M r! DMFII:ll:ll:ll:ll:ll:]Ll--I Illl:]Ell]Fll:IEIEIEIFIEI[:]M a
Email Address
Street Number if an Street Name or the words TO BOX" Unit or PO BOX Number
1 11 11 11 11 1
ci Stal� z
BB 0❑
I
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
Date Number (or note attached invoice(s) or bill(s))
PO Amount
38.46
10126110 7003731100072984 General Pro ram supplies
Total 38.46
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
38.46
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -7 7003731100072984 4239039 38.46 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
4 -Nov 2010
h IWO
Signature
38.46 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund