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Home My WebLink About193069 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 354720 Page 1 of 1 ONE CIVIC SQUARE COSTCO WHOLESALE MEMBERSHIP CHECK AMOUNT: $210.00 CARMEL, INDIANA 46032 PO BOX 34783 SEATTLE WA 98124 -1783 CHECK NUMBER: 193069 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4355300 PARKS 210.00 ORGANIZATION MEMBER BUSINESS MEMBERSHIP °o ANNUAL RENEWAL NOTICE a i s Business Pnrra 'Carcfholtler ry $50 RENEWAL MONTH= FEBRUARY 2011 MEMBER NUMBER: 000111782210072 r HauseholdCardhotder� t l^REE Add on Cardholder y $40 each CARDHOLDER'S NAME AMOUNT HOUSEHOLD MEMBER AMOUNT `:,F Add- ori�HouseholdCardholder FREE AUDREY KOSTRZEWA $50.00 JENNIFER SEWELL $0.00 BEN JOHNSON $40.00 MATT LEBER $0.00 fi TAMI POWELL $40.00 A K $0.00 v' SARAH CARLING $40.00 CRYSTAL ALLEN $0.00 MICHELLE COMPTON $40.00 LINDSAY ATKINSON $0.00 TOTAL RENEWAL FEE $210.00 Purchase l l Description P.O. P or F r� s 63 if you don t have any changes to your l i membershp rRENEW ONLINE AT< B udget i B M 5 CflSTCfl COM >`Simply lag `on to ttco coin, j 4 7 Purchaser Line Descr type RENEW =m the prodlJCt search box and f n z`A w x; Date /a �fotlovv the simple lnstractions to renew your, t b merittlership today 1 ti w Please see Instructions an reverse to allopre Oer e JOIN THE MORE THAN 2 MILLION MEMBERS USING COSTC0 SEKIFIVICES t CONSUMEW ERVICE Auto Nome.lnsurance Q Online Investing ;4 Boat RV Loans and: Refinancing` Personal Checks: y Costco Auto Program Personal Health.lnsurance�" ®Hgh Yield Savings Accounts CDs 0#' CA; k PA 1X M ty -3 Group.pental Plari for individuals identity: Frotecticn an�yin cA` V isit C ostco.com and search: Services Gostcodoesnotprovideservices; allservicesareprWdedbythirdparties, ElEXU213_B 1W10 6 Renewal of your membership constitutes acceptance of Costco's Privileges and Conditions of Membership and its Privacy Policy and Practices, which are available at our membership counter or online at costco.com. Please provide all cardholders with this information. Renewal Policy Memberships renewed within 2 months after expiration of the current membership year will be extended for 12 months from the expiration date. Memberships renewed more than 2 months after such expiration will be extended for 12 months from the renewal date. All cardholder changes will be effective upon receiptof renewal payment. New membership cards will not be sent unless new cardholders are added or changes are made to the account. CHANGES TO YOUR ACCOUNT.• Fill in the necessary information in the space provided below and adjust payment accordingly. Changes to your membership cannot currently be made online at costco.com. If adding household member cardholder. Add household member's name in space below the primary cardholder. *A household member card is available to primary cardholder's household member, domestic partner, or immediate family member over the age of 18 and living at the same address. Household member cardholders will-be askedto present proof that they live at the same address as the primary or add -on cardholder. If adding additional cardholders only: Add name at next available add -on cardholder position, then add fee at right to total fees due. If replacing cardholders: Cross out name, and replace with new name. Amount due will remain the same. If removing cardholders: Cross out name, and subtract fee at right from total fees due. Note: If paying cardholder is removed and household member card is attached and is to remain on the account, he /she must be moved to an add -on cardholder position and fees adjusted accordingly. If upgrading to Executive Membership: 1. Add the $SO Upgrade Fee to the Primary Membership Fee ($50). 2. Please add sales tax in NY, HI, AZ, NM, UT, and all other applicable states. 3. Check the box on the front of the remittance portion of this Renewal Notice. Note: Only the Primary Cardholder and the Primary's Household Member may upgrade to Executive Membership. Add-on Cardholders may convert to their own membership if they wish to upgrade to an Executive Membership. Limit one Executive Membership per household and /or business. Have questions about your renewal? Call us at 1-800- 774 -2678. EnNEBNR1Ag 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. 360854 Costco Membership NOT HSBC Terms P.O. Box 34783 Seattle, WA 98124 -1783 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 12121/10 111782210072 Annual Membership renewal 210.00 Total 210.00 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. 360854 Costco Membership NOT HSBC Allowed 20 P:O'. 'Box 34783 Seattle, WA 98124 -1783 In Sum of 210.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO #or INVOICE NO. ACCT #[TITL AMOUNT Board Members Dept 1 125 111782210072 4355300 210.00 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 16 -Dec 2010 Signature 210.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund