167341 12/23/2008 CITY OF CARMEL, INDIANA VENDOR 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCp
PO BOX 5219 CHECK AMOUNT: $199.13
CARMEL, INDIANA 46032
o, CAROL STREAM IL 6019] 5219 CHECK NUMBER: 167341
CHECK DATE: 12123/2009
DEPAR ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1150 4239040 019727 23.98 7003731100074683
1150 4239040 038964 165.15 7003731100074683
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)UCHER NO. WARRANT NO.
ALLOWED 20
t 0 6
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IN SUM OF
_�iymoo/ S 4c y /L
64 117-
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ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
�r5o b389�`! Z3�i��J 1 &5 bill(s) is (are) true and correct and that the
f 0/972 7 23 9 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Title
Cost distribution ledger classification if Director of Golf
claim paid motor vehicle highway fund
i
F�jase Direct Inqwnes To 1- 800 220 -8594
cos rco
_Wi/06ESALE
Account Number New Balance Payment Due Amount Past Due Due Date
7003 7 3 1f- 000 -4 683 $189 00 $.00 12/2
Billing Date Credit Line Available Credit
11/26/2008 $1,000 $810.87
This communication serves as official notice that all calls to /from our offices may be monitored and /or recorded for quality
assurance purposes.
STATEMENT OF YOUR ACCOUNT
FINANCE CHARGE SUMMARY
Credit Credit Average Daily Carries- 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 $12.20 1 0.00000% 00.00% 1 $.00 1 00.00% 1 $189.13 1 Soo 1 12/26/2008
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
10/31/2008 COSTCOWHOLESALE- 346 038964 00001 $165.15 0
00001 SUBTOTAL: $165.15
11/1112008 COSTCO WHOLESALE -347 019727 00002 S23.98
00002 SUBTOTAL: 523.98 0
11/20/2008 PAYMENT THANK YOU 00001 S323.07-
N
Return the below portion with payment. For billing errors or questions please refer to the back of the statement. Page 1 of 2
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y w
Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or unautho-
rized 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.
COSM CCSTCD
WHOLESALE
ACCOUNTSUMMARV BALANCE SUMMARY
CURRENT 1 -29 DAYS PAST DUE 30 -59 DAYS PAST DUE Outstanding Transaction $32307
+New
00 00 00 Purchase(s)/Debit(s) $189 13
60.89 DAYS PAST DUE 90 -119 DAYS PAST DUE 120.149 DAYS PAST DUE New Fees 00
00 00 00 r Finance Charges $.00
Payment(s) $32307
150.179 DAYS PAST DUE 180+ DAYS PAST DUE credrt(s) 00
00 00 New Balance $18913
V
N
Page 2 of 2
New address ur nhone nunbe
Please checs box and complete reverse side
1
Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or unautho-
rized 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.
STMTMC (10107)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER —CASE LETTERS
AND NUMBERS ONLY!
Er
❑u'a iiJ ❑[_I_ ill ❑u
Street Numtar A an Beat Name or the worse p0 90n I _w or PO 20 Ni,mper
it
a i
0 Stitt 7q,
nw.�r ter,.,..
❑�Li❑ ❑�iiJl�i
&d y Stale Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No 201 (Rev 1995)
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
C o 5 o Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
ed
3i 08 039 CGS �s
ii a8 0/472 -7 a 3
Total
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