166691 12/10/2008 CITY CIVIC SQUARE ,INDIANA VENDOR 361108 Page 1 of 1
ONE CIVIC SQUARE H S 8 C BUSINESS SOLUTIONS COSTCp
GHECK AMOUNT: $86.04
CARMEL,.INDIANA 46032 Po Szis
CAROL STREAM a 6oi97-5211 CHECK NUMBER: 166691
CHECK DATE: 1211012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
,,1046 4239037 86.04 7003 -7311- 0007 -2984
s
COSTCO
it P lease Direct Inquiries To 1- 800 220 -8594 _WNCIIL C
Account Number' New Balance Payment Due Amount Past Due :Due Date
7003 -7311- 0007.2984 $886.25 $779.90 $.00 12/2 /2 008
Billing Date Credit Line, Available Credit,
11/26/2008 $5,000 ;$4,113.75
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
C Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Rana
Plan Plan Daily Periodic ponding CHARGESat PERCENTAGE Balance Payment Expire
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 0.00000% 00.00% 5.00 00.00% $779.90 $77990 11/26/2008
Reg 00014 56.86 0.00000% 00.00% 8.00 00.00% $706.35 $.00 12/26/2008
ACCOUNT DETAIL
Transaction .:'Transaction Invoice User P.O.: Transaction
Date. Description Number ID Number: Amount'
11119/2008 COSTCO WHOLESALE -346 043445 00005 S86.04
1112112008 COSTCO WHOLESALE -346 016983 00005 $2031
00005 SUBTOTAL: 510635
10/24/2008 COSTCO WHOLESALE- 346 039624 00009 5416.55
00009 SUBTOTAL. 5416.55
10/27/2008 RETURN CARD #009 00009 S52874-
AA
'Ir
a,
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 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.
COSTCO
4V�iOLESALE
ACCOUNTSUMMARY BALANCE SUMMARY
CURRENT 1 -29 DAYS PAST DUE `30 -59 DAYS PAST DUE T on $89209
+New
$779.90 00 00 Purchase(s)/Debit(s) $522.90
60x89 DAYS PAST DUE 80.119 DAYS PAST DUE 120 -149 DAYS PAST DUE +New Fees 00
Finance Charges 00
00 00 00 Payment(s) $.00
150 -179 DAYS PAST DUE 180+ DAYS PAST DUE Credit(s) E52e.74
00 $.00 New Balance $88625
A c
B AFC ',P
7
Y 0 08
Page 2 of 2
N
New address or phone numbery
Please check box and complete reverse ,ioe
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.
STMT222C (10107)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER -CASE LETTERS
AND NUMBERS ONLY!
1❑❑ ❑i 7
Street Number if an Slmet Name or she words 0 BOX" Unn or PO BOY Number
E]EI]E 11 I I 1 1-1 El
❑❑LJ sta ff
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
(Costco) Purchase Order No.
361108 HSBC Business Solutions Terms
P.O. Box 5219 Date Due
Carol Stream, IL 60197 -5219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11126/08 7003731100072984 Club Supplies 8604
Total 86.04
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
86.04
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
7'( 3 -'13 0-- 006.7- `q E�LP
PO# or Board Members
Dept ept INVOICE NO. ACCT #/TITLE AMOUNT
1046 7003731100072984 4239037 86.04 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
5 -Dec 2008
Signature
86.04 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund