163759 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCO
CARMEL, INDIANA 45032 PO BOX 529 CHECK AMOUNT: $774.87
CAROL STREAM IL 60191 -5219 CHECK NUMBER: 163759
CHECK DATE: 911712008
DEPARTM ACCO P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239040 90.47 7003731100072984
1047 4239040 684.40 7003731100072984
Please Direct Inquiries To: 1 -800- 220 -8594 COSTC01 COSTCO
WFIOLESALE
>Account Number_ New Balance` Payment Due Amount Past Due. Due Date
7003.7311.0007 -2984 $1;282 63 $418.98 00 09/20/2008
Billing Date Credit line Available Credit
08/26/2008. 5000 $3,71737
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 Corres- FINANCE ANNUAL New Minimum Promo
Plan Plan Daily Periodic pending CHARGES at PERCENTAGE Balance Payment Expire
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 0.00000% 00.00% S.00 1 0000% $418.98 5418.98 08/26/2008
Reg 00014 $55.72 0.00000% 00.00° /a $.00 0000% $863.65 $.00 09/26/2008
ACCOUNT DETAIL
Transaction Transaction Invoice i User':.: P -O. Transaction
Date Description ,'Number ID (Number Amount
07/3112008 COSTCO WHOLESALE -346 070964 00006 $602.99 2
07/31/2008 COSTCO WHOLESALE -346 071129 00006 588.78
07131/2008 COSTCO WHOLESALE -346 071355 00006 56.89 0
07131/2008 COSTCO WHOLESALE -346 072501 00006 $81.41 0
00006 SUBTOTAL: $780.07
08/05 /2008 COSTCO WHOLESALE -347 020250 00007 583.58
00007 SUBTOTAL: $83.58 m
07131/2008 RETURN CARD 006 00006 $88.78
RECRTv D N
SEP 0 9, 2008
€3Y;
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 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 PO. 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.
COMM COSTCO
W/�O�.ESALE
ACCOUNTSUMMARY BALANCE SUMMARY f=
'CURRENT.::: 1.29 DAYS PAST. DUE :30 -59 DAYS PAST DUE oumtamg C
Transa $507.76
+New
$418 $.00 $.00 Pumhase(s)/Debd(s) 366366
6"0 DAYS PAST DUE 90 -119 DAYS PAST DUE 120 -149 DAYS PAST.DUE New Fees $00
00 $.00 00
Finance Charges 3 00
Payment(s) $00
150 -179 DAYS PAST: DUE 180+ DAYS PAST DUE Credit(s) $8878
$.00 $.00 New Balance $1,28263
SEP 0 2 2008
m
BY:
N
Page 2 of 2
W❑ 00.❑❑
New address or phone number?
Please check box and complete reverse side.
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.0 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(IOM7)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER -CASE LETTERS
AND NUMBERS ONLY!
Com an�
Email Address
Slreel N ,flla'n��I I �Sheet Name or the words "PO BOX" Unit or P1pO�e�I�I
C, 1=E1❑❑�❑E1❑❑❑❑❑ Star U WLJ ❑El
/D-M- M IF]
Costco 1 Fund1047 1 F und 10461
Food Food
Bevera Bevera
V#361108 Invoice 4239040 42390401
07/31 /081 70964001 60299
07/31108 7135500 6 89
07/31 /081 7250100 81.41
08/05/08 852 83 58
684.40 90.471 774.87
Costco Fund 1047 Fund 10461
Food Food
Beverag Beverage
V# 361108 Invoice 4239040 42390401
I
#347 NW INOIANOOLIS
MEMBER #111784829129
RESALE ON
264391 POTATO SALAD 5.99
264391 POTATO SALAD 5.99
28 1023 BAKED�BEANSD 4.919
71023 BAK D BEANS 4.19
35358 GR -K PASTA 9.18
35358 OR K PASTA 9.10
35358 GREEK PASTA 9.18
35358 GR -K PASTA 9.10
35358 ORE PASTA 9.26
Purchase 3 4# H WN 2.19
Descriptial
P.O.0 PaF RESALE TOTAL, 83.56
Q.L w i 0 4 0 NON RESALE TOTAL 1
Bud st p kiklc
U. w a VF Costco Wholes ;il,e 83.58
Purch pate -6- v
App roval pate SWIPED
Se9#: 000852 Ref#: 0205000
F ID t Y Wholesale e,P: AA
APPROVED
AMOUNT: $83.5
0347 010 000000D039 0025
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD REG
CASHIER 10
oi, 10:31 0347 10 0025 39
l[1L�1�7d�d1L
Thank You!
Please Come Again!
RECEIVED
SEP 0 2 2008
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
(Costco) Purchase Order No
361108 HSBC Business Solutions
P O Box 5219 Terms
Carol Stream, IL 60197 -5219 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
8/26/08 7 003731100072984 Food Beverage Amount
8/26/08 7 003731100072984 Food Beverage
PO 19120 F 602 99
8/26/08 7003731100072984 Food Beverage 81 41
9047
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance 774.87
with IC 5- 11 -10 -1 6
20
Clerk- Treasurer
.1
Voucher No Warrant No
(Costco)
361108 HSBC Business Solutions Allowed 20_
P.O. Box 5219
Carol Stream, IL 60197 -5219
In Sum of
774.87
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO #or INVOICENO ACCT #/TITLE AMOUNT Board Members
Dept
1047 7003731100072984 4239040 60299 1 hereby certify that the attached invoice(s), or
1047 7003731100072984 4239040 81 41 bill(s) is (are) true and correct and that the
1046 7003731100072984 4239040 90.47 materials or services itemized thereon for
which charge is made were ordered and
received except
y 2-Sep 2008
S IN l 1 �0/YYt iY)1 VU
Signature
774.87 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund