The URL can be used to link to this page

Home My WebLink About180786 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 354720 Page 1 of 1 ONE CIVIC SQUARE COSTCO WHOLESALE MEMBERSHIP CHECK AMOUNT: $140.00 CARMEL, INDIANA 46032 PO BOX 34783 SEATTLE WA 98124 -1783 CHECK NUMBER: 180786 CHECK DATE: 12/30/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION •.1207 4355300 11774019754 140.00 ORGANIZATION MEMBER l EXECUTIVE BUSINESS MEMBERSHIP ANNUAL RENEWAL NOTICE Business Primary Cardholder $50 RENEWAL MONTH: FEBRUARY 2010 MEMBER NUMBER: 000111774019754 Househo�dCartlholder FREE' CARDHOLDER'S NAME AMOUNT HOUSEHOLD MEMBER AMOUNT Add -0n Cardholtler $40 each ROBERT HIGGINS $100.00 KEN MILLER $0.00 Add -0n Household Cardholder FREE PAM LISTER $40.00 MELISSA A MONTGOMERY $0.00 Executive Upgrade $50 TOTAL RENEWAL FEE $140.00 RENEW ONLfNE AT COSTCO COM Iks easy to renew or?line� Simply kog ori_ta cosCa G em'type Renew it the product search bax <'and.folid the simple instri ctions to renew your membership today To add, remove or replace a cardholder. Please see Instructions on reverse. 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 receipt of renewal payment. New membership cards will not be sent unless new cardholders are added ar 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 househotd 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 asked to present proof thatthey live atthe same address atthe primary or add -on cardholder. If adding additional cardholders only: Add narne at next available add -on cardholder position, then add fee at rightto total fees dtse. 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 dui?_ dote: 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. (NOTE: Only the Primary Cardholder and the Primary's Household Member may be Executive Members, Add -on Cardholders may convert to their own membership it 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. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 7995) 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 d k2k� Et? r Purchase Order No. _�`,7�s� Terms YJ�1_2 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total I 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. ALLOWED 20 �70 IN SUM OF ON ACCOUNT O�F�APPRO PRIATION FOR 6f 0a& /02o 7 auA�se Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or X &/7 ss 3 ,40 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 nec" 20 G nat Cost distribution ledger classification if le claim paid motor vehicle highway fund