HomeMy WebLinkAbout167956 11/21/2009 CITY OF CARMEL, INDIANA VENDOR: 354720 Page 1 of 1
rf ONE CIVIC SQUARE COSTCO WHOLESALE MEMBERSHIP
0 CHECK AMOUNT: $210.00
CARMEL, INDIANA 46032 PO BOX 34783
SEATTLE WA 98124 -1783 CHECK NUMBER: 167956
CHECK DATE: 112112009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1.125 4355300 210.00 ORGANIZATION MEMBER
ANN �L ENEWAL NOTICE
,Business Pnmary Cardholder $50 a RENEWAL MONTH: FEBRUARY 2009 MEMBER NUMBER: 000111782x10072
Household Caholder
k Addn Cardhcilder Y $g0�eactt' CARDHOLDER'S NAME AMOUNT HOUSEHOLD MEMBER AMOUNT
AUDREY KOSTRZEWA $50.00 JENNIFER SEWELL $0.00
Add on Household Cardholder, j" FREE BEN JOHNSON $40.00 MATT LEBER $0.00
s,a f win t nx 1
n E e $40.00 ALLISON CHADWICK $0.�
TAMI POWELL
SARAH CARLING $40.00 CRYSTAL ALLEN $0.00
MICHELLE COMPTON $40.00 LINDSAY ATKINSON $0.00
TOTAL RENEWAL FEE $210.00
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Yr RENEW ONLINE AT +COSTCO COM
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s yr search box and follow the slrnple instructions' To add, remove or replace a cardholder,
y{ z to �erewayaurymernbershlp today c f T OR, to upgrade to Executive Membership: Please see instructions on reverse.
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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.
AEI cardholder changes will be effective upon receipt of 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 to the right of appropriate add -on cardholder.
'A household member card is available to primary or add -on cardholder's 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 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 $50 Upgrade Fee to the Primary Membership Fee ($50).
2. Please add sales tax in NY, HI, AZ, NM, UT, and all other applicable states.
3. Check the box on the front of the remittance portion of this Renewal Notice.
Note: Only the Primary Cardholder and the Primary's Household Member may upgrade to .Executive Membership.
Add-on Cardholders may convert to their own membership If they wish to upgrade to an Executive Membership.
Limit one Executive Membership per household and/or business.
Have questions about your renewal? Calf us at 1- 800 7742678.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
Costco (Membership fees) NOT HSBC
Terms
P.O. Box 34783
Seattle, WA 98124 -1783
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12116108 111782210072 Annual Membership renewal Feb'09
210.00
Total 210.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20,
Clerk- Treasurer
Voucher No. Warrant No.
Costco (Membership fees) NOT HSBC Allowed 20
P O
>SeattlW'WA
rj (i ICCG�I Sn7i� In Sum of$
210.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1125 1 11782210072 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
2 -Jan 2009
Signature
210.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund