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Home My WebLink About205432 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 354720 Page 1 of 1 ONE CIVIC SQUARE COSTCO WHOLESALE MEMBERSHIP j CHECK AMOUNT: $275.00 CARMEL, INDIANA 46032 PO BOX 34783 SEATTLE WA 98124 -1783 CHECK NUMBER: 205432 CHECK DATE: 1/17/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4355300 111782210072 275.00 ORGANIZATION MEMBER 1 BUSINESS MEMBERSHIP ANNUAL RENEWAL NOTICE o Business Pnin Cardholder $55 RENEWAL MONTH: FEBRUARY 2012 MEMBER NUMBER: 000111782210072 Household Cardholder`: FREE Add on Cardholder +�5areacli CARDHOLDER'S NAME AMOUNT HOUSEHOLD MEMBER AMOUNT AUDREY KOSTRZEWA $55.00 JENNIFER SEWELL $0.00 Add on Household Cardholder FREE BEN JOHNSON $55.00 MATT LEBER $0.00 Purchase TAM[ POWELL $55.00 Descripton �N1�UF}L Ml9ECdSH /P` dO la' SARAH CARLING $55.00 CRYSTALALLEN $0.00 MICHELLE COMPTON $55.00 LINDSAY ATKINSON $0.00 PO z Po�F G TOTAL RENEWAL FEE $275.00 d� /Yn(�er 7ClP I Bd uet w Line escr p �5 j o� Purchase Description Purchaser D` Date DEC 1 20 11 a! P.O. P or F Approval Date ao If you don t have y changes to your membership YR EW ONLINE AT Buor,e t GOSTCO COM' Simply log on to costao coin, 4 ;n u Line Descr type RENEWridthe productsearch box arid'i f; n follow the srm le mstruci7ons to renew our S P Y Purchaser D_, membership today Please see Instructions on reverse to add, emove or replace a car o er. JOIN THE MORE THAN 2 MILLION MEMBERS USING COSTC® SERVICES CONSUMER SERVICES Auto Home Insurance Online Investing $oat w Loans and Refinancing e Personal Checks 6 Costco Auto ram Pro Personal Health Insurance' Program P o High -Yield Savings Accounts :CDs o"ry ca, /4 PA& rx Identity. fion Group Dental Plan for Individuals T onlyin CA 't Visit Costco.com and search: Services Costco does not provide services all services are provided by third parties. 11 EX0213 0 10110 236 Renewal of your membership constitutes acceptance of Costco "s Privileges and Conditions of Membership and its Privacy which are available at our membership counter or online at costco.com. Please provide your household member cardholder 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 eff ective 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 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 atthe same address. Household member cardholders will be asked to present proof that they live atthe same address as the primary or add -on cardholder. If upgrading to Executive Membership: 1. Add the $55 Upgrade Fee to the Primary Membership Fee ($55). 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: Limit one Executive Membership per household and /or business. Have questions about your renewal? Call us at 1- 800 -774 -2678. EnNEGSNR 1/09 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. 354720 Costco Membership NOT HSBC Terms P.O. Box 34783 Seattle, WA 98124 -1783 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 12/19/11 111782210072 Annual Membership renewal 275.00 Total 275.00 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. 354720 Costco Membership NOT HSBC Allowed 20 P.O. Box 34783 Seattle, WA 98124 -1783 In Sum of 275.00 4 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 111782210072 4355300 275.00 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 11 -Jan 2012 Signature 275.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund