172852 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 361108 Page I of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC CHECK AMOUNT: $1,433.17
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197-5219 CHECK NUMBER: 172852
CHECK DATE: 5/27/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4230200 700373110007 1,211.57 7003-7311-0007-4683
1207 4238900 700373110007 120.36 7003-7311-0007-4683
1207 4239040 700373110007 101.24 7003-7311-0007-4683
L
LJ `tJ COSTCO
Please Direct Inquiries To: 1- 800 -220-8594
Account Number .New Balance Paymert`Due Arnuursf Past Due Due -Date
7003 7311 0007 4683` i d33 63 00 QQ 05�21/2OQ9
B,[Iling Date Credit Line Avallable Credit
®e
04/26(20Q0;: $2 000 $566 47`
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 CHARGf; SUMMARY
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
Plan an Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 0.00000% 00.00% $.00 00.00% S.36 $.00 04/26/2009
Reg 00014 $92.46 0.00000% 00.00% $.00 00.00% $1,433.17 $.00 05/26/2009
ACCOUNT DETAIL
iraasaction Transaction livace User P O Trarisact�on,:
Date; Qescripttort I�Iumber'.. tD Number Amount
04/07/2009 COSTCO WHOLESALE -346 041094 00001 $294.05-
04/09/2009 COSTCO WHOLESALE-347 025840 00001 $1,018.76 0
04/22/2009 COSTCO WHOLESALE -346 037520 00001 X120.36' o
00001 SUBTOTAL: $1,433.17 M
04/23/2009 PAYMENT THANKYOU 00001 40.04- o
v
THANKS FOR BEING A GREAT CUSTOMER. WE HAVE INCREASED YOUR CREDIT LIMIT TO 2,000.00 N
��llJ�o Y
U2S11011s lease TeieT lathe ba of the statemP�� Pag j 0
paym2Tlt.FOC b1lling QCCOCS 0(q
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Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or
unauthorized 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.
casmo COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
CUEtRENT 429 DAY9 PAST DUE- 30 59; DAYS:PAST DUE Transaction $640.40
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $1,433.17
+New Fees $.00
6p -$9 RAYS. PAST DUE 9Q 119 DAYS PAST DUE 120 1.49 DAYS
FAST 3
Finance Charges $.00
$.00 $.00 $.00 Payment(s) $640.04
150 =179 DAYS PAST DIIE 80+ DAYS PAST DUE Credit(s)
$.00
$.00 $.00 New Balance $1,433.53
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Page 2 of 2
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Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or
unauthorized 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 (10/07)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS
AND NUMBERS ONLY!
l_
2 m l)e r in an Street Name or the words "PO BOX Unit or PO BOX Numbe
Il_ LJ� ..J Stat L.JLJ C
ne
May. 19. 2009 9:44AM Costco Wholesale #346 No. 8 13 1 F. i
6:36:08 05/19/09 Sales Audit Transaction Detail. INP2709 PAGE 1
Warehouse: 346
Sales Date: 4/22/09 Reg 14 Trans Type: Tender
Time: 12;22 Tran 134 Tender:
Total: 770.35 Operator: 77 Block:
Member 000111 8 819 MILLER, KEN Mbr Type: Business
Tax: 50.40 Resale Total:
FSA/
EBT Item Description Amount Units
240502 NEXGRILL 7 BURNER GAS 599.99 1
261685 EMPTY PROPANE CYLN'DR 20LB 119.96 4
Costco CR 120.36
Cash Card #491362515290485 649.99
END OF REPORT
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
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
�A-)_S Purchase Order No.
Terms
s'�19 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
_666
Total
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.
ALLOWED 20
IN SUM OF
a�
asap
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
7 26 qp lop 0% a e bill(s) is (are) true and correct and that the
pb d 5-7 materials or services itemized thereon for
1a6, ,S which charge is made were ordered and
received except
20
Si na
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
c
It-
s
:R:3-16 CAS FI-E FON, IN
MEMBER 4111782210075
RESALE ON
3575 SPAGI'ETTI SC 4.59
3575 SPAG ETTI SC 4.59
3575 SPAG SC 4.59
283202 BEV NAPKIN 10.4;9
654003 SPAGIETTI 8.(,-
65400 1 SPAM ETTI 8, (1
127489 tiOL0 SPOON f,
12648 KS 0 11 .1_R Y
27735' 1c)" vill ll i:UPS
214025 PAPE1 PLATES
992756 PARMESAN 7.39
RESALE Td AL 87.79
NON RESALE TOTAL .00
TOTL
VF Costco Whole ale 87 79
XXXXXXXXXXXX2984 SWIPED
Seq 005307 Ref ;e5p: 409800
Costco Wholesale AA
FID Y: 00800
APPROVED
AMOUNT: $87.79
0346 012 0000000070 01'
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD`a 11
CASHIER: HEATHER S REG# 12
Wfilt hlolok:: 11 :38 0346 12 011,0 70
I I -IONK YOU!
COME AGAIN
�r
1
4347 NW INUTANAPOL.IS
MEMBER #111785098197
RESALE ON
10 10.89
30093 DOG BISCUITS 108.90',
VOID 10 10.89
30093 DOG BISCUITS 108.90-
10 7.37
2571 TOOTSIE FUN 73.70
7 10.89
30093 DOG BISCUITS 76.23
2 17.49
115 -1 STARB� ST 34.98
VOID 1151 STARB FI ST 17.49
1151 STARB0 ST 17,49-
350551 SKTTLS`CRAZY 11.99
350551 SKTTLS;CRAZY 11.99
1103 3 MUSK 1fiEERS 17.49
1160 SKITTL 5 17.49
1160 SKITTL .S 17.49
2 21.48 01 MILKYY 17.49
1202 SNICK 42,96
2 13.19
276263 NEST 3OCT 26.38
290879 MO., X 72CT 28.99
210000001312 CPN/276263 5.00-
210000001312 ORN/276263 5.00
RES E TOTAL 367.18
NON RESALE TOTAL .00
TOTAL
VF Costco Wholesale 367.18
XXXXXXXXXXXX2984 SWIPED
Se9 001809 Ref 07585700
Costco Wholesale ResP: AA
FID Y: 34631
APPROVED
AMOUNT: $367.18
0347 009 0000000158 0026
C OUPONS TENDERED 10.
TOTAL NUMBER'OF ITEMS SOLD s 30
CASHIER: JOSE H REG# 9
1Kfk4fP*11k 10:39 0347 09 0026 158
Thank Yo.!
Please Come R9ain!
oe
Sac (��&LZIV654
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C:: A 'r L_ E _.1-. 0 N, I N
hIEMBER #111782210075
RESALE ON
l681 :T0LAt 50'T 10.97
11361 FR...TO 50IT 10.97
9i ?4 34'� HOT DO 13UN 2.49
HOT DO 13UN 2.49
904134;+ H01 D0(i 13UN 2.49
90434C' HUT DOG 13UN 2.49
90484i 01 D0( BUN 2.49
90484; HOT DO( 13UN 2.49
9048 l HO _r DO 13UN 2.49
904$4 HOT DO 1 BUN 2.49
904+34; H01 DO( �3UN 2.49
50bb HN BF 1= 4KS 10.99
!i05Ei HN BF f= 1VKS 10.99
505 HIV BF F f*S 10.99
11381 FRI:TOLI) 'OCT 10.97
505 1 HN BF FR1 a 10.99
505Ei+ HN BF FRI K'a 10.99
RESi"d...E TOTAL 110.27
NON RESPLF TOTAL .00
TO I AL. i[oftm
VF Wholesale 110.27
XXXXXXXXX;>tKx2984 SWIPED
Sept 0003;'.,:: Ref 41: 02 °127900
CO51 co I+ ho l E sa l e Resp AA
FID Y: 1029
APPROVED
AMOUNT: $110.27
034E 007 0000000806 0067
CHAR; E .00
TOTAL.. NUMBER OF I rEMS SOLD 17
CASHIER: IsGi :HELL.E REG# 7
&&olfK0'j 13:3 0346 07 0067 806
i I -f i 1 t�l 4{ Y CI lJ