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171157 04/16/2009
a CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCp j CHECK AMOUNT: $640.04 CARMEL, INDIANA 46032 Po sox 5219 4 0 CAROL STREAM IL 60197 -5219 CHECK NUMBER: 171157 CHECK DATE: 4/16/2009 DEPARTMENT ACCOUNT PO NUMBER INVOIC NUMBE AMOUNT DESCRIPTIO 1207 4238900 700373110007 640.04 7003 7311 0007 -4683 I I I COSTCO Please Direct Inquiries To: 1- 800 220 -8594 WIfOLESALE d+rcouni Number Nev,�; e' a?attmenf Due Amourl;'Past Rue Due Rate ?f103 73f 1 f?007 d.683 $640.40 $,QQ >t?0 04/2012009 BHling Ljate Credit Line Available >tyredit 6l20Q9 $1,OO 60: 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 FINANCEi.CHARGE SUMMARY Credit Credit Average Daily Corres- FINANCE ANNUAL New N6nimum Promo Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire Description Number Balance Rate APR Periodic Rate RATE Due Reg 00014 $45.74 0.00000% 00.00% $.00 00.00% $640.40 $.00 04!26/2009 ;m ACCOUNT DETAIL Trans8Ct0A 7rdnsBGtrpri.: InvpWC+� User P p.:: Transaction;:: Rate Descrtpttor Number IU Number Amount 03/17/2009 COSTCO WHOLESALE -346 036787 00001 $432.52 03/19/2009 COSTCO WHOLESALE -346 052676 00001 $207.88 00001 SUBTOTAL: $640.40 APR 0 3 ?,OG9 BX: 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 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. COSTCO s ACCOUNT SUMMARY BALANCE SUMMARY Outstanding CURRENT: 129 .DAYS PAST DUE_ 30: -59 DAYS PAST C3UE Transaction $.00 +New $.00 $.00 $.00 Purchase(s)/Debit(s) $640.40 New Fees $.00 .:6"9. DAYS PAST'DU1 90 11:9 DAYS: PAST D IE 120x:149 DAYS PAST:DUE Finance Charges $.00 $.00 $.00 $.00 Payment(s) $.00 :W470 QAYS PAST ©UE 180 +_DAYS -PAST OUIE Credh(s) $.00 $.00 $.00 New Balance $640.40 s Page 2 of 2 r f i M P P b N N 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.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! Companv H am ❑M❑❑ 1 1 Email Address Street Number if�an Street Name or the words "PO BOX" Unit or PO BOX Number IJLJ LJL_! LJ ULJ I C itV State zip ❑❑❑-I❑❑❑ 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 /0'!,ss Purchase Order No. .S2 9 Terms S1;Zf1;ZM ,L 6 G /9� �`�2/ y Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) U 7k'7 q a2. Sa 11?-1,V 7 Ss Total &ZI61 yD 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 �5�� Si�JF SS SG� IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Vl� Board Members DEP E AMOUNT I hereby certify that the attached invoice(s), or dj bill(s) is (are) true and correct and that the ,2 G 6 5 materials or services itemized thereon for which charge is made were ordered and received except i 20 Y Z)X l I i V�T Cost distribution ledger classification if Title claim paid motor vehicle highway fund CAM7CO -It 396 C:AS I 1_.1_ 1 0N I N MEMBER #1ii784913819 RESALE ON t 278107 MEGLITE 2FC 29.99 4 11 22975 FLOORING 57,96 786529 NSF SHELF 99.99 349661 8PK PONARY 9.9i 349661 8PK PRIMARY 9 y F7 RESALE TOTA 207 +i' NON' RESALE TOTAL 00 XhTAL VF Costco Who 1 eshil 207.88 XXXXXXXXXkXX4683 y rti ,,SWIPED SP9ti, 002915 ReF #c Costo'�JhQ1'e- FID Y: 36043 APPROVED I AMOUNT: $20 .88 0346 014 0000000077 0049 CHANGE .00 TOTAL NUMBER OF ITEMS !�S01.D 8 CASHIER: MARK L 6 REG4 i4 &fAl:f flfP' 12:09 0346 1 14 00 77 THONK YOI."1 I t pt-EfASE COME: AGf'l l to 1 r� C b s7co 1 -4-5-16 C OS IN MEMBER #111784913819 :87292 BK- PLAUGE SH 5.59 A BUS RENEWAL 100.00 vOID RESALE 387292 BK -PLAID SH 5.59 -A 122975 FLOORING 14.49. 122975 FLOORING 14.49 122975 FLOORING 14.49 122975 FL60RING 14.49 1 229 15 F 14.49. 617029 SWATERx 4.85. 61702 A 5 /.SWATER« 4.85 4580.�P LMOLIVE; 7.48 10351 OROX WI r 12.62 50787 KKS 13G DRO 9.99 1101�MCILKY WA 17.49 1101 H9 LKY WAY 17.49 31265 M LTI SPONbi 11.79 29087 M &M MIX 72C1 28.99 290879 M &M MIX 72CT 28.99 1;0379 K8 NUT CADDY a 79 1202 SNICKERS 118 1202 SNICKERS 18 160422 60PK TERRY 79 221 KLEENEX 1 .45 2, /its U�SUB FI BUB 05 RESALE TOTAL 332.52 NON_ RESALE_ TOTAL 100.00 TOTAL Kl'� VF CosiCO Wholesale 432.52 XXXXXXX.XXXXX4683 SWIPED Seq#: 002878 Ref 03678700 CGstr_o Wholesale ResP: AA FID Y: 33082 APPROVED AMOUNT: $432.52 0346 011 0000000075 0057 CHANGE .00 TOTAL NUMBER OF ITEMS SOLD W 22 CASHIER: JAMES I REG# 11 12:22 0396 11 005 75 "Ft IANK YOU! 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