178172 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC
CARMEL, INDIANA 46032 PO BOX 5219 HECK AMOUNT: $659.21
CAROL STREAM IL 60197 -5219
CHECK NUMBER: 178172
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIP
1046 4239039 PARKS 71.18 7003731100072984
1047 4239039 PARKS 409.15 7003731100072984
1125 4238900 PARKS 178.88 7003731100072984
t
22 4.5
425895 NC SANITIZER 96.58 A
SALES TAX EXEMPT .N
TOTAL i�� -A °L!
WE r- +rn Whn I o--A I a 145!04
I i
COSTCO
C Please Direct Inquiries To: 1- 800 220 -8594 casyco
W►OOB.ESALE
Acc Number New Balance aymenf Due Amount Past Due Uue Date
7043, 7311;0007 2$84 $b9& 6Z
QO:. $00 10/2112009,
Etllling Date Credif;Lme AvailabW:Credit
09/28/G009 $5 440 $4,104 33
rr
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
e
FINANCE :CHARGE SUMMARY
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
Description Number Balance Rate APR Periodic Rate RATE Due
Reg 00014 $57.79 0.00000% 00.00% $.00 00.00% $895.67 $.00 10/26/2009
ACCOUNT DETAIL
Ti'an$2tcti0p TransaCtlOn InvOiC+~:
Qate OescnptioR';; Number: ID„ Number
tinount
09/09/2009 COSTCO WHOLESALE -346 032163 00005 $145.04
09/18/2009 COSTCO WHOLESALE -346 045137 00005 $105.02
00005 SUBTOTAL: $250.06
08/28/2009 COSTCO WHOLESALE -347 068828 00009 $409.15
00009 SUBTOTAL: $409.15
09/1912009 COSTCO WHOLESALE -346 039309 00013 $236.46
00013 SUBTOTAL: $236.46
09/18/2009 PAYMENT THANK YOU 00001 $957.64
Online Account Access lets you take control of your Account anytime, anywhere. Registration is easy, secure and waiting for you at
www. hrscomme rcia 1. corn
ff ir ��1�
OCT 0 2009
I
1
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.
COSTCO
iA/tAOLESALE
ACCOUNT SUMMARY BALANCE SUMMARY
t
Ou t s anding
CURRENT 1 29 :DAYS PAST DUE:: 30 =59 DAYS: PAST Transaction $957.64
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $895.67
New Fees $.00
60 88 DAYS PAST:DU E. .90 119:DAYS Pi4ST DUB 120 149 DAYS PAST DUE:
Finance Charges .00
$.00 $.00 $.00 Payment(s) $957.64
1150 179 DAYS PAST DUE 180 +:;DAYS' PAST DUE>.. Credit(s) $.00
$.00 $.00 New Balance $895.67
s
Page 2 of 2
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4 3
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!
an Name
Email Address
Street Number
if an tan t Name or the words TO BOX' Unit or PO BOX Number
❑L_1S_1 ❑L_1LJ LJ ❑L_1
C' Si L_J Z
Business Phone
❑❑LJ-❑❑
i
i �rn�a rr�rtr rr r�nrxes�aa+�ra rr �s.w T
Costco Fund 1047 Fund 101 Fund 1046
eneral
Gen Prog Other program
supplies supplies supplies PO
V# 361108 Invoice 4239039 4238900 4239039
08/28/09 6882800 409.15 22436
09/09/09 3216300 145.04
09/18/09 4513700 33.84 71.18 105.02
409.15 178.88 71.18 659.21
Costco Fund 1047 Fund 101 Fund 1046
General
Gen Prog Other program
supplies supplies supplies
V#361108 Invoice 1 4239039 4238900 4239039
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)
361108 HSBC Business Solutions Terms
P.O. Box 5219 Date Due
Carol Stream, IL 60197 -5219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/26/09 7003731100072984 General Program supplies 409.15
9/26/09 7003731100072984 Other supplies 178.88
9/26/09 7003731100072984 General Program supplies 71.18
Total 659.21
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
(Costco)
361108 HSBC Business Solutions Allowed 20
P.O. Box 5219
Carol Stream, IL 60197 -5219
In Sum of
659.21
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
7 I mb T Z'g� f
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 7003731100072984 4239039 409.15 1 hereby certify that the attached invoice(s), or
1125 7003731100072984 4238900 178.88 bill(s) is (are) true and correct and that the
1046 7003731100072984 4239039 71.18 materials or services itemized thereon for
which charge is made were ordered and
received except
7 -Oct 2009
Signature
659.21 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund