168009 01/21/2009 i
a CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCp
i CHECK AMOUNT: $495.33
CARMEL, INDIANA 46032 Po BOX 5219
CAROL STREAM IL 60197 -5219 CHECK NUMBER: 168009
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 700373110007 20.31 7003731100072984
1047 4239039 700373110007 131.48 7003731100072984
1125 4341993 700373110007 343.54 7003731100072984
C067CO
U3-g6 CAS`I IN
MEMBER 11782210075
17574 CAP SUN 6.89 A
17574 CAP SUN 6.89 A
349529 GO FISH 58Z 6.53
SALES T. EXEMPTION
TOTAL �fwtm
VF Costco iolesale 20.31
XXXX 003383 01698300
Re
XXXXXXXXXXX29 SWIPED
Costco Wholesale' esP: AA
FID Y 14097
APPROVED
AMOUNT: $20.31
0346 012.0000000070 0021
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD 3
CASHIER: HEATHER S REG# 12
10:17 0346 12 0021 70
THANK YOU!
PLEASE COME AGAIN!
s
t
:4I .5'q 6, C: I 1 I_ i._ I to h!
'IhSeason5 Greetings H;ypPy Ho l i daus"
MEMBER 41117850981.97
A
RESALE ON
6 @9.10_
578 *DIET PEPSI* 54.60
6 8.97
87 **SPR'(TE 53.82
7 9.10
4 9.99577 xPEPSI COLA)_ 63.70
27735 KS RED CUPS;, 39.96
4 9.69
21 ?025 PAPER PLATtS 38.76
'127489 SOLO SPO0 8.9t3
127489 SOLO SPW 8.9°
127509 SOLO FORK" 6.99
127509 SOLO FORK_ 8.99
127279 SOLO KNIV j 8.X39
127279 SOLO KNIVE,: 6 .89
22751 556 I Rf�SI iL' 1G' 1 .19
58601 KS NAPKIN f' c,
58601�KS NAPKIN 8.9y
RESALE TOTAL 343.54
NON RESALE TOTAL .00
TOTAL M --to
VF Cos tco Who l esa 1 e 343.54
XXXXXXnXXXXX296q SWIPI_D
Sev#:: 0003 038202u0
i co 04265 sale ResP RA
APNOVE17
(1M�UN s y43 51
0316 1 00641)() ()u43 0 141.
CHANGE Cr
37
r
i
c
LE
#317 NW INOlANAPOLIS
xxSeasons Greetings Happy Holidays xx
MEMBER #111785098197
RESALE ON
7 6.49
34423 COOKIES 24CT 45.43
2 6.49
37220 CHOC CHUNK 12.98
5623 BROCCOLI 4.59
309881 RUFFLES 28OZ 4.99
5623 BROCCOLI/ 4.59
3 4.99
172246 PELED CAROTS 14.97
'VOID 172246 P/ 'ROTS 4.99
172246 PAROTS 4.99
RESALE 87.55
NON RESALE .00
TOTAL d$��74
VF Costco ale 87.55
XXXXXXXXXXXX29 SWIPED
Se9 003773 R3036000
Costco Wholesale Resp: AA
FID Y: 16827
APPROVED
AMOUNT: $87.55
0347 011 0000000024 0029
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD 15
CASHIER: Mary Kay C REG# 11
iP -fA Z/ f1#l-: 12:26 0347 11 0029 24
Thank You!
Please Come Again!
I
cb sTco
AAMLAL~
ILE
m %Seasons Greetings Happy Holidays)()(
MEMBER #111785098197
RESALE ON
14845 120Z CUPS 7.49
265999 FORM PLATE 8.99
309881 RUFFLES 28 Z 4.99
309881 RUFFLES 28 Z 4.99
14845 120Z CUPS 7.49
933402 NACHO DO TO 4.99
933402 NACHO D ITO 4.99
RESALE TOT 43.93
NON RESALE TOTAL .00
TOTAL 'M(IN
VF Costco Wholesale 43.93
XXXXXXXXXXXX2984 SWIPED
Se9 000657 Ref 03781900
Costco Wholesale ResP: AA
FID Y: 41154
APPROVED
AMOUNT: $43.93
0346 009 0000000008 0152
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD 7
CASHIER: ANDREW M REG# 9
14:13 0346 09 0152 8
THFl iNK YOU!
PLEASE COME_ AGAlN!
Please Direct Inquirids To: 1 -800- 220 -8594 coswo
COSTCO
ccotant;Number? New;6alance Paylneit [7ue Amount Past t3ue Due Date
7003 731 000 $558 68 $2;:3 00, 01/2072009
EIillfng Date Credit Llne Available Credit
12126t2�08 $5;000 $4 441 32
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
FINAN.CE CHARGE. $t1MMARY
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 0.00000% 00.00% S.00 00.00% $20.31 $20.31 12/26/2008
Reg 00014 $35.89 0.00000% 00.00% $.00 00.00% $538.37 $.00 01/26/2009
ACCOUNT DETAIL
Transaction. Transaction IriV9iCS User P.O:: Transaction
Date Descrrpttor Num er ID .:Number Amount
0
12/03/2008 COSTCO WHOLESALE -346 037819 00009 $43.93 0
12/09/2008 COSTCO WHOLESALE -346 038202 00009 $343.54 n
12/1212008 COSTCO WHOLESALE -347 030360 00009 $87.55 a
00009 SUBTOTAL: $475.02 0
12/03/2008 COSTCO WHOLESALE -346 019433 00013 $63.35 0
00013 SUBTOTAL: $63.35
12/04/2008 PAYMENT THANK YOU 00001 $779.90-
12/12/2008 PAYMENT THANK YOU 00001 $86.04- o
o
N
✓4
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.
cosmol COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
O utstandin g
CURRENT 1 29:DAYS PAST DU:E 30 *59 DAYS PAST(:DUE Transaction $886.25
+New
$20.31 $.00 $.00 Purchase(s)/Debit(s) $538.37
60 as DAY$ FA. $T.DUE W 119 DAYS :PA$T DUE 120 =14� D
Finance Charges $.00
$.00 $.00 $.00 Payment(s) $865.94
150 175MAYS PAST`DUE 180f DAYS`PAST DUF- Credits) $.00
$.00 $.00 New Balance $558.68 v
n
N
Page 2 of 2
Neva' address .ir piu one iT•�hrr
J Please r.her:: a r,' c. ....,'e e• s� ,e
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!
ComCom a� ❑❑MI-1
Email Address
Street Number if an Street Name or the words TO BOX" Unit or PO BOX Number
0 11 11 1 E] 11 11 11 1 il 11 11 1
Ci State M Z
L "MCIE10 -0000
Costco Fund 1047 Fund 101
Club
Gen Prog Catering Activity
supplies Service Supplies
V# 361108 Invoice 4239039 4341993 4239037
12/03/08 657 43.93
12/12/08 3773 87.55
12/09/08 351 343.54
11/21/08 3383 20.31
131.48 343.54 20.31 495.33
Costco Fund 1047 Fund 101 Fund 1046
Club
Gen Prog Catering Activity
supplies Service Supplies
V# 361108 Invoice 4239039 4341993 4239037
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
(Costco) Purchase Order No.
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)) Amount
12/26/08 7003731100072984 General Program supplies 131.48
12/26/08 7003731100072984 Catering service 343.54
12/26/08 7003731100072984 Club activity supplies 20.31
Total 495.33
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
495.33
ON ACCOUNT OF APPROPRIATION FOR
101 General 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047. 7003731100072984 4239039 131.48 1 hereby certify that the attached invoice(s), or
1125 7003731100072984 4341993 343.54 bill(s) is (are) true and correct and that the
1046 7003731100072984 4239037 20.31 materials or services itemized thereon for
which charge is made were ordered and
received except
12 -Jan 2009
�A�2P /y(XX /i✓
i
Signature
495.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund