177894 09/29/2009 l�
CITY OF CARMEL, INDIANA VENDOR: 00352108 Page 1 of 1
ONE CIVIC SQUARE WAL -MART COMMUNITY CHECK AMOUNT: $83.00
CARMEL, INDIANA 46032 PO BOX 530933
ATLANTA GA 30353 -0933
CHECK NUMBER: 177894
CHECK DATE: 9/29/2009
DEPARTMENT ACCOUN PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 83.00 6032202000135815
t(
ACCOUNT INFORMATION ;BALANCE.SUMMARY
Account Number: 6032 2020 0013 5815 Previous Balance $223.03
Statement Date 09/16/2009 Payments $223.03
Payment Due Date: 10/12/2009 +1- FINANCE CHARGE (net) $0.00
Days In Billing Period 31 New Purchases $83.00
Credit Line $1,000 Credits, Insurance, Fees Adjustments (net) $0.00
Available Credit $917 New Balance $83.00
Minimum Payment $83.00
TRANSACTION SUMMARY
Buyer# Date Invoice Number Description Amount
02 08/14 001746 EAST 151 STREET CARMEL IN $3.92
02 09/09 009475 EAST 151 STREET CARMEL IN $79.08
TOTAL FOR AUTHORIZED BUYER NO 02 $83.00
08/20 PAYMENT THANK YOU $223.03CR
LATE Ct#ARE E S1I<BAMAR.... a
Monthly Corresponding Portion of Balance Subject Late
Periodic Annual Balance Assessed to Late Charge
Rate Percentage This Rate Charge
Rate
0-000% 0.00% ENTIRE $0.00 $0.00
ANNUAL PERCENTAGE RATE 0.000%
CARDHOLDER NEWS INFORMATION
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to boost your bottom line.
QUESTIONS? CUSTOMER SERVICE: PAYMENTS:
Mail questions (not payment) and your account number to: For account information, call toll free: Send payments to:
Wal -Mart Wal -Mart Community
P.O. Box 981064 1- 877 294 -1086 P.O. Box 530934
El Paso, TX 79998 -1064 Unless your name is listed on this Atlanta, GA 30353 -0934
Please write to the Billing Errors and Questions address below statement, your access to information Notice: See below for Billing Errors and other
if you have a question about your bill. on the account may be limited. important information.
Purchases, returns, and payments made just prior to billing date may not appear until next month's statement. Unless promotions call for special terms,
additional finance charges can be avoided if we receive the new balance by 5:00 p.m. (ET) on the due date. We reserve the right to obtain payment
electronically for any check or other instrument that you send to us by initiating an ACH (electronic) debit in the amount of your check or instrument to your
account. Your check or instrument will not be returned to you by us or your bank. Your bank account may be debited as early as the same day we receive
your payment. You may choose not to have your payment collected electronically by sending your payment (with the payment stub), in your own envelope
not the enclosed window envelope addressed to: Wal -Mart Community, P.O. Box 960095 Orlando, FL 32896 -0095 and not the Payment Address,
Billing Errors and Questions: In case of Errors or Questions about your Bill: If you think your bill is wrong, or if you need more information about a transaction
on your bill, write to us on a separate sheet at P.O. Box 981401, El Paso, TX 79998 -1401 as soon as possible. In your letter give us the following information:
Your name and account The dollar amount of the suspected error Describe the error and explain, if you can, why you believe there is an error. If you
need more information, describe the item you are unsure about.
Information About Payments: You must pay at least the Total Minimum Credits To Your Account: An amount followed by a minus sign is a credit
Payment by 5:00 p.m. (ET) on the Payment Due Date shown on the or credit balance unless otherwise indicated. Credits will be applied to your
Statement You may pay more than the Total Minimum Payment at any previous balance immediately upon receipt, but will not satisfy any required
time. Any Payments received after 5:00 p.m. (ET) on any business day, or payment that may be due.
on any day other than a business day, will be credited on the next business Telephone Monitoring: To ensure that you receive accurate and courteous
day. We may also offer services in which you may pay your bill by telephone customer service, your telephone calls with us may be monitored by our
"Pay by Phone') or through the Internet. We may charge fees for these employees or agents and you agree to this monitoring.
services. Our customer service representatives are instructed to tell you
about any fees for Pay by Phone services and any fee for making an online Credit Reports and Account Information: If you believe that we have
payment will be disclosed to you online. Credit to your Account may be reported inaccurate information about you to a credit bureau, please contact
delayed up to five days if payment (a) is not received at the Payment us at P.O. Box 981400, El Paso, TX 79998 -1400. In doing so, please
Address, (b) is not made in U.S. dollars drawn on a U.S. financial institution identify the inaccurate information and tell us why you believe it is incorrect.
located in the U.S., (c) is not accompanied by the remittance coupon If you have a copy of the credit report that includes the inaccurate
attached to your statement, (d) contains more than one payment or information, please include a copy of that report. You are hereby notified
remittance coupon, (e) is not received in the remittance envelope provided that a negative credit report reflecting on your credit record may be
or (f) includes staples, paper clips, tape, a folded check, or correspondence submitted to a credit bureau if you fail to fulfill the terms of this Agreement.
of any type. Conditional Payments: All written communications concerning Bankruptcy Notice: If you file bankruptcy you must send us notice,
disputed amounts, including any check or other payment instrument that: (i) including account number and all information related to the proceeding to
indicates that the payment constitutes "payment in full" or is tendered as full the following address, GE Money Bank, Attn: Bankruptcy Dept., P.O. Box
satisfaction of a disputed amount; or (ii) is tendered with other conditions or 103104, Roswell, GA 30076.
limitations "Disputed Payments must be mailed or delivered to us at PO
Box 981401, El Paso, TX 79998 -1401.
mmol�.—
Wa0mart v o o 0002 0002
o D o- Community
CITY OF CARMEL STREET DEPT 13661
AUTHORIZED BUYER 02
ACCOUNT #:6032 2020 0013 5815 P.O.
INVOICE 001746 DATE OF SALE :081409 STORE 1601
TRANSACTION 1746 AUTHORIZATION: 014543 REGISTER 10
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
047307267 BD ALCOHOL SWABS 2.000 EA $1.9600 $3.92
SUB $3.92 TAX $0.00 TOTAL INVOICE $3.92
CREDITS TOTAL $0.00
BALANCE DUE $3.92
CITY OF CARMEL STREET DEPT 13661
AUTHORIZED BUYER 02
ACCOUNT #:6032 2020 0013 5815 P.O.
INVOICE 009475 DATE OF SALE :090909 STORE 1601
TRANSACTION 9475 AUTHORIZATION: 009744 REGISTER 6
S.K.U. DESCRIPTION QUANTITY UNIT PRIC EXT. PRICE
011868911 RESOLVE FOAM CPT CLN 3.000 EA $3.5000 $10.50
058367996 DAWN ULTR ORIGINAL 3.000 EA $5.2400 $15.72
060801768 REYNOLDS 37.5' FOIL 1.000 EA $3.1200 $3.12
060801771 REYNOLDS HD 75' FOIL 1.000 EA $4.6200 $4.62
064225209 6 ROLL DECO TOWEL 12.000 EA $3.7600 $45.12
SUB $79.08 TAX $0.00 TOTAL INVOICE $79.08
CREDITS TOTAL $0.00
BALANCE DUE $79.08
FEW
°a
This is an attempt to collect debt and any information obtained will be used for that purpose.
Credit Bureau Reporting: We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on
your account may be reflected in your credit report.
Please print change of address, phone number, and or email below.
Street
Address
F] City,
ST, ZIP
Phone
E -mail
Business Phone Cell phone or other phone E -mail address
we can use to contact you
QUESTIONS. CUSTOMER SERVICE: PAYMENTS.
Mail questions (not payment) and your account number to: For account information, call toll free: Send payments to:
Wal -Mart Wal -Mart Community
P.O. Box 981064 1- 877 294 -1086 P.O. Box 530934
El Paso, TX 79998 -1064 Unless your name is listed on this Atlanta, GA 30353 -0934
Please write to the Billing Errors and Questions address below statement, your access to information Notice: See below for Billing Errors and other
if you have a question about your bill. on the account may be limited. important information.
Purchases, returns, and payments made just prior to billing date may not appear until next month's statement. Unless promotions call for special terms,
additional finance charges can be avoided if we receive the new balance by 5:00 p.m. (ET) on the due date. We reserve the right to obtain payment
electronically for any check or other instrument that you send to us by initiating an ACH (electronic) debit in the amount of your check or instrument to your
account. Your check or instrument will not be returned to you by us or your bank. Your bank account may be debited as early as the same day we receive
your payment. You may choose not to have your payment collected electronically by sending your payment (with the payment stub), in your own envelope
not the enclosed window envelope addressed to: Wal -Mart Community, P.O. Box 960095 Orlando, FL 32896 -0095 and not the Payment Address.
Billing Errors and Questions: In case of Errors or Questions about your Bill: If you think your bill is wrong, or if you need more information about a transaction
on your bill, write to us on a separate sheet at P.O. Box 981401, El Paso, TX 79998 -1401 as soon as possible. In your letter give us the following information:
Your name and account The dollar amount of the suspected error Describe the error and explain, if you can, why you believe there is an error. If you
need more information, describe the item you are unsure about.
Information About Payments: You must pay at least the Total Minimum Credits To Your Account: An amount followed by a minus sign is a credit
Payment by 5:00 p.m. (ET) on the Payment Due Date shown on the or credit balance unless otherwise indicated. Credits will be applied to your
Statement You may pay more than the Total Minimum Payment at any previous balance immediately upon receipt, but will not satisfy any required
time. Any Payments received after 5:00 p.m. (ET) on any business day, or payment that may be due.
on any day other than a business day, will be credited on the next business Telephone Monitoring: To ensure that you receive accurate and courteous
day. We may also offer services in which you may pay your bill by telephone customer service, your telephone calls with us may be monitored by our
"Pay by Phone or through the Internet. We may charge fees for these employees or agents and you agree to this monitoring.
services. Our customer service representatives are instructed to tell you
about any fees for Pay by Phone services and any fee for making an online Credit Reports and Account Information: If you believe that we have
payment will be disclosed to you online. Credit to your Account may be reported inaccurate information about you to a credit bureau, please contact
delayed up to five days if payment (a) is not received at the Payment us at P.O. Box 981400, El Paso, TX 79998 -1400. In doing so, please
Address, (b) is not made in U.S. dollars drawn on a U.S. financial institution identify the inaccurate information and tell us why you believe it is incorrect.
located in the U.S., (c) is not accompanied by the remittance coupon If you have a copy of the credit report that includes the inaccurate
attached to your statement, (d) contains more than one payment or information, please include a copy of that report. You are hereby notified
remittance coupon, (e) is not received in the remittance envelope provided that a negative credit report reflecting on your credit record may be
or (f) includes staples, paper clips, tape, a folded check, or correspondence submitted to a credit bureau if you fail to fulfill the terms of this Agreement.
of any type. Conditional Payments: All written communications concerning Bankruptcy Notice: If you file bankruptcy you must send us notice,
disputed amounts, including any check or other payment instrument that: (i) including account number and all information related to the proceeding to
indicates that the payment constitutes "payment in full" or is tendered as full the following address, GE Money Bank, Attn: Bankruptcy Dept., P.O. Box
satisfaction of a disputed amount; or (ii) is tendered with other conditions or 103104, Roswell, GA 30076.
limitations "Disputed Payments'), must be mailed or delivered to us at PO
Box 981401, El Paso, TX 79998 -1401.
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/21/09 $83.00
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.
ALLOWED 20
Wal -Mart Community
IN SUM OF
P. O. Box 530933
Atlanta, GA 30353 -0933
$83.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
001;k �-ok()v�� g 11s
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
2201 42- 389.00 $83.00 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
/Thursday,,Septerr�rper 24, 2009
Street Commissioner
Mreel
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund