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167711 01/07/2009 CITY OF CARMEL, INDIANA VENDOR: 00352108 Page 1 of 1 ONE CIVIC SQUARE WAL -MART COMMUNITY CHECK AMOUNT: $95.76 CARMEL, INDIANA 46032 PO BOX 530933 ti«o� oo ATLANTA GA 30353 -0933 CHECK NUMBER: 167711 CHECK DATE: 1/7/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION 2201 4238900 STREET 95.76 6032202000135815 I ACCOUNT INFORMATION BALANCE'SUMMARY Account Number: 6032 2020 0013 5815 Previous Balance $189.33 Statement Date 12/16/2008 Payments $0.00 Payment Due Date 01/112009 FINANCE CHARGE (net) $0.00 Days In Billing Period 30 New Purchases $95.76 Credits, Insurance, Fees Adjustments (net) $0.00 New Balance $285.09 Minimum Payment $285.09 TRANSACTION .SUMMARY e yerA Date Invoice Number Description Amount Bu 05 12/02 006794 EAST 151 STREET CARMEL IN $13.90 05 12/02 000576 EAST 151 STREET CARMEL IN $81.86 TOTAL FOR AUTHORIZED BUYER NO 05 $95.76 A Y LATE..CFfARL3E SE1MM e 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':NEWSi INFORMATION YOUR ACCOUNT HAS 2 PAYMENTS DUE. PLEASE MAIL THE MINIMUM PAYMENT DUE TODAY. PLEASE DISREGARD IF PAYMENT HAS ALREADY BEEN MAILED. A Sam's Club Business Membership offers incredible savings on essential business items. We invite you to experience our Every Day Low Cost. Come and discover the kind of savings, convenience, services, and benefits our Business Members enjoy. Already a Sam's Club Business Member? Upgrade to a Business Plus Membership and enjoy more business solutions to boost your bottom line. n 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. Wa0mar� v0o 0002 0002 o Community CITY OF CARMEL STREET DEPT 32470 AUTHORIZED BUYER 05 ACCOUNT #6032 2020 0013 5815 P.O. INVOICE 006794 DATE OF SALE: 120208 STORE 1601 TRANSACTION 6794 AUTHORIZATION: 002562 REGISTER 91 S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE 059870225 1.5 ECONOMY VIEW 5.000 EA $2.7800 $13.90 SUB $13.90 TAX $0.00 TOTAL INVOICE $13.90 CREDITS TOTAL $0.00 BALANCE DUE $13.90 CITY OF CARMEL STREET DEPT 32470 AUTHORIZED BUYER 05 ACCOUNT #6032 2020 0013 5815 P.O. INVOICE 000576 DATE OF SALE: 120208 STORE 1601 TRANSACTION 576 AUTHORIZATION: 002344 REGISTER 12 S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE 059373861 BNTY 8R REG PALLET 2.000 EA $5.9900 $11.98 061236845 MC 10C THERMAL COFF 1.000 EA $69.8800 $69.88 SUB $81.86 TAX $0.00 TOTAL INVOICE $81.86 CREDITS TOTAL $0.00 BALANCE DUE $81.86 0 0 e e 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 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)) 12/30/08 $95.76 I 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 $95.76 ON ACCOUNT OF APPROPR TION FOR Carmel Street Department bc_-) G 2L i3 _5 9 l PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 42- 389.00 $95.76 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 0 7 'ednesday De c ber 31, 2008 r Street Commissider 1 itle Cost distribution ledger classification if claim paid motor vehicle highway fund