207888 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTCp
CARMEL, INDIANA 46032 CHECK AMOUNT: $46.54
Po eox szls
uh `o CAROL STREAM IL 60197 -5219 CHECK NUMBER: 207888
CHECK DATE: 4110/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 31.55 7003 -7311- 0007 -4683
1207 4239099 14.99 7003 -7311- 0007 -4683
cbs
VVNM is
83 COSTLETON, IN
6110 EAST 86TH STREET
CASTLETON, AN 46250
MEMBER #1
RESALE.-ON
416502 T =SHIRT BAG 14.99
RESALE TOTAL 14.99
NON RESALE T T .00
TOTAL LWA
VF Costco W lesale 14.99
-4A
XXXXXXXXXXXX168 SWIPED
03/16/12 12:13jQj
Sev 002660 APP 048411
Costco Wholesa4� ResP: AA
Tran ID 207646009000
Merchant ID 99034611
APPROVED,- PURCHASE
AMOUNTa: $14.99
0346 012;0000000079 0116
CHANGE .00
ry
TOTAL NUMBER OF TEMS SOLD 1
CASHIER: ANDREW B. REG# 12
Wfi[1/►AK, 12:13 0346 12 0116 79
TI 1ANK IYOU!
PI-Er--iSE COME AGAIN
i
uf �c
#397 NW INDIANAPOLIS
9010 MI/50CT
INDIANAPO
MEMBER
E 904849 HOT .D.69
E 904849 HOT D.69'''
'E 904849 HOT D2.69
E 5497 BAKED 1.59
E 188138'FRITO 1.89
TOTAL _M��
VF Costco Wholesale 31.55
03/07/12X16:5583 SWIPED
Se9 001365 APP 013476
Costco Wholesale r ResP: AA
Tran ID 206735451000
Merchant ID 99034711
APPROVED PURCHASE
AMOUNT: $31.55
0347 007 0000000116'0179
CHANGE .00
TOTAL NUMBER'OF ITEMS SOLD 5
CASHIER: MELISSA M REG# 7'
19fifY61011: 16:55 0347 07 0179 116
Thank You!
Please Come Again!
Please Direct Inquiries To: 1- 800 220 -8594
C YC® C 7STC J
WHOLESALE
Account Number New Balance Payment Due Amount Past Due Due Date
7003- 7311- 0007 -4683 $46.54 $.00 $.00 04/20/2012
Billing Date Credit Line Available Credit
03/26/2012 $2,000 $1,953.46
TDD /Hearing Impaired: 1- 800 365 -0166
STATEMENT OF YOUR ACCOUNT
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 $3.21 0.00000% 00.00% S.00 00.00% S46.54 5.00 04/26/2012
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
03107/2012 COSTCO WHOLESALE -347 013476 00003 S31.55
03/16/2012 COSTCO WHOLESALE -346 048411 00003 $14.99
00003 SUBTOTAL: S46.54
Manage your account anytime! Enroll in paperless statements pay your bills online. Secure registration at www.hrscommercial.com
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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
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
cyc®
WNOLESAIE
ACCOUNT SUMMARY
BALANCE SUMMARY
CURRENT 1 -29 DAYS PAST DUE 30 -59 DAYS PAST DUE Outstanding
e Transaction $.00
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $46.54
60 -89 DAYS PAST DUE 90 -119 DAYS PAST DUE 120 -149 DAYS PAST DUE New Fees $.00
Finance Charges $.00
$.00 $.00 $.00
Payment(s) $.00
150 -179 DAYS PAST DUE 180+ DAYS PAST DUE Credit(s) $.00
$.00 $.00 New Balance $46.54
C
Page 2 of 2
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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
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!
C Name
Email Address
Street Number d an Street Name or the words TO BOX" Unit or PO BOX Number
Business Phone
❑❑C
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))
03/07/12 )03- 7311 0007 -46 Food $31.55
03/16/12 048411 Bags $14.99
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
HSBC Business Solutions
IN SUM OF
P.O. Box 5219
Carol Stream, IL 60197 -5219
$46.54
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 1 7003 7311 0007 42- 390.40 I $31.55 1 hereby certify that the attached invoice(s), or
AAAl
1207 048411 I 9Q� $14.99
I 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, April 05, 2012
Director, Broo hire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund