210873 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
0 a. ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC&ECK AMOUNT: $453.70
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197-5219 CHECK NUMBER: 210873
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 PARKS 78 . 32 7003-7311-0007-2984
1096 4239039 PARKS 375 . 38 7003-7311-0007-2984
COSTCO
Please Direct Inquiries To: 1-800-220-8594 �cosyco.
Account Number New Balance Payment Due Amount Past Due Due Date
7003-7311-0007-2984 $453.70 $.00 $.00 07/21/2012
Billing Date Credit Line Available Credit
°® 06/26/2012 $5,000 $4,546.30
TDD/Hearing Impaired: 1-800-365-0186
® IMPORTANT ANNOUNCEMENT: Effective October 1,2012 we will no longer accept credit card payments at HSBC Bank Branches.We
® apologize for any inconvenience this may cause you. Please make your payments using any of these three easy methods: by mail, by
phone,or online.The correct mailing address, phone number, and Web address for your account are listed on the front of this billing
® statement. For more information about making a payment, please review the instructions located on the back of this statement.Thank
youl
® 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 $31.67 0.00000% 00.00% S.00 00.00% S453.70 S.00 07/26/2012
ACCOUNT DETAIL
Transaction Transaction Invoice User P.O. Transaction
Date Description Number ID Number Amount
06/13/2012 COSTCO WHOLESALE-346 038273 00005 $78.32
00005 SUBTOTAL: $78.32
06/01/2012 COSTCO WHOLESALE-346 050997 00014 5253.15
06/01/2012 COSTCO WHOLESALE-346 051513 00014 5107.55
06/01/2012 COSTCO WHOLESALE-346 051657 00014 517.11
06/01/2012 COSTCO WHOLESALE-346 052545 00014 534.68
00014 SUBTOTAL: 5412.49
06/01/2012 RETURNED MERCHANDISE 00014 $37.11-
06/22/2012 PAYMENT-THANK YOU 00001 S897.38-
Secure Registration at.www.hrscommercial.com Enroll in paperless statements,track spending, pay your bill and update personal
information online with Account Access.
TFD
JUL 0 3 2012
Return the below portion with payment.For billing errors or questions please refer to the back of the statement. Page 1 of 2
I
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.
cosyco
COSTCO
�/aq'Q®ICE
® An ENERGY STAR CFL uses about 75% less energy than standard incandescent bulbs and lasts up to 10 times longer. To learn more,visit
® www.energystar.gov
ACCOUNT SUMMARY BALANCE SUMMARY
® Outstanding
CURRENT 1-29 DAYS PAST DUE 30-59 DAYS PAST DUE Transaction $897.38
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $490.81
® 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) $897.38
150-179 DAYS PAST DUE 180+DAYS PAST DUE Credit(s) $37.11
$.00 $.00 =New Balance $453.70
Page 2 of 2
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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!
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Email Address
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Street Number if an ❑❑ Street Name or the words TO BOX"❑❑❑❑❑ Unit or PO BOX Number
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Costco _ Fund 108 Fund 109
— j– iGeneral
1program Gen Prog Gen Prog
supplies supplies supplies i
V#361108 Invoice# 4239039_4239039_ 4239039
1082-3 1096-41
06/01/121 51657 $ 17.11 _
06/01/12 ___52545 g 15. $ 18.69 $ 34. �—
06/01/12 credit $_ (17.1111) $ (20.00) $ (37.1111)
06/01/12 51513 $ 107.55
06/01/12 509971 $ 253.15
06/13/12 382731 $ 78.32
_ $ 78.32 15.99 $ 359.39 $ 453.70
Costco Fund 108 Fund 109
General
program Gen Prog Gen Prog —T
supplies supplies supplies
V#361108 Invoice# 4239039 4239039 4239039
} 1082-3 1096-41 jl 096-60
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 17698 Date Due.
Baltimore, MD 21297-1698
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
6/26/12 7003731100072984 General Program supplies $ 78.32
6/26;12 70037'31100072984 General Program supplies $ 15.99
6/26112 7003731100072984 General Program supplies $ 359.39
Total $ 453.70
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
I
Voucher No. Warrant No. I
(Costco)
361108 HSBC Business Solutions Allowed 20
P.O. Box 17698
Baltimore, MD 21297-1698
In Sum of$
$ 453.70
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE 1109 - Monon Center
-69 6htUL-'X— -
'–a
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-3 7003731100072984 4239039 $ 78.32 i hereby certify that the attached invoice(s), or
1096-41 7003731100072984 4239039 $ 15.99 biil(s) is(are)true and correct and that the
1096-60 7003731100072984 4239039 $ 359.39 materials or services itemized thereon for
which charge is made were ordered and
received except
12-Jul 2012
P Zld/dm-uno, _
Signature
$ 453.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund