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212226 08/28/2012 \�f CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1 0 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC&ECK AMOUNT: $519.20 CARMEL, INDIANA 46032 PO BOX 5219 CAROL STREAM IL 60197-5219 CHECK NUMBER: 212226 CHECK DATE: 8/2812012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 PARKS 225 . 88 GENERAL PROGRAM SUPPL 1082 4239039 PARKS 47 . 92 GENERAL PROGRAM SUPPL 1095 4238000 PARKS 69. 99 SMALL TOOLS & MINOR E 1095 4239040 PARKS 175 . 41 FOOD & BEVERAGES I COSTCO — Please Direct Inquiries To: 1-800-220-8594 ® 1H/P�LESAL� . .. . Accougf;Number;: New:Balance Payment Due: :: Amount ft VD Due: ate 7003 73:1:1.0007:2984 $519 20 : $245:40:: $00 08/20/2012 .� ,.: .: . Blllfngpate Credit Lme Available Credit 07/ 6/2012 $5;000 $4,480 80 Mn TDD/Hearing Impaired: 1-800-365-0186 STATEMENT OF YOUR ACCOUNT FINANCEiCHARGE 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 $8.18 0.00000% 00.00% S.00 00.00% S245.40 S245.40 07/26/2012 Reg 00014 S18.25 0.00000% 00.00% S.00 00.00% S273.80 S.00 08/26/2012 ACCOUNT DETAIL Transaction Transaction Iriyoce User :PO :; Transaction ::; .. . bate Description Number ID: Number Amount;; 07/05/2012 COSTCO WHOLESALE-346 063136 00005 S47.92 07/11/2012 COSTCO WHOLESALE-346 033760 00005 5225.88 00005 SUBTOTAL: S273.80 06/26/2012 COSTCO WHOLESALE-346 061957 00013 5245.40 00013 SUBTOTAL: S245.40 07/20/2012 PAYMENT-THANK YOU 00001 S453.70- Who likes paper cuts? Electronic statements are here!Sign up now at www.hrscommercial.com Programmable thermostats save energy and cut costs by making it easy to set temperatures a few degrees cooler in winter and a few degrees warmer in summer. AUG 13 2012 =r 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. 9 COSTCO COSTCO ® ACCOUNT SUMMARY BALANCE SUMMARY ® u Stan rng _ CURRENT 1 39_DAYS PAST DUE :.:.::30-59 DAYS PAST DUE Transaction $453.70 +New $245.40 $.00 $.00 Purchase(s)/Debit(s) $519.20 60 89 DAYS PAST DUE, 90 1:19 DAYS:PAST DUE 120 149 DAYS PAST DUE +New Fees $.00 ,_ .._ ...._ _. _ +Finance Charges $.00 $.00 $.00 $.00 Payment(s) $453.70 150 179 DAYS PAST DUE 180 DAYS PAST DUE Credit(s) $.00 ® $.00 $.00 =New Balance $519.20 Page 2 of 2 1-11-1 n FIE n ❑ New address or phone number? Please check box and complete reverse side. 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. STMT222C(10/07) TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS AND NUMBERS ONLY! C an Name Email Address street Numb n[:]0E Street Name or the words"PO BOX" U r pp tN rN❑❑❑ IE]EID❑❑ ❑DaD❑❑E ooa0000a00000000ao Soo �000L Business Phone M=/=F1aF1000 V, 396• CASTL�ETON , IN 6110 EAST,r86TH STREET CASTLETON, IN 46250 MEMBERS #11f1'782210075 68794 HOAGIE ROLLS 1 .99 468744'N.OAGIE�ROLLS 1 .99 4687g�►_1 NGIEdROLLS 1 .99 468744 !HOFGTF/ROLLS 1 .99 367352 KS BEEF FRNK 9.99. E 367352 KS BEEF FRNK 9,.99 E 367352 KS BEEF FRNK -9.99 -E- 367352 KS BEEF .FRNK ; 9.99 TOTAL VF Costco Wholesa a .47.92 XXXXXXXXXXXX2984 SWIPED 07/05/12 13:38" . ' Seq#_ 003019'APP#:, 063136 Costco Wholesale_ Resp: ,AA .Tran ID#: 218719445000 Merchant ID 99034611 APPROVED - PURCHASE / AMOUNT: $47.92 1 ! 0346 011 0000000044 0019 CHANGE .00�' TOTAL NUMBER OF ITEMS SOLD - 8 CASHIER: JOE S REG#1.111 13:38 0346 11 0019 44 THANK YOU ! pj_EASE COME AGAIN!. I _ E �i �� , t � �� ° a do ' sib CASTL-ETON , TN ,E 6110 EAST 86TH STREET CASTLETON. IN 46250 E` MEMBER #111782210075 G RESALE bN y 4 @ 19.49 BOX 14P 77.96 758425 IRIS B ` 8 @ 18.49 147.92 no 332507 CLEARB, ,;y'3PK w •r4` ---- tttSRLt I UI tiL '''°-Z2�.68 •' - ` NON RESALE TOTAL .00 TOTAL ►�.-�:I:] VF Costco Wholesale 225.88 :. XXXXXXXXXXXX2984 ,r 07/11/12 12:24 .. Seq#: 000448 APP#: 033760 Costco Wholesale ResP: AA• Tran ID 219333766000 Merchant ID 99034611 APPROVED - PURCHASE AMOUNT: $225.88 0346 009 0000000090 0108 -------------------------------------- CHANGE .00 .;°<. TOTAL NUMBER OF ITEMS SOLD - 12 CASHIER: LEILAH R REG# 9 Jr/Af/i'*1V#' 12:24 0346 09 0108 90 THANK YOU ! PLEASE COME AGAIN ! , l i lay WO CbS7CO q3,46 CASTLF_TON , i-N 6110 EAST 86TH, STREET'*' CASTLETON,/IN" 46250 MEMBER f#1/01 87920 i 29 RESAL[ ON I " 650998 OSTERI .1 MWO 69.99 E 1160 SKITTLES 19.49 E 1160 SKITTLES 19.49 E 1160 SKITTLES 19.49 E 1160 SKITTLES 19.49 E 1160 SKITTLES 19.49 i E 1151 ISTARBURST 19.49 E 1151 ISTARBURST 19.49 E 1151 STARBURST 19.49 E 1151 STARBURST 19.49 RESALE TOTAL 245.40 NON RESALE TOTAL .00 TOTAL_ VF Costco _ _Wholesale 245.40 XXXXXXXXHXXx2984 SWIPED 06/26/12 13:43 Se9#: 001141 App#: 061957 Costco Wholesale Resp: AA Tran ID#: 217848610000 Merchant IO 99034611 APPROVED - PURCHASE AMOUNT: $245.40 0346 008 0000000021 071 -----------------�------ -- - -------- CHANGE✓�� .00 TOTAL_ NUMBER OF S L m 10 CASHIER: DAVID R. REG# 8 13:43 0346 08 0071 21 THANK YOU ! PLEASE COME AGAIN ! 1 "i �' �� e r.. Costco General General Small- program program Food & Tools & f: supplies supplies Beverage Minor Equ V# 110$ Ihvoice# 4239039 4239039 4239040 4238000 m 3---.i I 10814 1082-3 1095-1 1095-1 06/26/12 61957 $ 175.41 $ 69.99 $ 245.40 07/11/12 33760 $ 225.88 07/05/12 63136 $ 47.92 $ 225.88 $ 47.92 $ 175.41 $ 69.99 $ 519.20 Costco General General Small program program Food & Tools & supplies supplies Beverage Minor Equ V# 361108 Invoice# 4239039 42390391 4239040 4238000 1081-4 1082-3 1095-1 11095-1 xw 4 : COSTCO i ACCOUNT SUMMARY BALANCE SUMMARY Outstanding CU........ 1 39 DAYS PAST DUE::; 30.59 DAYS;:PAST DUE . Transaction $453.70 +New $245.40 $.00 $.00 Purchase(s)/Debit(s) $519.20 +New Fees $.00 60=89 DAYS PAST DUE 90 119:DAYS PAST DUE; 120 1!49:DA:YS PAST.DUE.. _ _. ......: . __...... _._ +Finance Charges $.00 $.00.... $.00 $.00 - Payment(s) $453.70 15U=1 T9 DAYS PAST DUE, DAYS PAST DUE::.:... Credits) $.00 $.00 $.00 =New Balance $519.20 Page 2 of 2 El El❑❑❑.❑1-1 aNew address or phone number?box and complete reverse Side. Please check i 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 Purchase Order No. (Costco) 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 $ 225.88 7/26/12 7003731100072984 General Program sup lies $ 47.92 7/26/12- 7003731100072984 General Program supplies $ 175.41 7/26/12 7003731100072984 Food & Beverage $ 69.99 7/26/12 7003731100072984 Small tools & Minor equipment Total $ 519.20 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 5-11-10-1.6 120 Clerk-Treasurer Voucher No. Warrant No. (Costco) 361108 HSBC Business Solutions Allowed 20 P.O. Box 17698 Baltimore, MD 21297-1698 In Sum of$ $ 519.20 ON ACCOUNT OF APPROPRIATION FOR 108 - ESE/ 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-4 7003731100072984 4239039 $ 225.88 1 hereby certify that the attached invoice(s), or 1082-3 7003731100072984 4239039 $ 47.92 Lill(s) is (are)true and correct and that the 1095-1 7003731100072984 4239040 $ 175.41 materials or services itemized thereon for 1095-1 7003731100072984 4238000 $ 69.99 which charge is made were ordered and received except 23-Aug 2012 Signature $ 519.20 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund