215329 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1
0 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC
s t CARMEL, INDIANA 46032 PO BOX 17698 HECK AMOUNT: $164.30
o� BALTIMORE MD 21297-1698 CHECK NUMBER: 215329
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 PARKS 164 .30 7003-7311-0007-2984
Please Direct Inquiries To: 1-800-220-8594 ccsrcol COSTCO
Account A* 6 . ...... ......
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[7003-7311-0007-2984 Due Date
$164.30 1,1.: :::�:::11212111201:21:.�..
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Available Cr*djU.........:..:.:...
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11/26/2012
. . . ... ............
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TDD/Hearing Impaired: 1-800-365-0186
STATEMENT OF YOUR ACCOUNT
.......... ........ ......
........... ......
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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 $10.60 0.00000% 00.00% $.00 00.00% $164.30 $.00 12/26/2012
ACCOUNT DETAIL
7
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Date ..........
................. du t
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11/02/2012 COSTCO WHOLESALE-346 052222 00016 $164.30
00016 SUBTOTAL: $164.30
10/27/2012 PAYMENT-THANK YOU 00001 $202.45-
11/07/2012 LATE FEE CREDIT ADJUSTMENT 00001 $3.04-
11/24/2012 PAYMENT-THANK YOU 00001 $132.81-
Even small changes can make a big difference Using reusable containers, printing only when necessary and paying bills online reduce
waste to landfills and the number of trees used for consumer products,
DEC:C
8 2012
Return the below portion with payment.For billing errors-or questions, I f 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 PO.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.
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COSTCO
11VHMESUE
ACCOUNT SUMMARY BALANCE SUMMARY
....
Outstanding
f
's ` I "DAYS:PAST_DUE::: 3& :DAYS:PAST:DUEr:>
Transaction $338.30 RRT
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $164.30
... ...
New Fees 0
GSt-99 DAYS PAST::pEJE: A.1tS:A DA
ST DUE: :120149' YS:PAST DU€ +
+Finance Charges .00
$.00 $.00 $.00
- Payment(s) $335.26
1501?9:C3A1fS Pl1ST CfUE: 1904 DAYS:PAST nUE;::`: Credit(s) $3.04
o $.00 $.00 =New Balance $164.30
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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.
22CAP720290(10/12)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS
AND NUMBERS ONLY!
C an Name
Email Address
Street Numb it an v) Street Name or the words TO BOX" Unit or PO BOX Number
1-1❑111:1 ❑ ❑❑❑❑❑❑
nc t State
f-][:][:][-]F-1[11:11:11:]ElF-IEIEIEIEII:11:11:1
Business Phone
❑❑❑ ❑❑❑—EI❑❑❑
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 H S B C 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
11/26/12 7003731100072984 General program supplies $ 164.30
LLI
Total $ 164.30
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 H S B C Business Solutions Allowed 20
P.O. Box 17698
Baltimore, MD 21297-1698
In Sum of$
$ 164.30
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
�dui-- -7-3 1 I- obn - )lrls y
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-60 7003731100072984 4239039 $ 164.30 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
6-Dec 2012
Signature
$ 164.30 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund