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Home My WebLink About217163 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 361108 Page 1 of 1 �. ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS COSTC CARMEL, INDIANA 46032 PO BOX 17698 ( HECK AMOUNT: $285.08 BALTIMORE MD 21297-1698 CHECK NUMBER: 217163 CHECK DATE: 2/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 285 . 08 7003731100072984 Please Direct Inquiries To: 1-800-220-8594 C057co. COSTCO .... . Acctsunt Nurntier New F3alance (i Payment Due.;{ Amoun#F'astpue Que Date 7443 731,1 0007 49$4 $285 Q8 < $:pQ $.OQ 42/24!2413 BiAtr►g Date Credit I�tne Available Credit 41/2672Q13 $5,040 $4,7f4.92 TDD/Hearing Impaired: 1-800-365-0186 STATEMENT OF YOUR ACCOUNT o FINANCE CHARGE SUMMART► u Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo C Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire Description Number Balance Rate APR Periodic Rate RATE Due 0° Reg 00014 $18.39 0.00000% 00.00% $.00 00.00% $285.08 $.00 02/26/2013 0 0 0 ACCOUNT DETAIL ° TFa11SaiGfton TraasA6W.r.t InYofCe W.6.0 P Q Trafi tton Date t?escrtptitin Number ID Number `Amount . 01/17/2013 COSTCO WHOLESALE-346 002164 00016 $194.01 00016 SUBTOTAL: $194.01 01/09/2013 COSTCO WHOLESALE-346 072028 00017 $91.07 00017 SUBTOTAL: $91.07 New Year, New You!Manage your account online and take control. Enroll today www.hrscommercial.com Y/ FD FEB 4 2013 Return the below portion with payment.For billing errors or questions please refer to the back of the statement. Page 1 of 2 22CAP720290(10/12) TO ENSURE ACCURACY, PLEASE PRINT NEATLY ONLYSING UBPER-CASE LETTERS AND NUMBERS Com an Name ❑❑❑❑❑0❑❑❑❑❑❑M Eess ❑❑❑❑❑❑❑❑❑❑❑❑❑❑II❑ ❑❑❑Ea U Street Number if an Street Name❑e❑❑❑❑❑❑❑❑ ❑❑��❑❑❑ ❑❑ State Z' ❑ EEiE]OEIEIEIEIEIEIEIEIEIE]EIE]EIEI Business Phone m m 0 a 0 0 O O O N O O a m v C) 0 0 0 0 80,993 80uvlag MON= 00$ 00$ o 00'$ (s)8paj0 nE]1SVcl:SJIVQ.±Q81 . 3W.iSVd 5)lVQ ........................................................................................................................................................................... 00'$ (s)luaw,(ad 00+$ 00'$ 00,$ 00$ s86js40 aoueuid+ 00$ saaj MON+ n©1Sdd sAva 6t+1 ou 3na lsy.as�lva al O6 3nd:iv.a skv.a 69-09;:;:: 80 483 (9)i!ga0/(9)9sayojnd 00'$ 00,$ 004 MaN+ sv.0o uooesueil ..... 6uipuas1np V 4 ... .':..:: AuvwwnS 30NVIV8 Auvwwns 1Nn000v 001SOO ®�:, #346 CASTLETON , IN 6110 EAST 86TH STREET CASTLETON, IN 46250 MEMBER #111816719041 EESALE 754450 GROVEST. OZ E 754450 GROVEST. O 5.65 E 106913 SKIM MILK 5.65 6456 ORVILLE M 2'59 E 698223 NUTRIGRNV y T 10.99 E 37220 CHOC CHUN 11 '25 E 87 **SPRITE*' 6.99 E 18600 CLEMENTIN S 7.99 E 18600 CLEMENTIN S 5'99 84 *COCA-COL 5'99 E 309881 RUFFLES 2 Z 7'99 E 309881 RUFFLES 28 5.29 A 16009 FRSH FRUIT 5'29 E 16009 FRSH FRUIT 11 .99 1 E 16009 FRSH FRUIT 11 '99 E 16009 FRSH FRUIT 11 '99 ! Purchase n_ _ E `32858 SLICED APP E 11 .99 ) Description �( E 31952 APPLE JUIC 8.99 3 P.O.#T�-_ 35 E '36763 PULL APART 4.99 3 P or EE 36763 PULL APART\ 4.gg G. # D�ICo D ��3 9039 36763 PULL APART 4.99 Budget 36763 PULL APART LineDescr 11PS4) � S►�PPv-t* E 955407 BROWNIE BITE 6.99 �• E 541338 PRETZELCRISP Purchaser I Date!`q_� 3 E 30669 BANANAS 5'69 ---- Approval E 30669 BANANAS 1 .39 I Date(/_ / 18695 CHINET LUNCH 1 .39 T[ON 13.99 RESALE TOTAL !44.00 NON RESALE TOTAL VF TOTAL movj1101m -- Costco Wholesale 194.61 XXXXXXXXXXXX2984 --- 01/17/13 14:48 SWIPED ----- Seq#: 003931 App#: 002164 Costco Wholesale Resp: AA ,00 Tran ID#: 301726441000 Merchant ID 99034611 � 11 APPROVED - PURCHASE AMOUNT: $194.01 -0346 008 0000000067 0093 -------- CHANGE .00 TOTAL NUMBER OF ITEMS SOLD - frit/i_119I14:48 0346 08 0093R67# 8 THANK YOU ! PLEASE COME AGAIN ! Gen Prog Gen Prog supplies supplies -----,— 3 1108 _I Invoic__ e# — 4239039 4239039 — 1/09/13 l 72028 1096-60 1096-70 p j/17/13 2164 $ 91.07 �---- -- $ 194.01 -----_�—_ �_ $ 194.01 $ 91.07 $ 285.08 II 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 1/26/13 7003731100072984 General program supplies $ 194.01 1/26/13 7003731100072984 General program supplies $ 91.07 Total $ 285.08 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. (Costco) 361108 H S B C Business Solutions Allowed 20 P.O. Box 17698 Baltimore, MD 21297-1698 In Sum of$ $ 285.08 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-60 7003731100072984 4239039 $ 194.01 1 hereby certify that the attached invoice(s), or 1096-70 7003731100072984 4239039 $ 91.07 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 7-Feb 2013 Signature $ 285.08 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund