217982 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 367001 Page 1 of 1
ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL
CARMEL, INDIANA 46032 PO BOX 5219 CHECK AMOUNT: $563.34
CAROL STREAM IL 60197-5219 CHECK NUMBER: 217982
CHECK DATE: 3/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 563 . 34 7003731100072984
Please Direct Inquiries To: 1-800-220-8594 COSTCO
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Account Number New Balance Payment Due Arnount.Past Due Due Date
7DO3-7311-0007-2984 -$563.34 $.00 $00 A3/23/2013 "
.
Billing:Date Credit Line` Available Credit
02126!2013 = $5,000 $4,436.66:
TDD/Hearing Impaired: 1-800-365-0186
STATEMENT OF YOUR ACCOUNT
0
0
FINANCE:CHARGE SUMMARY
0
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
Q
Description Number Balance Rate APR Periodic Rate RATE Due
o
4 °o Reg 00014 $36.34 0.00000 °00.00!0
$.00 00.00% $563.34 $.00 03/26/2013
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ACCOUNT DETAIL
° trainSactiOn
TrdnSaction Invoice User '>P:0- Transaction
M
c Date Descrlpiion Number ID Number Amount
02/06/2013 COSTCO WHOLESALE-346 042534 00005 $482.20
00005 SUBTOTAL: $482.20
02/18/2013 COSTCO WHOLESALE-346 072641 00006 $81.14
00006 SUBTOTAL: $81.14
02/15/2013 PAYMENT-THANK YOU 00001 $285.08-
® Avoid being a victim of identity theft.Manage your account online.Sign Up at www.hrscommercial.com
LMAR p 4 2013
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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
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Important Notice:Promptly review this statement and notify Capital One Commercial in writing of any errors or unauthorized
purchases.If you do not notify Capital One Commercial within 60 days of errors or unauthorized purchases,this statement
will be presumed to be correct.
Write to Capital One Commercial at P.O.Box 4160,Carol Stream, IL 60197-4160.
You may telephone Capital One Commercial at 1-800-210-8115,but it will not preserve your rights.
Notify Capital One Commercial in writing of the cancellation of a credit card or authorized user.
COSYCO. COSTCO
WadOILESALE
ACCOUNT SUMMARY BALANCE SUMMARY
.... . ..:. . OuIrt.nding CURR... 14§bAYS.0AST DUE DAYgPAST;:DUE: :: Transaction
$285.08
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $563.34
19::DAYS:PAST.DUE: 1�0. +New Fees $.00
.89:DAYS PAST:DUE.: -149..DAYSPAST DUE
....... -- . . . ... +Finance Charges $.00
$.00 $.00 $.00 Payment(s) $285.08
150w**79***D A*YS:.:P A-St"DbE M4:.DAYSPAST-7DUE
..... . -- .—... .... ......... .... .. .. Credit(s) $.00
. ...........--........ .. ....
0
0 $.00 $.00 =New Balance $563.34
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Rage 2 of 2
- - - - - - - - - - - -
Important Notice:Promptly review this statement and notify Capital One Commercial in writing of any errors or unauthorized
purchases.If you do not notify Capital One Commercial within 60 days of errors or unauthorized purchases,this statement
will be presumed to be correct.
Write to Capital One Commercial at P.O.Box 4160,Carol Stream, IL 60197-4160.
You may telephone Capital One Commercial at 1-800-210-8115,but it will not preserve your rights.
Notify Capital One Commercial in writing of the cancellation of a credit card or authorized user.
22CAP720298(02/13)
TO ENSURE ACCURACY, PLEASE PRINT NEATLY USING UPPER-CASE LETTERS
AND NUMBERS ONLY!
E—a, Acc°ss _
Sri _ 'a _ Street Name o,!he v°ords"PO BOX Unt c'°0 DOX n'- _
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Costco Fund 108
GeneralGeneral General
program program program
supplies supplies supplies
V#361108 Invoice# 42390391 4239039 4239039
1081-3 X1081-8
02/06/13 42534 $ 427.37 _ $ 54.83 $ 482.20
02/18/13_ 72641 $ 81.14
$ 427.37 $ 81.14 $ 54.83 $ 563.34
Costco Fund 108
General General General -
program program program
supplies supplies supplies
V#361108 Invoice# 4239039 4239039 4239039
1 �1081-3 �1081-8 1081-11
I
t
I
i
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
(Costco) Purchase Order No.
Capital One Commercial Terms
P.O. Box 5219 Date Due
Carol Stream, IL 60197-5219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
-
2126113 —.7003731,1 D0072984_General.program supplies $ 427.37
2/26/13 7003731100072984 General program supplies $ 81.14
2/26/13 7003731100072984 General program supplies $ 54.83
Total $ 563.34
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)
Capital One Commercial .Allowed 20
P.O. Box 5219
Carol Stream, IL 60197-5219
*new name & address In Sum of$
563.34
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-3 7003731100072984 4239039 $ 427.37 1 hereby certify that the attached invoice(s), or
1081-8 7003731100072984 4239039 $ 81.14 bill(s) is (are)true and correct and that the
1081-11 7003731100072984 4239039 $ 54.83 materials or services itemized thereon for
which charge is made were ordered and
received except
7-Mar 2013
1!9, ,JCA 1/0)q -
Signature
$ 563.34 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund