221913 07/17/2013 CITY OF CARMEL, INDIANA VENDOR: 367001 Page 1 of 1
ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL
CARMEL, INDIANA 46032 PO Box 5216 CHECK AMOUNT: $208.23
CAROL STREAM IL 60197-5219
CHECK NUMBER: 221913
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 208 . 23 7003-7311-0007-2984
Please Direct Inquiries To:1-800-220-8594 CAMM0 MWHOLILLE 1 COSTCO
ESA
....... ..... . ........ ........- - .
A ount Number New.$jlance Payment:Due Amount Past Due. ()ue Date. ::-
.... ......
7003-731.1-0007-2984
$208,23: $-00 .>:. . .......- ::::::4:00 ,07/9119613
... Billing Date:
Credit:Line. AvaillableCredit
........ .......
06/26/2013::::: $5000 $4:j79137:
. .. .......
TDD/Hearing impaired: 1-800-365-0186
STATEMENT OF YOUR ACCOUNT
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�.�FIN.AN CE�CH AFG ESUMARY: ....-%..� -............
............................. .. ......... ....... .. ..
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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
C? Reg 00014 $13.43 0.00000% 00.00% $.00 00.00% $208.23 $.00 07/26/2013
0
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ACCOUNT DETAIL
...... ................. ........
..... .. .. ...... ......
rans ...... .>:>:>: .. Invoice -_.._ 0: ................... anisactilim:
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buntla.11011:- -��... ....:.7:.�:.�.� ��i:� :-� : .. .:�.
....... ....... .... ..
.......... ................ ..........
......... .. ......... ...................
06/06/2013 COSTCO WHOLESALE-346 010160 00016 $208.23
00016 SUBTOTAL: $208.23
05/24/2013 PAYMENT-THANK YOU 00001 $1,468.38-
06/21/2013 PAYMENT-THANK YOU 00001 $313.31-
Secure Registration at-www.hrscommercial.com. Track spending, pay your bill and update personal information online with Account
Access.
JUL - 5 2013
E=Y:
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 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.
CAM17CO
#396 CASTLETON , IN
6110 E:.AST_II86TH STREET
CASTLETOW, IN 46250
MEMBER 111816719041
I
RESALE ON
E 237686 GOGURTALLNAT 7.89
E 237686 GOGURTALLNAT 7.89
E 237686 GOGURTlf1LLNAT 7.89
E 16009 FRSH FRUIT 11 .99
E 30174 8 GR4.IN 4.69
E 29598 VEG TRAY 9.99
E 29598 VEG TRAY 9.99
E 29598 VEG TRAY 9.99
E 29598 VEG TRAY 9.99
740338 9 OZ#CUP 9.49
199393 COLOR CUPS 8.99
E 31952 'APPLE .JUICE 7.99
E 8 2% MILK 1 .99
E 106913 SKIM MILK 1 .99
E 106913 SKIM MILK 1 .99
E 106913 SKIM MILK 1 .99
E 754450 GROVEST. OZ 5.65
E 754450 GROVEST. OZ 5.65
E 676704 MUSTARD 2/30 4.49
E 16009 FRSH FRUIT 11 .99
E 16009 FRSH FRUIT 11 .99
E 955407 BROWNIE BITE 6.49
E 955407 BROWNIE BITE 6.49
E 955407 BROWNIE- BITE 6.49
E 31865 BAGELS 5.49
E 31865 BAGELS- 5.49
E 31865 BAGELS 5.49
E 16009 FR', H FRUIT 11 .99
E 172246 PELED CAROTS 5.79
RESALE 70TAL 208.23
NON RESALE TOTAL .00
TOTAL �� *i0**9
VF' Costco Wholesale 208.23
------- -L----------
XXXXXXXXXXXX298q ,'P SWIPED
06/06/13 11 :24 1'
Seq#: 003629 APp# ; 010160
Costco Wholesale .f ResP: AA
Tran ID#: 315733899000
Merchant ID 99034611
APPROVED)- PURCHASE
AMOUNT: $208.23
0346 004 0000000035 0060
CHANGE I .00
TOTAL NUMBER OF ITEMS SOLD = 29
CASHIER: Josh H REG# 4
11 :25 0346 04 0060 35
THANK Y13U !
PLEASE COME nGoIN !
cosreo. COSTCO
�VVHMESALE
ACCOUNT SUMMARY BALANCE SUMMARY
.................... . ........
...... . .. .............. ........ ........ Outstanding
....:DAY.S:PAST::DU]E.:.:.: 9::DAYS:PASTDUF. Transaction $1,781.69
.......... ..... ..... ......... ........................... --.......
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $208.23
w Fees $.00
+N
60;i89.,-VAXS:PAST DUE.:.:.:. .:.A"wj1.9.DAYSPMTWI�- VAYSPAST.DW.]
........... .............. ..........
........... ...... ... .. ........... ............ +Finance Charges $.00
$.00 $.00 $.00 Payment(s) $1,781.69
. ...... ....... .... ......
:1-90-1.79::DAYS::PAST.DUE:.:..::.:1804..DAYS PAST DU
...... .. . . . . ......... ... Credit(s) $.00
o $.00 $.00 =New Balance $208.23
0
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Page 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!
Email Address
❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑
Street Number if an ❑❑❑ Street Name or the words_ 'PO BOx�❑❑ Unit or u�0❑❑❑
Stale
Business Phone
❑❑❑F❑❑❑-❑❑❑❑
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.
367001 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
6/26/13 7003731100072984 General program supplies $ 208.23
Total $ 208.23
I 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
i
Voucher No. Warrant No.
(Costco)
367001 Capital One Commercial Allowed 20
P.O. Box 5219
Carol Stream, IL 60197-5219
In Sum of$
$ 208.23
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or Board Members
Dept#
INVOICE NO ACCT#/TITL AMOUNT
1096-60 7003731100072984 4239039 $ 208.23 i.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
10-Jul 2013
Signature
$ 208.23 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund