226936 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 367001 Page 1 of 1
ONE CIVIC SQUARE CAPITAL ONE COMMERCIAL CHECK AMOUNT: $274.11
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197-5219 CHECK NUMBER: 226936
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 PARKS 274 . 11 7003-7311-0007-2984
Please Direct Inquiries To: 1-800-220-8594 02SYCO. COSTCO
!A/B/OL�AL�
Accaut>i:Number New Balance Payment.D.1....ue Amau�t Past.Due Due;'Date
:70.03 7311 0007 2984 $274.11 $00 $QQ 12/21!2013
BIHmg;;Date Credrt Lrne ` Available Credit
11/26/2013 $5,000 � 4 725 89
TDD/Hearing Impaired. 1-800-365-0186
STATEMENT OF YOUR ACCOUNT DEC 2 2013
. .
F._:
0
F:.INANCE`CHARGE S.U.M.MA#tY. ;11. ..
0
Credit Credit Average Daily Corres- FINANCE ANNUAL New Minimum Promo
a Plan Plan Daily Periodic ponding CHARGES at PERCENTAGE Balance Payment Expire
o Description Number Balance Rate APR Periodic Rate RATE Due
9 Reg 00014 $17.68 0.00000% 00.00% $.00 00.00% $274.11 S.00 12/26/2013
0
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ACCOUNT-DETAIL
° Trat+saclion Tra1lSaGttCA fnvuice User. P
Trans@Ctlon
M
Date
Dt3scrtpttvil Num:Eier . Ib Number Amount::: ., .
.....: .
11/15/2013 COSTCO WHOLESALE-346 041966 00016 5274.11
00016 SUBTOTAL: $274.11
11/20/2013 PAYMENT-THANK YOU 00001 $419.98-
Return the below portion with payment.For billing errors or questions please refer to the back of the statement. Page 1 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.
COSTCO
ACCOUNT SUMMARY BALANCE SUMMARY
Outstanding
CURRENT 1 29 DAYS-PAST DUE 30 5 DAYS PAST DUE Transaction $419.98
+New
$.00 $.00 $.00 Purchase(s)/Debit(s) $274.11
+New Fees $.00
604%DAYS PAST DUE: ....410440::DAY PAST UUE 12DYt4$pAY$PA i3UE i s
`'' +Finance Charges $.00
$.00 $.00 $.00 Payment(s) $419.98
150 7.179.DAYS PASS'DOE 1804 DAYS PAST
:EkUE Credit(s) $.00
o $.00 $.00 =New Balance $274.11
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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!
C any Name
Email Address
❑ooa0000000000000000000a0000
Street Number li,any, Street Name or the words TO BOX" TI Unit or PO BOX Number
CIU❑❑❑❑�❑❑D❑❑EI❑❑❑❑❑❑❑
State
LJE Z1❑❑❑
Business Phone
❑❑❑/❑❑❑-E]❑n'I1In
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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
11/26/13 7003731100072984 General program supplies $ 274.11
Total $ 274.11
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
Voucher No. Warrant No.
(Costco)
367001 Capital One Commercial Allowed 20
P.O. Box 5219
Carol Stream, IL 60197-5219
In Sum of$
$ 274.11
ON ACCOUNT OF APPROPRIATION FOR
109 MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-60 7003731100072984 4239039 $ 274.11 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
5-Dec 2013
T Signature
$ 274.11 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund