HomeMy WebLinkAbout228487 1 /28/2014 »,F CITY OF CARMEL, INDIANA VENDOR: 354720 Page 1 of 1
ONE CIVIC SQUARE COSTCO WHOLESALE MEMBERSHIP
0 CHECK AMOUNT: $165.00
CARMEL, INDIANA 46032 PO BOX 34783
SEATTLE WA 98124-1783 CHECK NUMBER: 228487
CHECK DATE: 1/28/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4355300 GOLF 165 . 00 ORGANIZATION & MEMBER
EXECUTIVE BUSINESS MEMBERSHIP o ��
ANNUAL, RENEWAL, NOTICE
usines"s.�rimary Cardholdere`. $55 RENEWAL MONTH:FEBRUARY 2014 MEMBER NUMBER: 000111774019754
HouseholdCardholdei: FREE<.. CARDHOLDER'S NAME AMOUNT HOUSEHOLD MEMBER AMOUNT
Add on.Gardholde " +$55. each ROBERT HIGGINS $110.00 KEN MILLER $0.00
Add on Househo}d Cardholder FREE PAM LISTER $55.00 MELISSA A MONTGOMERY $0.00
,EXecu6ve Upgrade +$55
TOTAL.RENEWAL FEE $165.00
If you dont have any.changes to your
membership;RENEW;;ONLINE'AT;
COSTCO COM_;Simply log onto"cos., com,
type RENEWin_the producfsearcti bo ,and
follow-the..sirriple.instruchons to,renew.your.
membershi toda. Please see Instructions on reverse to add,remove or replace a cardholder.
Think Costco First
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Renewal of your membership constitutes acceptance of Costco's Privileges and Conditions of Membership and its Privacy
Policy and Practices,which are available at our membership counter or online at Costco.com.Please provide all cardholders
with this information.
Renewal Policy—Memberships renewed within 2 months after expiration of the current membership year will be extended for
12 months from the expiration date.Memberships renewed more than 2 months after such expiration will be extended for 12
months from the renewal date.
All cardholder changes will be effective upon receipt of renewal payment.
New membership cards will not be sent unless new cardholders are added or changes are made to the account.
CHANGES TO YOUR ACCOUNT. Fill in the necessary information in the space provided below and adjust payment accordingly.
Changes to your membership cannot currently be made online at Costco.com.
If adding household member cardholder: Add household member's name in space below the primary cardholder.
*A household member card is available to primary cardholder's household member,domestic partner,or immediate family
member over the age of 18 and living at the same address.Household member cardholders will be asked to present proof that
they live atthe same address as the primary or add-on cardholder.
NOTE: Limit one Executive Membership per household and/or business.
Have questions about your renewal? Call us at 1-800-774-2678.
EnEGSNR VIZ
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/01/14 1000111774019754 Dues I $165.00
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.
ALLOWED 20
Costco Membership
IN SUM OF $
P.O. Box 34783
Seattle, WA 98124-1783
$165.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 10001117740197 I 43-553.00 I $165.00 1 hereby certify that the attached invoice(s), or
rn
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
Thursday, January 09, 2014
41-7-> Ij ,
Director, Brookshire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund