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bocci. w1 i.. 0 wU - to s-e.Q cG <br /> . . / -tbv,; V I_n_ ; o k e 16a <br /> ;. COEPO033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) 06/10/2013 3:01PM <br /> ✓✓'' <br /> Cardholder: STEECK,DIANE Account Nbr: 4558 <br /> General Ledger Account No <br /> Description (specify item purchased /business Transaction <br /> Trans Date Vendor Name _ ° purpose) ,,.L Amount Account Fund Org Pgm Grant Project <br /> 35/31/2013 BEST BUY 00006007 a in oat fa.6 /e.5, � case $464.95 6 2 s. / , L 1(64: <br /> / SG/Yen /DM iec74e r, /� r. /efoa/r 1630 <br /> 36/01/2013 FRED -MEYER #0417 er $24.99 Z of,, <br /> / � ed , eas.� ne. C 9 53;rj 9e3 zi . 37,./.c <br /> vrr h ter - /15 a /e_7 <br /> 36/08/2013 STAPLES 00104646 / S /KS �r `n0rli�rr fu6/e�- $14.99 (;2.gc°0 535 ck3 <br /> ✓ z 1 <br /> 36/10/2013 PHOTODON O. /) -q /QPe J'UC.Cn c e s $ 32 . 80 coicipc� 5--s5 gt.,30 <br /> 717)--- ll 1e / zic 3z� <br /> 36/13/2013 REI COM / Cav�ritry� 0 /e 650 (S 'PS $480.00 6,z <br /> S3S ���� <br /> Total Statement Summary: $1,017.73 <br /> I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knowledge, the materials furnished, services rendered, expense incurred, or <br /> other item of indebtedness as charged in the foregoing bill is a true and correct charge against the City of Eugene; that the claim's just and due; and hat payment for <br /> these charges has not been requested or made from petty cash, department order or other method. <br /> A �j' Statem ent Date: 06/17/2013 � 0� <br /> G-1 /3 <br /> 1 <br /> Card older's Signature Date <br /> For lost/stolen cards, call: Reviewed and Approved by: <br /> Bank of America: (800) 305 -7735 <br /> Treasury Office: 682 -5027 "7 , 6: /��, � <br /> Supervisor's Signa re V Date <br /> • <br />