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COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) 0(if022005 5:57PM <br /> <br /> Cardholder: Clark,Debbie <br /> Account Nbr. 6770 <br /> ~ f , ffiWQx`T ~~'+Y r ~ t General Led er Account No. <br /> Tranr Date Vendazt~no ~ • ~ ~ ~ ptlo,~(r<Pacliy~m Pu~S~?~Id~l~w?Frp, ~Tr~~nµ~„ . r'~`~;. _ > <br /> „ . `rp1lEPR~wkn -..,r~~,<a .~.-~,~ount«: ~AccoUnC~ Fund °0 ~P ~ ~Grr,nt Pro' ct <br /> 510512005 REGISTER GUARD GJN 4243 RG AD $5.04 61731 531 9332 97 945176 <br /> 510512005 REGISTER GUARD GJN 4243 RG AD $117.60 61731 531 9332 97 945176 <br /> 510512005 REGISTER GUARD GJN 4243 RG AD $45.36 61731 531 9332 97 945176 <br /> Total Statement Summary: $1,901.77 <br /> I, the undersigned, do hereby certify under penalty of perjury, that the materials furnished, services rendered, expense incurred, or other item of indebtedness as charged <br /> in the foregoing bill is a true and correct charge against the City of Eugene; that the claim is just and due; that no part of the same has been paid; and that I am authorized <br /> io sign for the payee. yy~~~~~~ <br /> Statement Date: 05117/2005 C'~~' <br /> Cardholders Signature Date <br /> For IosUstolen cards, call: <br /> Bank of America: (800) 305-7735 ~ 3 ~ Q <br /> Te+amin~ flffiro• RA9AM7 C <br /> Supervlaora Signature Date <br /> <br />