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COEP0033 PROCUREMENT CARD TRANSACTION St1MMARY (LOGj o~itanoos tt:t2AM <br /> <br /> Cardholder: Keppier,Peggy Account Nbr: 3066 <br /> x~~` ';t s` ~ ~ r~ r~'~ ~ ~ <br /> ~ ~ ~ General LedgerAcCOUnt Na. <br /> t.,,; i tern puFChasedlbosiness ' ~.x7'ran~aC'jt~n ~ • <br /> TransQttt§ ;VendorNam~,~;~`~`~. - ? ~Atrrpunty2; ACCOUnf Fund Org:" Pgm Grant Prefect <br /> ~x.~ ..r.;~;;~....... . r. <br /> /27/2006 LANE COUNTY PUBLIC WOR Lenore Estates Prj #4335 $200.00 61862 631 9350 44 <br /> Total Statement Summary: X200.00 <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 /> to sign for the payee. <br /> Statement Date: 07/17/2006 <br /> Cardholder's Signature Date <br /> For IosUstolen cards, call: <br /> Bank of America: (800) 305-7735 <br /> TrPaCI w (lffirP' RA7_rin77 <br /> Supervisor's Signature Date <br /> 0 <br /> co <br /> i <br /> 0 <br /> a~ <br /> -o <br /> tv <br /> w <br /> n <br /> G <br /> <br />