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coePOO3a PROCUREMENT CARD TRANSACTION SUMMARY (LOG) o~io~i2oos s:o2Prn <br />Cardholder: Clark,Debbie Account Nbr: 6719 <br /> ~, ~ <br />D <br />i <br />i <br />if <br />i <br />/ General Ledger Account No. <br /> <br />Trans Date <br />Vendor Name escr <br />pt <br />on (spec <br />y <br />tem purchased <br />business <br />purpose) Transaction <br />Amount <br />Account <br />Fund <br />Org <br />Pgm <br />Grant <br />Project <br />Total Statement Summary: ~z,4ui.y[ <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 l am authorized <br />to sign for the payee. <br />Statement Date: 06/17/2009 ~ ! ,,~'• ~ ~~ ~( /~G~ ~~..ri~fr, <br />Cardhol er' ignature. ate <br />For IosUstolen cards, call: <br />Bank of America: (800) 305-7735 -~.- v~,r <br />Treacnrv llffira• RR9-Fn97 ` ~~ <br />pervisor's ignature Date <br />