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COEP0005 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) 061252010 0:52PM <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 hem of indebtedness as charged in the foregoing bill is a true and correct charge against the City of Eugene; that the claim is j st and due: and that payment for <br />these charges has not been requested or made from petty cash, department order or other method. r-I , {CIA A 171'7 <br />Statement Date: 06/17/2010 <br />For lost/stolen cards, cell: Re~evkd d7lppmved b ' / <br />Bank of f America: (800) 305-7735 V l0 <br />Treasury Office: 682-5027 <br />,61 i - ~ O <br />S lsors Signature Date <br />Cardholder. Brintnall,Schkara Account Nbr. 5557 <br />