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_COEPM33- PROCUREMENT CARD TRANSACTION SUMMARY (LOG) 06@s20101123AM <br />Cardholder. Corey,Kurt AccountNbr: 8582 <br />APWA <br />AMERICAN PUBLIC WORKS <br />AMERICAN PUBLIC WORKS <br />APWA <br />AMERICAN PUBLIC WORKS <br />AMERICAN PUBLIC WORKS <br />Total Statement Summary: <br />$45.00 <br />62200 <br />011 <br />8910 <br />87 <br />$35.00 <br />61861 <br />011 <br />8910 <br />87 <br />$50.00 1 62200 1 011 1 8910 1 87 <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 is just and due; and that payment for <br />these charges has not been requested or made from petty cash, department order or other method. <br />Statement Date: 06117/2010 ~C7 <br />ardholdees Signature Date <br />For lostlstolen cards, call: eviewed and Approved <br />Bank of Affice: 305-7735 q ~~f o <br />Treasury Office: 682-5 82-5027 <br />Supervisor's Signature ---ale <br />SCANNP A <br />DATE' <br />INITIALS: <br />17, <br />