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COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder: Eva,Kathy Account Nbr: 4652 <br />a <br />611 112 01 0 <br />DAS MANUFACTURING INC <br />drains to stream markers <br />$292.90 <br />62900 535 8921 41 <br />Total Statement summary: 4-<a[.Vu <br />I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knovAedge, 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 daim 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: 06/17/2010 <br />For lost/stolen cards, call: <br />Bank of America: (800) 305-7735 <br />Treasury Office: 682-5027 <br />08/1812010 9:57AM <br />/ U /C d <br />SCANN <br />DATE: <br />INITIALS: <br />Cardholder's Slgnahlte Date <br />Reviewed and - prod b) <br />Supervisor's Signature Date <br />