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COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder. Donahue,Tammy Account Nbr. 9773 <br />01124/2011 6 05PM <br />-Kim- Ew W- - ARM <br />72J23/2010 NATIONAL PUBLIC EMPLOY NPELRA MEMBERSHIP $175 00 61861 011 8930 87 <br />SHRM ORG SHRM MEMBERSHIP $180 00 61861 011 8930 87 <br />Total Statement Summary: 355.00 <br />I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knowledge, the materials furmshed, 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 lust 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: 01/17/2011 <br />For lost/stolen cards, call. <br />Bank of America (800) 305-7735 <br />Treasury Office. 682-5027 <br />Cardholdees Sig ture Date <br />Rewewed a pr ved by: ~-7 <br />Su misoes Signature Date <br />I <br />