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COSIO033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) Otrz42011 406PM <br />Cardholder: Flowers,Jeffrey Jane <br />1 I (STOCK 'INTERNATIONAL <br />stock photo credits for displays <br />Account Nbr: 2739 <br />$175.00 1 62900 1 535 1 8921 1 41 <br />r 112/2011 I SHOPKO 00400986 I bowls for home show displays I $2490 162900 1535 I 8921 I 41 I I <br />Total Statement Summary: $199.90 <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 riot been requested or made from petty cash, department order or other method <br />Statement Date: 01/172011 ()O~~ 2LLL~±,L l 2y ll <br />rd s Signa Date <br />For lost/stolen cards, call Reviewed and Ap <br />Bank of America: (800) 3057735 <br />Treasury Office. . 6825027 <br />Supervisor's Signature Date <br />kV01 ~ <br />