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COEPe033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) 1212orz010 a 32AM <br />Cardholder. Jones,Eric R <br />Account Nbr: 4732 <br />e <br />HE 1 11 -.1, <br />fl <br />1/29/2010 ACT'GOPRSA PRSA meeting $2000 61711 Oil 8920 87 <br />2109/2010 AMERICAN PUBLIC WORKS PAWS education matenals $11600 62900 Oil 8920 87 <br />Total Statement Summary: 135.00 <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 Rem 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 d that payment for <br />these charges has not been requested or made from petty cash, department order or other method <br />Statement Date. 12/17/2010 ~ ~ • - /Z/1% <br />Cardholder's Signature Date <br />For lost/stolen cards, call Rewe proved by <br />Bank of America. (800) 3057735 <br />Treasury Office, 682-5027 <br />u rsoes ignature oat. <br />ATFr,V-,-, J <br />5WO <br />IZI Z~I~O <br />