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COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder: Eva,Kathy Account Nbr: 4652 <br />10/28/2010 8:22AM <br />' :TM l; <br />V . -•n.. <br />55~;; <br />p: ' 4~ p,x <br />'~r;"~:% •"~sAi..!'."r.. <br /> <br />:rK.# Y M.~E_'C??$: rcx ..xe; y^mp °f <br />n ' .'$v}i_.5,a .".A" <br />Ine9a ,•y'i ` <br />{~4 <br />ru ':.?4,. <br />^ X.S, v+» <br />' T : <br />x.~, ..e s . <br />~}i jrxzv ;:G a)rfenefal 'LB C nrIQN0.i.i. a,. <br />~ <br />A <br />' <br />. <br />.A'-*".:.:' <br /> <br />a a <br />ra71si <br />8ted <br />a !^5., <br />,::.<rE„ <br />M:Pt!!I?ose)~ <br />.,.sse~ <br />o„Jltri4iirrt. <br />lRoeon 4 t1m <br />0/13/2010 <br />123SIGNUP ASSOCIATION <br />workshop <br />$15.00 <br />61711 <br />535 <br />8921 <br />41 <br />Total Statement Summary: $15.00 <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 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: 10/15/2010 <br />For lostfstolen cards, call: <br />Bank of America: (800) 305-7735 <br />Treasury Office: 682-5027 <br />" / (fry NI 7 0 <br />Cardholder's Signatg'e Date <br />Reviewed and Approved by: <br />C ~ ~ /a~-°7~zcav <br />Supervisors Signature Date <br />It7 <br />