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CCEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOO) <br />Cardholder: Diller,Della M Account Nbr. 9154 <br />10022010 9 49AM <br /> <br />. ' • , - > v <br />• • - <br />- <br />^ x <br />;D <br />r <br />e <br />o <br />oerlahd LadgN.A6WU11t No. i _ - <br />~ <br />r <br />u <br />. <br />escdptmti(apecily,tem purohaeedlbusiness <br />' <br />T <br />ti <br />n <br />an <br />- <br />r <br />' <br />Trans Data, <br />a <br />Name , <br />Vendo <br />purpose) <br /> <br />.~Artwurd <br />-Adecu <br />R <br />Fund <br />•.Org,- <br />,;Pgm <br />a <br />Pro ct <br />9/2010 <br />PAYPAL'PRESSPUBLIS <br />Recrmtment Advertising - Wastewater <br />$128.91 <br />61731 <br />533 <br />8710 <br />40 <br />0/072010 <br />SHERATON SEATTLE HOTEL <br />IPMA conference <br />$584.25 <br />61711 <br />011 <br />8930 <br />87 <br />Total Statement Summary: $713.16 <br />I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knowledge, the materials fumished, 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 due; and that payment for <br />thew charges has not been requested or made from petty cash, department order or other method. <br />Statement Date: 10/15/2010 //Ljo ~ 14l•6" /d y0 <br />Cardholder's Signature Date <br />For lost/stolen cards, call: Reviewed and Approved by: <br />Bank of America: (8W)305-7735 <br />/r~ •1Z- 26r ~ <br />Treasury Office: 682-5027 2222~itMk~4~ <br />upervlwr's Signature Date <br />,ell <br />