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COEaeahs PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder. Corey,Kurt AccountNbr, 8582 <br />0smt201012:59PM <br />d7'ansDate< <br /> <br />~ <br />vy~~ RI r , xIµ. WJk <br />n~A~. ~ ..5i~ <br />I <br />t`+ <br />~1i' <br />o-y <br />z1~. <br />'ACCOUPt'~ <br />- : <br />~d ~'»"tlr~`titl drP.9rnJ e <br /> <br />i <br />X`132010 <br />UNITED 0164511685116 <br />Bag Charges for flight to APWA Conference <br />$23.00 <br />61711 <br />011 <br />8910 <br />87 <br />Total Statement Summary: 23.00 <br />I, the undersigned card holder, do hereby cerbly under penalty of perjury, that, to the best of my knowledge, the materials furnished, services Tendered, 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 datm 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: 08/17/2010 <br />Cardh Ider's Signature Date <br />For lostistolen cards, call: Revi d and Approved by: <br />Bank of America: (800) 305-7735 <br />Treasury Office: 682-5027 <br />Supervisor'ss Signature bate <br />J~al <br />-A 10' <br />