COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder: Corey,Kurt Account Nbr: 8582 <br />=1a 10 9:52AM <br />as.~: <br />. <br />~,y . .,t 4S ~,ex <br />'a.. ~ .~;s',ri. ,.;,tRx <br />e <br />..~:;n trt <br />: <br />iai <br />Ito <br />h <br />, <br />r'.;)'1'^ <br />- <br />7raasDate> <br />~ : Yi : `.r5a <br />4•,'ti'1.st i. ` <br />ndorName"'. I.`~... `r,~:. z <br />j <br />c <br /> <br />"nsw". r! ~.'~s• <br />" <br />Y.: `'«Y=~:. ..'~•';'n..: <br />p;lYl <br />''Sr: <br />..;.AtiiiRnac;~, <br />ff"n.., :.aq,( <br />:A <br />: <br />. <br />6ttttd <br />1,1,x.24 <br />. <br />~;pgm'. <br />' <br />`tl;iafi~ <br />±ruleat: <br />2/0812010 <br />SUSHIYA,INC. <br />lunch mtg w/ Lisa Arkin <br />$16.00 <br />62200 <br />011 <br />8910 <br />87 <br />Total Statement Summary: $16.00 <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: 0211712010 - <br />Ca holders Signature Date <br />For lost/stolen cards, call. Re t wed and Approved by: <br />Bank of America: (800) 305.7735 <br />Treasury Office: 682-5027 d <br />Supervisors Signature Date <br />