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CoEP n PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder. Eva,Kathy Account Nbr: 4652 <br />12222009 10 09nn1 <br />t. <br />n..ay3 <br />» <br />Tre 'rb <br />ks Date, <br />':-4.;': ie - r <br />a r <br />r. TY) - r _ <br />: <br />Vendor,-ne:: <br />~'S 4__~...._.. kSyx., <br />~'.t ~'=4•. yG ssmm '"P:Y_a. rte.. <br />l _ <br />rv:r:;. _ !u•:>".~`¢R = _ <br />P rpase) <br />_ w..: <br />..tl viF?F9_. <br />I•..r.. <br />tsa <br />tv - <br />mount <br />q~ ..imam- <br />sa <br />,'~•t'a:t i. •ei`'i ,e.a i <br />General6etlge <br />:j.., sc _ <br /> <br />vkccount Find -~'Oigwd <br />+i rl <br />i Acccr~ <br />~a-`-_. <br />=-`Pgm <br />Wo'g • } ~ <br />nt No_ <br /> <br />i.M •"i~1Y,L°-_:r <br />Grant '.P.iujeatp <br />21'02/2009 <br />DOLLAR STORE NO 41 <br />supplies for school curriculum <br />$21.36 <br />61846 <br />535 <br />8921 <br />41 <br />2102/1009 <br />DOLRTREE 2712 00027128 <br />supplies for school curriculum <br />$14.00 <br />61846 <br />535 <br />8921 <br />41 <br />2/02/2009 <br />FRED-MEYER #0417 <br />supplies for school curriculum <br />$19.20 <br />61846 <br />535 <br />8921 <br />41 <br />210312009 <br />FRED-MEYER #0417 <br />supplies for school curriculum <br />$5.49 <br />61846 <br />535 <br />8921 <br />41 <br />Total Statement Summary: $60.05 <br />I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knovviedge, 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: 12/17/2009 <br />For IosVstolen cards, call: <br />Bank of America: (800) 305-7735 <br />Treasury Office: 682-5027 <br />Cardholder's Slgnat w Date <br />Reviewed and Ap j proved <br />Supervisors Signature Date <br />