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COEP0033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Cardholder: Jones, Eric R Account Nbr. 4732 <br />171192009 9'59AM <br />5'i: <br />, ,«fi.. 'a'iax;..;"" :.r <br />' <br />..rea Ft~»': <br />.~~Q <br />I <br />fl <br />t <br />.•e":a..' <br />1` <br />l <br />a. ~dy. ~ <br />, i;,4 G@/ieral4Ad1teerAi cxnunt <br />, <br /> <br />. <br /> <br />.,O <br />^T <br />. <br /> <br /> <br /> <br />N <br />}lo <br />iWb <br />- <br />scr <br />@S6r <br />p <br />Cn <br />ac <br />:y <br />f8rlseet <br />tni <br />; <br />"jP" <br /> <br />c` <br />ra <br />, <br />ns <br />ats <br />, <br /> <br />< <br />ne <br />e <br />t- <br />P4!ti <br />mor <br />At <br />irit. <br />m <br />ec <br />7/30/2009 <br />ACT'GOPRSA <br />PRSA meetmg <br />$15.00 <br />61711 011 8920 <br />87 <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 d 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 V / <br />Cardholder's Signature Date <br />For lost/stolen cards, call: Reviewed and Approved by: <br />Bank of America: (800) 305-7735 <br />Treasury Office: 682-5027 <br />Supervisor's Signature Date <br />