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COEP0033 <br />Cardholder Tintle,Robert <br />PROCUREMENT CARD TRANSACTION SUMMARY (LOG) <br />Account Nbr: 0277 <br />051182010 312PM <br />ai <br />~ <br />R.p R m•q~^fF 6 `Pr". " <br />d'+a <br /># <br />A~rr7 JR~,t~~nt"Sr iH 5" <br />ij <br />'w%~F ~ <br />:TV <br />~ <br />S q <br />ryyp'"~"'k. <br />s <br />iiY"4rs .d.lr''d';?r.:li't~N✓ Ji n <br />ws <br />h <br />t'"w <br />f+." + <br />S " <br />Erg <br />,r r <br />M-✓ <br />;y'a <br /> <br />1 <br />n <br />r <br />. <br />.prr ~r" <br />;~Descn <br />e ffy1 item purchesedfbusinesstw <br />tion (s <br />t <br />p <br />`"TninsactI `i <br />t <br />rel edger Account No: <br />'Gene <br />~ <br />' <br />e <br />~ <br />^ <br />t~ <br />, <br />gv` <br />' <br />e <br />` <br />~ <br />4 <br /> <br />p <br />p <br />r <br />e <br />5,~ <br />o <br />~S <br /> <br />~ <br />~ <br />" <br />' <br />~ <br />c <br />id <br />` <br />1 <br />' <br />" <br />k <br />`,7rens <br />Dat <br />;,V <br />ndor, Name„ <br /> <br />y., x.1 <br /> <br />a <br />se),;:•.'„ <br />:,Purp <br />a <br />, <br />, <br />, <br />. z# <br /> <br />outl, <br />count u <br />Org . „Pgm <br /> <br />iGrsn <br />t <br /> <br />A <br />,P, rolecLi <br />!20/2010 <br />ALBERTSONS#560 Q <br />AAC Meeting 04/21/10 <br />$5243 <br />62200 <br />511 <br />9170 <br />55 <br />$52 43 <br />Total Statement Summary <br />I, the undersigned card holder, do hereby certify under penalty of perjury, that, to the best of my knovAedge, 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 lust and due, and that payment for <br />these charges has not been requested or made from petty cash, department order or other method ry <br />Statement Date 05117/2010 ~a - <br />Ca holders Signature Date <br />For lost/stolen cards, call Reviewed and Appr2pp by <br />Bank of America (800) 305-7735 <br />Treasury Office 682-5027 S-[L,62 <br />Su pit n or's Signature Date <br />SCANNED- WA <br />DATE <br />INITIALS' <br />ID <br />