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MEM033 PROCUREMENT CARD TRANSACTION SUMMARY (LOG) Ma201201010:dankt <br />Cardholder. MAST STROUD,KIM Account Nbr. 6657 <br />10 R I! <br />MEME MW - - - - - R - _ - <br />= - - Wmv - = x - - <br />81242010 STOCK *INTERNATIONAL clip art $87.50 62900 011 8920 87 <br />8/242010 STOCK 'INTERNATIONAL clip art $87.50 62900 535 8921 41 <br />Total Statement Summary: 175.00 <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 hue 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: 09/17/2010 <br />For lost/stolen tends, call: <br />Bank of America: (800) 305-7735 <br />TreasuryOffice: 682-5027 <br />Date <br />q/zilbo <br />Reviewed and Approved by: 10 allo <br />Supervisor's Signature Date <br />10 <br />