241067 01/13/15 y ..4Q_gy
l 4F� CITY OF CARMEL, INDIANA VENDOR: 178002
ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $*******725.54*
CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK NUMBER: 241067
PO BOX 644467 CHECK DATE: 01/13/15
PITTSBURG PA 15264-4467
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 A32257 609.58 GENERAL PROGRAM SUPPL
1096 4239039 A32257 115.96 GENERAL PROGRAM SUPPL
P.o,Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
RETURN SERVICE REQUESTED Statement Date: 1/3/2015
Due Date: DUE UPON RECEIPT
Amount Due: $725.54
PAULA SCHLEMMER � �T�,��
CARMEL CLAY PARKS&RECREATIO
1411 EAST 116TH STREET LJAN0 2015
CARMEL, IN 46032
By_
e, .
SMIMUN29- ¢7i84LQaysMe �p86�1;12)Days 113+Days
$0.00 $0.00 $0.00 $0.00 $0.00
ACCOUNT BILLING
TICKET P.O./REF# CARD# STORE DA1TE TICKET AMOUNT
PROCESSED
1114314657 002601 283 959 12/08/2014 $19.55
1114315497 217776 283 959 12/11/2014 $65.01
1114315742 363018 283 959 12/12/2014 $41.60
1114315743 364187 283 959 12/12/2014 $44.32
1114315744 365370 273 959 12/12/2014 $115.96
1114315745 387389 283 959 12/12/2014 $106.41
1214316274 016630 283 959 12/15/2014 $44.46
1214316595 075653 283 959 12/16/2014 $14.97
1214317371 319900 283 959 12/19/2014 $8.48
1214317372 320007 283 959 12/19/2014 $58.12
For questions or copies,please contact Kroger Accounts Receivable toll free at 888-327-4911(Gammie ext.65563 or Sarah ext.61825)or by email(cammie.combs@kroger.com
or sarah.mueller@kroger.com).Please review your account promptly and advise if payments have been made.There will be a$5.00 fee for each ticket copy requested.
Please retain the top portion for your records Page 1 of 2
P.O.Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
RETURN SERVICE REQUESTED Statement Date: 1/3/2015
Due Date: DUE UPON RECEIPT
Amount Due: $725.54
ACCOUNT BILLING
IGKET P.O./REF# CARD# STORE DATE TICKET AMOUNT
PROCESSED
1214317373 334155 283 959 12/19/2014 $31.47
1214317374 334515 283 959 12/19/2014 $45.27
1214317375 337143 283 959 12/19/2014 $84.41
1214317407 340720 283 980 12/19/2014 $17.98
1214317966 107881 283 959 12/23/2014 $11.27
1214318489 030451 283 959 12/29/2014 $16.26
For questions or copies,please contact Kroger Accounts Receivable toll free at 888-327-4911(Cammie ext.65563 or Sarah ext.61825)or by email(cammie.combs@kroger.com
or sarah.mueller@kroger.com).Please review your account promptly and advise if payments have been made.There will be a$5.00 fee for each ticket copy requested.
Please retain the top portion for your records Page 2 of 2
----------------------------------------------------------------------------------------------
Tear Along Perforation and Return Bottom Portion Page 2 of 2
TICKETS AMT TICKETS AWV �. Customer No: A3225.7
1214317373 $31.47 1214317407 $17.98 Statement Date: 1/3/2015
1214317374 $45.27 1214317966 $11.27
1214317375 $84.41 1214318489 $16.26 Amount Due: $725.54
Amount Enclosed:
REMIT PAYMENT TO:
Central Customer Charges
PO Box 644467
Pittsburgh, PA 15264-4467
ease indicate e eing paid by placing a cnecmoonthe corresponding DOX. amount paid is artrerent,please
denote the amount
' I
Kroger Fund 108
enema enera enera enera enera enema enema enera
Prog Prog Prog Prog Prog Prog Prog . Prog
Supplies Supplies Supplies Supplies Supplies Supplies Supplies Supplies
V#178002 4239039 4239039 4239039 4239039 4239039 4239039 4239039 4239039
1081-1 1081-2 1081-4 1081-6 1081-8 1081-11 1081-99 1096-60
$ 725.54 $ 44.32 $ 93.91 $ 149.42 $ 45.27 $ 106.41 $ 84.60 $ 85.65 $ 115.96
$ 44.32 $ 44.46 $ 65.01 $ 45.27 $ 106.41 $ ' 41.60 $ 58.12 $ 115.96
$ 31.47 $ 84.41 $ 19.55 $ 16.26
$ 17.98 $ 14.97 $ 11.27
$ 8.48
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
178002 Kroger- Central Customer Charges
P.O. Box 644467 Date Due
Pittsburgh, PA 15264-4467
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
1/3/15 A32257 General Program supplies $ 44.32
1/3/15 A32257 General Program supplies $ 93.91
1/3/1-5'- A32257 General Program supplies _$.____ _ 149.42
1/3/15 A32257 General Program supplies $ 45.27
1/3/15 A32257 General Program_supplies $ 106.41
1/3/15 A32257 General Program supplies $ 84.60
1/3/15 A32257 General Program supplies $ 85.65
1/3/15 A32257 General Program supplies $ 115.96
I hereby certify that the attached-invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6 Total - $ 725.54
120
Clerk-Treasurer
Voucher No. Warrant No. i
Allowed 20
178002 Kroger- Central Customer Charges
P.O. Box 644467
Pittsburgh, PA 15264-4467 In Sum of$
$ 725.54 1
i
r
ON ACCOUNT OF APPROPRIATION FOR
108 ESE/109 Monon Center
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT ,
1081-1 A32257 4239039 $ 44.32 1 hereby certify that the attached invoice(s), or
1081-2 A32257 4239039 $ 93.91 bill(s)is (are)true and correct and that the
1081-4 A32257 4239039 $ 149.42 materials or services itemized thereon for
1081-6 A32257 4239039 $ 45.27 which charge is made were ordered and
1081-8 A32257 4239039 $ 106.41 f received except
1081-11 A32257 4239039 $ 84.60
1081-99 A32257 4239039 $ 85.65
1096-60 A32257 4239039 $ 115.96
January 8, 2015
Signature
$ 725.54 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund