247364 07/15/15 CITY OF CARM L, INDIANA VENDOR: 178002
.�: ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $ 88.52
CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK NUMBER: 247364
MIioN/. PO BOX 644467 CHECK DATE: 07/15/15
PITTSBURG PA 15264-4467
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 A03849 88.52 TRAVEL & LODGING
P.O.Box 1648 Customer No: A03849
Hutchinson,KS 67504-1648
RETURN SERV CE REQUESTED Statement Date: 6/20/2015
Due Date: DUE UPON RECEIPT
Amount Due: $114.26
ACCOUNTS PAYABLE
CARMEL POLICE DEPT
3 CIVIC SQUARE
CARMEL, IN 46032
Current 29-56 Days 57-84 Days 85-112 Days 113+Days
$88.52 $25.74 11 $0.00 $0.00 $0.00
ACCOUNT BILLING
TICKET P.OJREF# CARD# STORE DATE TICKET AMOUNT
PROCESSED
0315341509 062280 110 959 04/28/2015 *$18.15
0415343347 142287 110 959 05/06/2015 '$7.59
0415347786 126697 110 959 05/28/2015 $30.58
0415348002 191343 090 959 05/29/2015 $3.98
0515349792 065578 090 959 06/09/2015 $13.96
0515350188 175555 110 959 06/11/2015 $40.00
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$5.00 fee for each ticket copy requested.
Please retain the top portion for yourrecords Page 1 of 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Kroger
Central Customer Charges
IN SUM OF$
P.O. Box 644467
Pittsburgh, PA 15264-4467
$88.52 -
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I ( I 43-430.03 I $88.52 1 hereby certify that the attached invoice(s), or
bills is are true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, July 09, 2015
� II
Chief of Police
Title
Cost distribution ledger classification if 1
claim paid motor vehicle highway fund
'I i
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
06/20/15 CarmelFest Water/Beth retirement $88.52
1 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
, 20
Clerk-Treasurer