247930 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 178002
® r ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $**"**`565.08'
CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK NUMBER: 247930
PO BOX 644467 CHECK DATE: 07/28/15
PITTSBURG PA 15264-4467
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 A32257 420.11 GENERAL PROGRAM SUPPL
1095 4239040 A32257 100.00 FOOD & BEVERAGES
1096 4239039 A32257 44.97 GENERAL PROGRAM SUPPL
P.O.Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
�. RETURN SERVICE REQUESTED Statement Date: 7/18/2015
. 7AD
Due Date: DUE UPON RECEIPT
JUL 2 1 2015 Amount Due: $565.08
8By
PAULA SCHLEMMER
CARMEL CLAY PARKS&RECREATIO
1411 EAST 116TH STREET
CARMEL, IN 46032
E:; Currents 29=56 Day`s - m? 57=84'.Dayg r ' "' 85=112'Days, X113+;Days ,
$565.08 $0.00 $0.00 1 $0.00 $0.00
ACCOUNT BILLING
F,O/REFn# At
CARD# STORE _ � ,DATE:TIGKET AMOUNTS -=''
T,.PROCESSED
0515352605 209989 283 959 06/25/2015 $22.97
0515352606 210142 283 959 06/25/2015 $8.00
0515352867 305402 273 959 06/27/2015 $44.97
0615353121 019576 283 959 06/29/2015 $59.58
0615353734 235065 283 959 07/02/2015 $3.52
0615354221 006809 283 959 07/06/2015 $142.94
0615354222 006939 283 959 07/06/2015 $49.15
0615354780 180672 283 959 07/09/2015 $17.99
0615356149 243031 283 959 07/17/2015 $8.00
0615356150 243091 283 959 07/17/2015 $107.96
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 1 of 2
P.O.Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
- RETURN SERVICE REQUESTED Statement Date: 7/18/2015
Due Date: DUE UPON RECEIPT
Amount Due: $565.08
ACCOUNT BILLING
G :- DATE TICKET
.TICKET _ P:O:/REF# CARD#' STORE PROCESSED
0615356151 259090 233 959 07/17/2015 $100.00
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.muelier@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 AMT Customer No: A32257
0615356151 $100.00 Statement Date: 7/18/2015
Amount Due: $565.08
Amount Enclosed:
REMIT PAYMENT TO:
Central Customer Charges
PO Box 644467
ease indicate e s being pai by p aang a c ec ox in the correspon ingox. amoun paid is different,please Pittsburgh, PA 15264-4467
denote the amount
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
rate per hour, number of units, price per unit, etc.
whom, rates per day, number of hours,
Payee Purchase Order No.
178002 Kroger- Central Customer Charges Date Due
P.O. Box 644467
Pittsburgh, PA 15264-4467
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s)) PO#
Date Number ( $ 60.48
7/18/15 A32257 General Program supplies $ 59.58
7/18/15 A32257 General Program supplies $_ 107.96
7/18/15 A32257 General Program supplies $ 142.94
7/18/15 A32257 General Program supplies $ 49.15
7/18/15 A32257 _ General Program supplies $ 44.97
7/18/15 A32257 General Program supplies $ 100.00
7/18/15 A32257 Food & Beverage
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
$ 565.08
with IC 5-11-10-1.6
20`
Clerk-Treasurer
Voucher No. Warrant No.
Allowed 20
178002 Kroger- Central Customer Charges
P.O. Box 644467
Pittsburgh, PA 15264-4467 In Sum of$
$ 565.08
ON ACCOUNT OF APPROPRIATION FOR
108 ESE / 109 Monon Center
PO#or Board Members
Dept-#
INVOICE NO. ACCT#/TITL AMOUNT
1082-3 A32257 4239039 $ 60.48 1 hereby certify that the attached invoice(s), or
1082-4 A32257 4239039 $ 59.58 bill(s)is(are)true and correct and that the
1082-5 A32257 4239039 $ 107.96 materials or services itemized thereon for
1082-10 A32257 4239039 $ 142.94 which charge is made were ordered and
1082-11 A32257 4239039 $ 49.15 received except
1096-22 A32257 4239039 $ 44.97
1095-1 A32257 4239040 $ 100.00
July 23, 2015
Signature
$ 565.08 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund