252035 1 2/02/15 u!.C,gMR
' CITY OF CARMEL, INDIANA VENDOR: 178002
a.
ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $"`......26.95'
:. =a CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK NUMBER: 252035
PO BOX 644467 CHECK DATE: 12/02/15
PITTSBURG PA 15264-4467
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 A03849 26.95 OTHER MISCELLANOUS
P.O.sox 1648 Customer No: A03849
Hutchinson,KS 67504-1648
t - RETURN SERVICE REQUESTED Statement Date: 11/7/2015
Due Date: DUE UPON RECEIPT
Amount Due: $26.95
ACCOUNTS PAYABLE
CARMEL POLICE DEPT
3 CIVIC SQUARE
CARMEL, IN 46032
Current 29-56 Days 57-84 Days 85-112 Days 113+Days
$26.95 $0.00 $0.00 $0.00 $0.00
ACCOUNT BILLING
TICKET P.O./REF# CARD# STORE DATE TICKET AMOUNT
PROCESSED
1015374850 187201 090 959 10/21/2015 $15.88
1015376279 125420 110 959 10/28/2015 $11.07
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.conbs@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 1
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))
11/07/15 water/snacks $26.95
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Kroger
Central Customer Charges
IN SUM OF $
P.O. Box 644467
Pittsburgh, PA 15264-4467
$26.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 42-390.99 $26.95
I hereby certify that the attached invoice(s), or
I I I
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, November 23, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund