252127 12/02/15 CITY OF CARMEL, INDIANA VENDOR: 370102
® ONE CIVIC SQUARE NEIL SHAH CHECK AMOUNT: $**....*211.90*
=a CARMEL, INDIANA 46032 13360 SIOUX TRAIL CHECK NUMBER: 252127
CARMEL IN 46033 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 4359033 211.90 MAYOR'S YOUTH COUNCIL
1 Great food.
Low prices.
14800 HAZELL DELL RD
317-844-1004
Your cashier was Kasha
KROGER PLUS CUSTOMER *******4228 Q
MR 7675007069 VISA $100 105.95 1_ p u mpk.n C
GV ************3587 100.00 Blnc
t'tR 7675007069 VISA $100 105.95
GV ************8472 100.00 Slnc
TAX
**
BALANCE211.94
IN 46062
!EISA Purchase **********.**1603
REF#: 022322 TOTAL: 211.90
VISA 211.90
CHANGE 0.00
DOTAL NUMBER OF ITEMS SOLD = 0
10/22/15 08:01pm 980 12 128 145
OCTOBER FUEL POINTS
REDEEM 100PTS TO SAVE .10 PER GAL.
ON ONE PURCHASE OF UP TO 35 GAL.
SAVE UP TO $1 PER GAL AT KROGER OR
.10 PER GAL AT SHELL ON 1 FILL-UP.
=UEL POINTS THIS MONTH 1551
fHIS i1
VISIT WWWNKROGERTCOM/FUE3
L FOR DETAILS
Annual Card Savings $563.21
Now Hiring - Apply Today!
aobs.kroger.com -
www.kroger.com
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))
10/22/15 Receipt $211.90
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
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Neil Shah
IN SUM OF $
13360 Sioux Trail
Carmel, IN 46033
$211.90
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
y
854 Receipt
Ma oes Youth Council $211.90 1 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 30, 2015
Y��2zz
Director, Community elations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund