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316823 10/6/2017 CITY OF CARMEL, INDIANA VENDOR: 00350363 CHECK AMOUNT: $**.......5.97* :a ONE CIVIC SQUARE PETTY CASHC/O MAYOR'S OFFICE CHECK NUMBER: 316823 CARMEL, INDIANA 46032 C/0 MAYOR'S OFFICE CHECK DATE: 10/06/17 MUTON 0p DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION PROMOTIONAL FUNDS 1160 4355100 5.97 / 0 T� « « qO 0 d - q O i § � 2 2 I � o M \ 0 2 ccn @ C 2 ƒ q _A k k S n m 4m -n CA) £ ■ 9 g n , o > 7 m m / § S 9 � ƒ ƒ 0 q / k ° m $ ° R 02 4 > n O iO 7C m CD 8 Z z =r \ i ( 7 Z / 0 / & / / / $ CL / x / � -§ CD 12 § K §# R 46 i $ f 3 A k CD 7 g $ [ - 0 $ ! 3 § \ CD i w § \ CL � \ ƒ % 2 5, k E 7 » k C § CD f § ; 7 , \ID f 7 CD / m § \� \ j ) \ / 0) ; e '< \ 0 } 0 2 0) -n M C / f � // § kk � k C } ( * \ E ® Z » _ 3 ; § %E k FT E § 0 � 7A / D CD ar 0 D �E r- _Q n $ 2 2 � r- + q z \ M 0 / j U -0 \ \ r- 0 Cb (D + ® 3C CD CD o §co \ k 0 n a CL CO) a0 PL M CD \ # ] k § 0 \ § , 2 CIL > \ § D -4 ) EMPLOYEE REIMBURSEMENT rD -T1 n Sales tax is not reimbursable NAME: � - ADDRESS: -1911 GaXW Ian —SvJ TOTAL$AMOUNT OF RECEIPT(S)ON THIS PAGE:$ t2 ,I PURPOSE OF EXPENSE: c., Use separate sheet for different purposes or events, as account coding may vary AFFIX ORIGINAL RECEIPT(S) BELOW OR ATTACH, IF RECEIPT IS FULL PAGE ..... ...... ._.............. e Pacers' Uffcial GraceryStare of the Indiana Pacer, 1217 S. RANGELINE RD. n 317-846-4818 Your cashier was KATE FIJI WATER 2.15 F MEX BAR PORK BKRY APL CKY SC RK GER SAVINGSV******4d775;31 RK GER COOKIES SC KROGER SAVINGS BKRY COOKIES Sc KROGER SAVINGS KROGER PLUS CUSTOMER Y#s$ BALANCE 0.63 US DEBIT Purchase 1B.75 ************2383 - C PURCHASE: 8005 CASHBACK:320.00 AID: ADDO0000980840 TC: 03B4F393D7AA72F4 VERIFIED BY PIN DEBIT 38.;5 CHANGE 20.00 TOTAL NUMBER OF ITEMS SOLD = 5 KROGER SAVINGS $ 300A SAVINGS i 3 . 09/21/17 12:53pn 959 36 119 632