180865 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 178002 Page 1 of 1
ONE CIVIC SQUARE KROGER CO
�J CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK AMOUNT: $1,177.05
PO BOX 644467 CHECK NUMBER: 180865
°."..r PITTSBURG PA 15264 -4467
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 PARKS 185.90 CLUB ACTIVITY SUPPLIE
1046 4239040 PARKS 368.17 FOOD BEVERAGES
1047 4239039 PARKS 153.62 GENERAL PROGRAM SUPPL
1047 4239099 PARKS 14.54 OTHER MISCELLANOUS
1047 4341993 PARKS 454.82 CATERING SERVICE
Tear along per /oration and return lop portion
ACCOUNT BILLING
-Out A� of Due Date C ber AMOUNT D
12/05/2009 01/02/2010 A32257 $1,177.69
ti P 0 JREF DATE TICKE g
TICKET STOR AM O UNT
1 .PROCESSED
A10392 139932 233 959 10/23/2009 54.98
A32657 006132 233 959 11/01/2009 24.99
A33271 064283 273 959 11/03/2009 50.61
A34190 235567 233 959 11/06/2009 49.98
A45087 046920 273 959 11/10/2009 50.92
A46040 156898 263: 959 168.11
A46041 158504 273 959 11/13/2009 12.17
A46042 161927 .263 Y '''959 3 ;11/13/2009 9.744'
B16354 102871 263 086 1' 158.75
B16355 F„ 263 i 0 86 1`111,6/2009 5.14-
B16659 001239 e` 233: ;:959: 11/1'6/2009 14.54
B16999 123571 273;: 959 11/1.7/2009 15.01
B18013 240919 233 959 111/20/2009 124.95
B28989 108512 263: X 959 11/24/2009 54.94
B28990 138522 273 959 .11/24/2009 24.91
B29422 200148 233; 959 11/27/2009 99.96
B30933 182519 ,a 263`- 959 ;12/03/2009 100.51
B30934 185353 h 233 959 1 2/03/2009 24.99
B31212 224345 14 263 -959 1- 2/04/2009 67.80
959 12/04/2009 74.97
B31213 241539 :y233
``'01E117 '1'
LIu DEC 7 0 2009
For questions or copies, please contact Kroger Accounts Receivable toll free at 888 -327- 4911(EXT. 65563 or 63250) or
email us at kash.carhelpdesk@kroger.com.Please review your account promptly and advise if payments have been
made.
There will be a $5 fee for each ticket copy requested.
Please retain bottom portion for your records. Page: 1 of 1
DOCQ
Ar. 3 •26.7
era I 1.%911 UriT
1.j ti,t112000Nrat01;
5 -7.
SKLJ 6 aJ ord
g# Di1 Titnit krnaii
21 959 139 10 a170 149 1111005758 BKRY112SH WI-IT $24.99 S0_00 $00O Regular Swiped
CAKE SS
21 S0.00 S0.00 $24_99 Credit Card Swiped 5858840000002577
TLf $499
r 7 7.7.: 3
vp tras,
173
u DEC 0 1 2009 Li
Purchase
Description
0
P.O.
P or F
0 G.L
Bud el 3 t escr
Line
Purchaser Date
APPrPvel Date
0.
In
z
0
a,
Kroger 1 Fund 1046 Fund 1047
General
Club Food Prog Other Catering
Supplies Beverage Supplies Misc. service PO
V #178002 Invoice 4239037 4239040 4239039 4239099 4341993
6132 11/1/2009 24.99
10/23/09 139932 54.98 22750
11/13/09 156898 168.11 22863
11/13/09 161927 9.74 22894
11/13/09 161927 -0.64 22894
11/16/09 102871 158.75 22895
11/16/09 102871 -5.14 22895
11/10/09 46920 50.92 22880
11/03/09 64283 50.61 22849
11/17/09 123571 15.01 22849
11/06/09 235567 49.98 22837
11/13/09 158504 12.17 22888
11/20/09 240919 124.95 22837
11/16/09 1239 14.54
11/24/09 108512 8.49 46.45 54.94
11/24/09 138522 24.91
11/27/09 200148 99.96 22837
12/3/09 182519 100.51
12/4/09 224345 67.80 1
12/3/09 185353 24.99 1 22995
12/4/09 241539 74.97 1 22995
185.90 368.17 153.62 14.54 454.82 1177.05
Kroger Fund 1046 Fund 1047
General
Club Food Prog Other Catering
Supplies Beverage Supplies Misc. service
V #178002 Invoice 4239037 42390401 4239039 4239099 43419931
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
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
178002 Kroger Central Customer Charges
P.O. Box 644467 Date Due
Pittsburgh, PA 15264 -4467
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/5/09 A32257 Club.supplies 185.90
12/5/09 A32257 Food Beverage 368.17
12/5/09 A32257 General Program supplies 153.62
12/5/09 A32257 Other Misc. 14.54
12/5/09 A32257 Catering service 454.82
Total 1,177.05
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
178002 Kroger Central Customer Charges
P.O. Box 644467
Pittsburgh, PA 15264 -4467 In Sum of
1,177.05
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1046 A32257 4239037 185.90 I hereby certify that the attached invoice(s), or
1046 A32257 4239040 368.17 bill(s) is (are) true and correct and that the
1047 A32257 4239039 153.62 materials or services itemized thereon for
1047 A32257 4239099 14.54 which charge is made were ordered and
1047 A32257 4341993 454.82 received except
23 -Dec 2009
Signature
1,177.05 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund