164751 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 129401 page 1 of 1
ONE CIVIC SQUARE MICHAEL HOLLIBAUGH
0 CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK AMOUNT: $42.75
CHECK NUMBER: 164751
CHECK DATE: 1011612008
DEPARTMENT A CCOU NT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
,J192 „4355100 42.75 PROMOTIONAL FUNDS
aat
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The Miracle Rest -gurani irOua
welcomes You to Ounk i n Donuts
9/30/2008 7:22:01 AM
Eat In
Order Number: 345695
?_egister:l Tran Seq No: 345695
"ashier:Hiram E.
2 12 Donuts 15.90
2 Bx Joe Orig Blnd 27.90
Box Joe 12 Donuts (3.90)
Box Joe 12 Donuts (3.90)
Sun. Total: $36.0
Tax:
Total: $38.33
Discount Total: ($7.80)
Change $1.67
Cash $40.00
Michael Thompson, General Manager
317 581 -0257
ww
J
Right Store. Right Price.
1217 S. RANGELINE RD,
317- 846 -9818
YOUR CASHIER WAS SELF CHECK001
KROGER PLUS CUSTOMER *r *2769
KRO GRANBAR PC 1.97 F
SC 1120 KRO GRANBAR (1.66) 0.31 -F
KRO GRAN BAR PC 1.97 F
SC 1120 KRO GRAN BA (1.66) 0.31 -F
TROP ORNG JC 3.93 F
TAX
BALANCE
CASH
CASH 1.00
CASH 1.00
CHANGE 0.25
TOTAL NUMBER OF ITEMS SOLO 3
t *4 KROGER SAVINGS
KROGER PLUS SAVINGS 0.62
TOTAL SAVINGS (8 Pct.) 1 0.62
*r KROGER SAVINGS
09/29/08 10 26Pm 959 89 129 999
**Kroger Plus Fuel Rewards
Prior months remaining:$998
Redeem bsi 09/30/08
*Fuel Rewards
Receive a 10-cent per gallon discount
off your fuel purchase
each time you spend $100 in groceries.
Accumulate now through 09/30/08
Redeem now through 10/31/08
*Certain Restrictions apply
*See store for complete details
Qualifying this order $6
Qualifying this month $218
*SEE WHAT YOU ARE SAVING TODAY*
YOU SAWED $0.62
WITH YOUR PLUS CARD
BY USING YOUR KROGER PLUS CARO,'YOUR
ANNUAL SAVINGS TO DATE IS $599;69
I
THANK YOU FOR SHOFFING KROGER
i
CUSTOMER SERVICE IS EVERYONE'S JOB.
LET ME KNOW HOW WE ARE DOING.!
1
CHARL BECHEL, MANAGER
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.
J Payee
Y Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
ZS3 4a 7
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
G a ADCs
Z/C�. 5
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT4/TlTLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
55 q,,?, 75 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
1 01131200K
ig rp
os
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund