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164312 09/30/2008 a. co CITY OF CARMEL, INDIANA VENDOR: 176002 Page 1 of 1 *f ONE CIVIC SQUARE KROGER CO 0 CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK AMOUNT: $226.07 PO BOX 644457 CHECK NUMBER: 164312 PITTSBURG PA 15264-4467 CHECK DATE; 9130I2008 DE PARTMEN T AC COUNT PO NUMBER INVOICE NUM AMO DESCRIPTION 1046 4239037 A32257 108.16 CLUB ACTIVITY SUPPLIE 1046 4239039 107.91'GENERAL SUPPL .1046 4239099 A32257 10.00 OTHER MISCELLANOUS Tear along perforation and return top portion. ACCOUNT BILLING Qutstanding.As Of Due Date Customer Number AMOUNT 'DUE 09/06/2008 10/04/2008 A32257 $366.93 TICKET P.O:IREF. CARD STORE DATE 71QKET AMOUNT PROCESSED 736956 005851 223 959 08/11/2008 14.81 8915 959 08/14/2008 5.00 8916 980 08114/2008 5.00 738193 110122 203 959 08/15/2008 36.97 749710 030022 203 959 08/2112008 49.98 740179 084811 253 959 08/23/2008 23.75 811602 084408 223. 959 08/28/2008 31.48 812064 133753 213 959 08/30/2008 20.96 823361 062703 223 959 09/04/2008 35.04 823702 090334 223 959 09/05/2008 26.83 823872 109754 203 959 09106/2008 117.11 For questions or copies, please contact Kroger Accoul)tS Receivable totl free at 888-327-49 11 (EXT. 65563 or 63250) or email us at kash.carhelpdesk @krotrer.com Please review your account promptly and advise it payments have been made. There will be a $5 fee for each ticket copy recluestecl. Please retain bottom portion for your records. Page: 1 of 1 THE KROGER CO. Kroger Accounting Services Hutchinson Customer Accounts Receivable 2700 E. 4th Hutchinson, KS 6750 (888) 3 27 -4 September 11, 2008 SEP 2 2 2008 Dear Valued Customer, Please be advised that the remittance address on your customer charge account billing has chanced. Please update you records to reflect the new remittance address, as payment processing at the former address will Below is our Substitute W -9 to help you update your records. If you have any questions, please contact us at (888) 327-4911. We thank you for your cooperation and understanding as we make this transition. SUBSTITUTE W -9 Please be advised that Kroger Accounting Services performs various accounting functions for the Kroger Company and its subsidiaries. Please note that the Kroger Company is incorporated, exempt from backup withholding and a 1099 is NOT required. Nature of business is retail. Kroger Limited Partnership I Division 021: Central Federal Tax ID Number: 31- 1569568 Remit to Address for Pa rnents: Central Customer Charges P.O. Box 644467 Pittsburgh, PA 15264 -4467 Signature Jennifer McClenahan, Manager Customer Accounts Receivable Kroger Fund 1046 F und 1 047 General Club Other Prog Supplies Misc. Supplies V #178002 Invoice 4239037 4239099 4239039 08/11/08 5851 14.81 08/14/08 8915 5.00 08/14/08 8916 5.00 08/15/08 110122 36.97 08/21/08 30022 49.98 08/28/08 84408 31.48 09/04/08 62703 35.04 08/30/0 133753 20.96 09/05/08 90334 26.83 108.16 10.00 107.91 226.07 Kroger Fund 1046 F und 1 047 Genera Club Other Prog Supplies Misc. Supplies V #178002 Invoice 1 4239037 4239099 4239039 Kroger RECEIVED AUG 19 2008 Invoice# 89 1 MSC 305099 9 PO 80X 415000 $Y' NASHVILLE, TN 37241 -5000 CARMEL CLAY PARKS RECREATION Customer: A32257 1411 EAST 116TH STREET Terms: Net Cash CARMEL IN 46032 Date: 8/14/2008 Store: 959 Amount: 5.00 519424 $78.85, PAULA For Office Use Only DR 021 0021100 1 CR 021 0025860 5.00 r Kroger Invoice# 008916 MSC 305099 V AUG 1 92008 PO BOX 415000 NASHVILLE, TN 37241 -5000 gi BY: CARMEL CLAY PARKS RECREATION Customer: A32257 1411 EAST 116TH STREET Terms: Net Cash CARMEL IN 46032 Date: 8/14/2008 Store: 980 Amount: 5.00 519449 $147.44. PAULA For Office Use Only DR 021 0021100 1 CR 021 0025860 5.00 V\ 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 Kroger Purchase Order No. 178002 Central Customer Charges Terms P.O. Box 644467 Date Due Pittsburgh, PA 15264 -4467 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/6/08 A32257 Club supplies 108.16 9/6/08 A32257 Other Misc. 10.00 9/6/08 A32257 General Program supplies 107.91 Total 226.07 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 1 20 Clerk- Treasurer i Voucher No. Warrant No. Kroger 178002 Central Customer Charges Allowed 20 P.O. Box 644467 Pittsburgh, PA 15264 -4467 I\ +e�N In Sum of 226.07 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT#fTlTLE AMOUNT Board Members Dept 1046 A32257 4239037 108.16 1 hereby certify that the attached invoice(s), or 1046 A32257 4239099 10.00 bill(s) is (are) true and correct and that the 1046 A32257 4239039 107.91 materials or services itemized thereon for which charge is made were ordered and received except 23 -Sep 2008 Signature 226.07 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund