164311 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 178002 Page 1 of 1
ONE CIVIC SQUARE KROGER CO
I O CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK AMOUNT: $9.68
PO BOX 644467
CHECK NUMBER: 164311
PITTSBURG PA 15264 -4467
CHECK DATE: 9/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 9.68 TRAVEL LODGING
i'
Tear along perforation and return top portion.
ACCOUNT BILLING
"Outstanding As Of Due Date'' Customer Number AMOUNT DUE
09106/2008 10/04/2008 A03849 $130.21
TICKET P.O. /REF. CARD STORE DATE TICKET. .AMOUNT
PROCESSED
638874 001207 110 959 07/14/2008 29.29
639158 024536 110 959 07/15/2008 29.03
639159 024547 110 959 07/15/2008 43.76
639467 049465 110 959 07/16/2008 18.45
749090 029230 110 959 08/19/2008 9.68
For questions or copies, please contact Kroger Accounts Receivable toll free at 888 327 -491 l (EXT. 65563 or 63 250) or
email us at kash.carhelpdesk@kro g encom 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 bottan portion fol• your records. Page: 1 of 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.
Payee
r
Central Customer Charges Purchase Order No.
P.O. Box 644467 Terms
Pittsburgh, PA 15264 -4467 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/23/08 a ent for items for media dinner 9.68
Total
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
Central ustomer Charges
IN SUM OF
P.O. Box 644467
Pittsburgh, PA 15264 -4467
9.68
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. a I hereby certify that the attached invoice(s), or
1110 430 -03 9.68 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
September 23 20 08
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund