160441 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 178002 Page 1 of 1
t ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $37.23
CARMEL, INDIANA 46032 INDPLS CUSTOMER CHARGES
PO BOX 415000
NASHVILLE TN 37241 -5000 CHECK NUMBER: 160441
CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DE SCRIPTION
1110 4343003 A03849 37.23 TRAVEL LODGING
v
.P�
e
7ear along perfaration and return top portion.
ACCOUNT BILLING
Outstanding As Of Due Date Customer Number AMOUNT DUE
05/17/2008 06/14/2008 A03849 $62.79
..DATE TICKET
TICKET P.O./REF. CARD# STORE. AMOUNT
PROCESSED
236521 033961 110 959 03125/2008 21.47
310973 084646 110 959 04/10/2008 4.09
424481 126089 110 959 05/16/2008 4.09
348865 025428 110 959 04/2912008 19.30
423010 004554 110 959 05/12/2008 13.84
For questions or copies. please contact Kroger Accounts Receivable toll free at 888 -327 -491 1(EXT. 65563 or 63250) or
email us at kasli.carhelpdeskOn 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.
]'lease retain bottom portion for 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
MSC 305099 Purchase Order No.
Kroger IndianapoliskCustomer Charges
P.O. Box 415000 Terms
Nashville, TN 37241 -5000
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/17/08 payment for refreshments for meetings and applicant 37.23
testin
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
MSC 305099
Kroger Indianapoiis Customer Charges IN SUM OF
P.O. Box 415000
N ashville, TN 37241 -5000
37.23
ON ACCOUNT OF APPROPRIATION FOR
p olice general fund
Board Members
PO# or INVOICE NO. ACCT /T1TLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
37. 23 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
June 3 2008
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund