HomeMy WebLinkAbout202784 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 360690 Page 1 of 1
ONE CIVIC SQUARE JOHN THOMAS
i CHECK AMOUNT: $28.46
CARMEL, INDIANA 46032 11576 CREEKSIDE LANE
CARMEL IN 46033 CHECK NUMBER: 202784
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4462830 28.46 116TH ST COLLEGE TO R
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ue iFoir -t tr��
Jts Wou I I've
1217 S. RANGELINE RD.
317- 846 -4818
A, S C YOUR CASHIER WAS SELF CHECKOUT
KROGER PLUS CUSTOMER *9656
�L-P 10 1.48
1 A KRO FRTSNKS PC 10.00 F
SC PLUS CARD SAVINGS 4.80
�J �S JJ!h sU sb TABLECOVER 1.99 T
3 5.49
16.47 F
U l I PF GOLDFISH
TAX
BALANCE 28.60
*•k *1093
REF 000000
PURCHASE: 28.60
CASHBACK: 40.00
TOTAL `68.60
OBIT 68.60
CHANGE 40.00
TOTAL NUMBER OF ITEMS SOLD 14
*x KRO:ER SAVINGS
ER PLUS SAVINGS- 4 ..80
SAVINGS 14 Pc{ 4780 i
KROGER SAVING5 ht(# t
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
Purchase Order No.
nefri h R Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
lU `I CbX
m 2Q It
Total Z�
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
IN SUM OF
4(0
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
r1 C. 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
C 20
Wig �tu
Title Y
Cost distribution ledger classification if
claim paid motor vehicle highway fund