244784 4 /29/2015 J� CITY OF CARMEL, INDIANA VENDOR: 364942
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: S"**'
*'301.96*
CARMEL, INDIANA 46032 PO Box 1602 CHECK NUMBER: 244784
vM, INDIANAPOLIS IN 46206 CHECK DATE: 04/29/15
k�TpN�•
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1944600 301.96 FOOD & BEVERAGES
�i I IlIII HIIIFE I'll '
MER P. INUruititH
7 51 6 1 -�017'Ei 4 6()0
S 1;r�OOVSHIRP' GA01.5 CLUD HIPUBLIC HHTIONHI 20 CUSTOMER—N O.NUMBER
I��. CUSTO
'
0 INVOICE
L HISTHIMINO COMPHY Rc -C
D ORDER NO. PERMIT/LICENSE NO. TYPE
INVOICE DATE
700 W. RR251-03542 ALL 04/2?/iS
T I HI 4'032 1NDIANAPOLIS, IN 4622S-144-17
0 ROUTE STOP EXPIRATION DAT TEAMS
DAYS
31 7( 2 9.1 '7042 31-Ti-636-488-0 7 3/1 72 NE 11-5
SPECIAL INSTRUCTIONS:Iw. .-, 51T*.,1E PE"1"1 T
7 103 .I DIV.NO.SALES NOI.JDIV.NO.SALES NO. IV.NO.SALES
No
DIV.N
O.SALES NO.
OA -r.Gh.-" �, L. 1321 122 .4 132-I`
DELIVERY NOTES: VENDOR 1D NUMBER INVOICE TYPE DUFDATE
SCOT T N,1)N!T(,;0 h E R YL I-q,,, `C, e
PR'INTED 2'01S 04 23 i�i;l I S 2: 5?
ITEM NUMBER LINE LOC. DESCRIPTION SIZE PACK CASES~ BOTTLES LIST DISCOUNT UNIT COST NET BOTTLE NET PRICE
BULK C. UPC VINTAGE RC RETURN RETURN PRICE DEAL# COST
20�F 20
1'�40043 D033 GREY GOOSE V01"'A I L 1. 217. OC 7. `,F 3 )C"
s4i3 RHOS JACK' DANIEL'S If L N WHS14Y i L 12 3 30. ?2 30. 92 3 92 76
To tf IP R1 Dr, be r:ore Pr i en el LI, -,Iba�.e help bLi Liour deliveries.
0
C)
LU
0
W
LITERS GALLONAGE RETURN CODES: A-Out of Stock
LIQUOR LITERS GALS. WINE LITERS/GALS. BEER LITERS I GALS. B-Picking Error
_0-DA not order C-Too Early/Too Late 3 7
2-Pricing Error D--Damaged on Truck
3-Out of Business E-NoMoney 11)1. 516
4-Duplicate F-Office Cancel
LOW WINE LITERS —6-Won'1 scan or not authorized H-Defective HIGH WINE LITERS J GAL I GALS. SPARKLING TER GALS. — J-Short on CHECK#
ACCEPTED <7--,�7-�
CHECK AMOUNT
lcdiee,on usiness accept the merchandise
RECEIVED BY
�Cl
the license? rifcce iet r%mployee thereof of the b
invoice
ge tnof��
s ead y that best of my knowledge'there has been no change in PAGE I
this
0 �s��ess without
noti�t( to the State Alcohol Board and is the holder of an DATE: TIME:
effec"ve'ermi"icensl,There will be a$50 service charge for any dishonored check.We are not
responsible for, boa go, loss, or damage to merchandise after delivery or acceptance by tl
Common Carrier. ��/ 21 ell(:�;7
DRIVER SIGNATURE— A
VOUCHER NO. WARRANT NO.
ALLOWED 20
Republic National Distributing Company
IN SUM OF $
P.O. Box 1602
Indianapolis, IN 46206
$301.96
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I 1944600 I 42-390.40 I $301.96 1 hereby certify that the attached invoice(s), or
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
I
Monday, April 27, 2015
Director, Brooks Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
04/23/15 1944600 Wine&Spirits $301.96
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