246514 06/17/15 y ur�.F�gy
r , CITY OF CARMEL, INDIANA VENDOR: 364942 2.82"
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: $"'..**24
: _� CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 246514
,ytrm,"�� INDIANAPOLIS IN 46225-1447 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1980578 242.82 FOOD & BEVERAGES
7-777777-77'____':
_.
i � i ii ilj U[PUBLIC HHUNI
S BROOKSHIRE GOLF CL1JL" 24 C�NO. USTOMER P.O.NUMBER INVOICE NUMBER° CITE ��F CARrll 1. DISTflIDUTING CDMPflNV'LlC INVOICE i S C7
D 1212.0 BROOKSHIRE PRWY ORDER NO. 'PERMIT/LICENSE NO. TYPE INVOICE DATE
T
700 ;. Nor SVt'eiR29-0:3-42 ALL 0610 •:'1 7
0 Cr`1 ;N 460�t� INDIANAPOLIS,OLs:S, IN 4622S-1447 ROUTE STOP EXPIRATION DAT TERMS
f:317)--2`i'1-904"" +:317)-606-4880 614 009 0:'%1:3/'II NET 1E SAY~;
SPECIAL INSTRUCTIONS: STATE PERMIT W49'_(, ?133 SHIPMENT NO. DIV.NO.SALES NO.DIV.NO.SALES NO.DIV.NO.SALES NO. DIV.NO.SALES N0: '
39247 13213 1221;3 1321:3 i2 is
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE DUE DATE
iT1V0iC e 06:`��r'�
PRT14TFD 2019 06 02 * 19:27:02
ITEM NUMBER' LINE LOC. DESCRIPTION SIZE PACK CASES BOTTLES LIST DISCOUNTUNI C
T
"`' NET BOTTLE
BULK LOC. NET PRICE
UPC �� 'VINTAGE RC'',, RETURN RETURN PRICE DEAL# " COST
340,21,43 , RN0c . JAGERNEIS T ER 1L 12 2 26. 33 26. 33 2u. 3;3 E2. 66
4020 R C 2 2 JIM DEAN WHT GQ 1L 12 2 20. 38 20. :38 2C. 38 40. 76
T`Pa
97083'"083' RA03 MAKERS MARK90 :I L 12 4 37. 3 S 37. 39 37. 31::: 149. 40
59.1''1'•3 RRI-I42. PINNACLE VODKA L 12 4 16. 27 16. 27 00 CIO GGA
� 12 fiD03 RED .St•A0 F*Id u1III�I DEAN -'ta 1L.' 12 2 21. 74 21. 74 00,'= 00. 00
, z
`r 'F' 'mss 'n 'Fisf>.trar Fra m •e+'.a -x cca +r.c�s •;`.y.9.., es 5.n_.4 r+4Tecs-i7.-`aa-.•�e•.. ic�7 f•�cc ,y'E.v•e�ds4zr 1cr�ir.to `rd-elicyan raa
�.
�O
LLcU
G
• - U
LI-TER$,tGALLpRETURN CODES:, A-Out of Stock
LIQUOR'CITERS/GALS. WINE LITERS/GALS. BEER LITERS/GALS. &Picking Error
0-Did not order C-Too Eady/Too Late
2-Pricing Error O-Daroaged on Truck 14 14 t` 14
3-Out of Business E No Money •
.
3. 71) 4-Duplcate F Offke Ca cel ' c'I c7. 1't'�
HIG WINE LITERS/GAL. W WINE LITERS GALS. PARKLING LITERS GALS.
6-Won't scan or not autfrodzed N-Defective CHECK R
J�Shod on�Truck
��.°�''�,
ACCEPTED �v/ '. % �.°"�?✓d�
RECEIVED BY CHECK AMOUNT
I,as the licensee,agent ofIN liceif or.employee thereof of the business accept the,merchandise
shown on the invoice and cerfflyl-thaTto the best of my knowledge there has been no change in i PAGE 1
ownership of this business without notification to the StatPATE: TIME:
e Alcohol Board and is the holder of an
effective permitAicense.There will be a$50 service charge for any dishonored check.We are not I i
• responsible for breakage, loss, or damage to merchandise after,delivery or acceptance by I
• • ••! Common Carder.
VOUCHER NO. WARRANT.NO.
ALLOWED 20
Republic National Distributing Company
IN SUM OF $
P.O. Box 1602
Indianapolis; IN 46206
$242.82
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 1980578 I 42-390.40 I $242.82 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
Tuesday, June 09, 2015
Director, Brookshi 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))
06/04/15 1980578 Wine&Spirits $242.82
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