246951 06/30/1 5 % CITY OF CARMEL, INDIANA VENDOR: 364942
® it ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: $..... 129.24"
CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 246951
INDIANAPOLIS IN 46225-1447 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1999526 129.24 FOOD & BEVERAGES
DI�9 DB SO i M ll 111111 N : �. .�. ::QI�Q H MIN a I H I IQ I _. . .�
$ BROOKSNIRE GOLF CLUB ', �� �� ��� 23 :=MER P.O.NUMBER INVOICE NUMBER0..' cCITY OF CARMEL. k < HISTHIBRING COMPHN� ��� INVOICE 1999526
D 12120 BROOKSHIRE PKWY ORDER NO. PERMIT I LICENSE N0. TYPE INVOICE DATE
700 W. Morris Street RR29-03542 ALL 06/25/15
T
0 CARMEL IN 46032 INDIANAPOLIS, IN 462.25-1947 ROUTE STOP EXPIRATION DAT TERMS
(317)-291'-9042 (317)-636--4880 616 012 07/13/1 ASSN COD
SPECIAL INSTRUCTIONS: STATE PtRMIT W49-09133SHIPMENT N0. DIV.NO.SALES NO.DIV.NO.SALES NO.DIV.NO.SALES NO DIV.NO.SALES NO.
39948 13.13r 12213 13213 1,2213
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE DUE.DATE
Invoice 06/2S/15�
# PRINTED 2015 '06 24 19: 25:25
ITEM NUMBER LINE LOC. DESCRIPTION SIZE PACK CASES BOTTLES LIST _ DISCOUNT NET BOTTLE
BULK LOC.' UPC C'_ ' VINTAGE RC--,,RETURN, `RETURN��„ PRICE _DEAL# UNIT COST COST NET PRICE
43001 B347 WOODBRIDGE MOSCATO 750M 12 1 77. 00 7. 00 70. 00 5. 83 70. 00
45233 KBOS CRUZAN CITRUS RUM 1L 12 2 17. 62 17. 62 17. 62 35. 24
:'12�4I36�3°
4946 GF52 KNOB CREEK RYE 100 750M 6 1 37. 25 s' 37. 25 . 00 . 00 00'
4620 ON14 KNOB CREEK SNCL BRL .RSV 750M 6 1 38. 75 38. 75 . 00 . 00 : 00
...�:__•,;
4
49062 RB13 PM GR AMBER PCN BRANDY 750M 12 2 12. 00 12. 00 12. 00 24. 00
5--,--...__. t�21-2�►iSf520+J2.4_�" ��.,...r.rw..._r��. __
aL:i';a~it,t'iretitfi�itallu ° :3TL�fiditi; t tiiiib%'le].p bu cclln ti6 ."l.tfAfi,ct o6ur deliveries.
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0 RETURN CODES: A-W of Stock
LIOUOR LITERS/GALS. WINE LITERS/GALS. BEER LITERS/GALS. B-ftng Error
D-Did not order C-Too Eady/Too tate x 6 18 / 18
2-Pricing Error D-Damagad on Truck
F I3-Out of Business E-No Money ® q
.1, 3;_ , 2. 38 129. 24
4-0uplicete F-Olfice Cancel . .
-
B-Won't scan or not authorized µpafec ve
IGH WI E LITER AL . LOW WIN LITER ALS. PARKLIN LITERS GALS. i ,I�hoA Truck �' CHECK#
ACCEPTED
2. 38 ��s r,✓.i�`� C'�'°,d`as
RECEIVED BY CHECK AMOUNT
I,as the licensee,age6t of K.license,o mployee reof of t¢e�''ess accept merchandisePAGE �.
shown on the invoice and certify that to the bes my knowl there has been no change in
ownership of this business without notification the Stat�e Alcohol Board and is the holder of an DATE: TIME: '- -
effective le for
There will be a$50ma s �rchan for any dishonored check.We are not
D 0 . responsible for breakage, loss, or damage to merchandise after delivery-or acceptance by (CJI! lJ `i.✓/`�l/
A Common Carrier. i R.SIGNATUREti.
D° 0 OOD IVE
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))
06/25/15 1999526 Wine&Spirits $129.24
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
Republic National Distributing Company
IN SUM OF $
P.O. Box 1602
Indianapolis, IN 46206
$129.24
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 1999526 I 42-390.40 I $129.24 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
Friday, June 26, 2015
Director, Brookshir off Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund