247630 07/21/15 ?r
MF. CITY OF CARMEL, INDIANA VENDOR: 359294
® l' ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $*****"*202.30*
f_ CARMEL, INDIANA 46032 PO BOX 2856 CHECK NUMBER: 247630
KOKOMO IN 46904-2856 CHECK DATE: 07/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 202.30 FOOD & BEVERAGES
MID ERICAINVOICE
I
CITY OF CARMEL
BGE dba BR0t3KSH IRE GOLF 'CL•UB'
INCE fir; € 12120 BROOKSHIRE PARKWAY .
2755 Commerce'Dr. CARMEL IN 4603'x'
i
P.O. Box 2856 r F A
Kokomo, IN 46904-2856 RR2963542 EXP. 16,113/15
765-459-3117
800-382-0675
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
07/23/15 612496 Dustin Smith 13 800 .13
BASE September 29, 2014
PROMO #0715
WINE W3428870
209 S� Bud Lt 24 Lse Can 18.60 148.80
225 1� Bud Lt 1/4 BBL 53.50 30.00 83.50
Y!
l
Cases 8 1/4 Barrels 1
• •. •. • TOTAL SALE 232.30
10303- ! EMPTY AB 1/6 30.00 5447, 6Z9 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10301 EMPTY CROWN 1/4 BBL 30.00 N
9230 PUMP DEPOSIT
9270 IMPORT PUMP DEPOSIT K 232.30
TOTALRETURNS .
0 CREDITS
❑ Cash ❑ EFT ❑ Escrow Check Number Gt �<�7 � U ® . 5 7
-30
Driver � /i �9 Received By .
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))
07/23/15 I 612496 I Beer I $202.30
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
with 1C 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc. IN SUM OF $
P.O. Box 2856
Kokomo, IN 46904-2856
$202.30
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
-r
1207 I 612496 I 42-390.40 I $202.30 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
Thursday, July 23, 2015
Director, Broo hire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund