249006 08/26/15 o
CITY OF CARMEL, INDIANA VENDOR: 364942
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: $*******353.02*
CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 249006
INDIANAPOLIS IN 46225-1447 CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 2040871 353.02 FOOD & BEVERAGES
MINI �I dill 1111IN111 I MI �n � ��Rt}�5'ft
1 7 U U . ll.l� LLY U Il Il 9 {I E tfL t
S BROOKSHIRE GOLF CLUB c� 19 CUSTOMER N0. CUSTOMER P.O.NUMBER INVOICE,NUMBER^'' I I
° CITY OF CARMEL
HISTHIBUTING COMPHR IN INVOICE 7916 2040871- '
D 12120 DROOKSHIRE PKUY ORDER N0. PERMIT/LICENSE N0. TYPE INVOICE DATE
700 W. Morris Street kk29--03543 ALS. 08/33/Is
T
CARMEL. IN 46032 INDIANAPOLIS, IN 46225-1447 ROUTE STOP EXPIRATION DAT TERMS ".slk`
(317)-291-1042 017)-636-4880 614 002 07/13/1 NET 15 DAYS
SPECIAL INSTRUCTIONS: STATE PERMIT W49-09133 SHIPMENT NO. DIV.NO.SALES NO.DIV.NO.SALES NO.DIV.NO.SALES N0. DIV.NO.SALES NO.
t_ 12213 i.i213 14'1;3
41.S30 1.3
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE DUE DATE
% Invoice 08/28/15 ,
sF PRINTED 2015 08 12 19: 17: 18
ITEM NUMBER LINE LOC. DESCRIPTION SIZE PACK CASES BOTTLES LIST DISCOUNT NET BOTTLE
BULK LOC. UPC VINTAGE RC RETURN RETURN PRICE DEAL# UNIT COST COST NET PRICE
73433 RC03 BACARDI SUPERIOR RUM 1L 12 2 19. 71 19. 71 19. 71 39. 42
OL .___..____ . 08048001,5305 it.4
340043 ,RS03 GREY GOOSE VODKA IL 6 ,/ 4 38. 17 " ' 38. 17 38. 17 .152. 68
080406698000"
5413 RH03 JACK DANIELS BLK WHSKY 1L12 - �2 32. 92 32. 92 32. 92 65. 84
4020 RC22 JIM BEAM UHT 80 IL 12 1 20. 38 20. 38 20. 38 20. 38
& Itd _� _ 18n�►8€�OG218 -
97083 RA03 MAKERS MARK 90 1L 12 2 37. 3r, 37. 35 37. 35 74. 70
5 085246139424 . ....
E�E'LL BE CLOSED C690kt DAY 9/7
,To he D, RNDC be c�rr6-envx;roniseh tills Ori .rid.l t lease eln b cc nso I at�� our deliveries.
a.
- CC
CC
O
i
• RETURN CODES: A-Out of Stock
LIQUOR LITERS/GALS. WINE LITERS/GALS. BEER LITERS/GALS. B-Picking Error
R-Did not order
'-Too
EadyRoo Late
-P Error
2 ncn o
g D-Damaged on Truck
3-Out of Business E-No Money e t
2. 9 ' 4-Duplicate F-Office Cancel 353. 02
HIGH WINE LITERS GAL 6-Won't scan or not authorized H-Defective CHECK#
LOW WINE LITER / AL. PARKLIN LITER /GAL . J-Short on Track
ACCEPTED
RECEIVED BY CHECK AMOUNT
I,as the licensee,agent of this licensee,or employee thereof of the business a e the merchandise
shown on the invoice and certify that to the best of my knowledge there has can no change in PAGE 1
' ownership of this business without notification to the State Alcohol Board and is the holder of an DATE: TIME:
effective permitAicense.There will be a 5.50 service charge for any dishonored check.We are not
'® ® responsible for breakage, loss, or damage to merchandise after delivery or acceptance by
Carrier.arrier. J 1
DRIVER SIGNATURE .. -
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.
i
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/13/15 2040871 Wine&Spirits $353.02
1 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
$353.02
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 2040871 I 42-390.40 I $353.02 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, August 13, 2015
Director, Brook ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund