249874 09/23/15 .coq
�';t. CITY OF CARMEL, INDIANA VENDOR: 364942
® it ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: $.....**147.71
:. ?4 CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 249874
''r aH. `• INDIANAPOLIS IN 46225-1447 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 2070886 147.71 FOOD & BEVERAGES
dOMMIM Ii0HIM81Q���I� II 6I i1��I� alb i
S q RE GOLF CLUB r B II:C N 0 L 27 CUSTOMER NO. ', CUSTOMER P.O.NUMBER . INVOICE NUMBER
0 BRO KSHI � ,
L CITY OF CARMEL OISTHIOUTING COMPHY IN INVOICE 7916 2070886
D 12120 BROOKSHIRE PKWY ORDER N0. PERMIT/LICENSE NO. TYPE INVOICE DATE
T 700 W. Morris Street RR29-03542 ALL 09/17/15
0 CARMEL IN 46032 INDIANAPOLIS, IN 46225-1447�' ROUTE I STOP EXPIRATION DAT TERMS
(317)--291-9042 (317)-636-4880 615 002 07/13/16 . NET 15 DAYS
SPECIAL INSTRUCTIONS: STATE PERMIT W49'-09133 SHIPMENT NO, DIV.NO.SALES NO. IIV.NO.SALES NO.DIV.NO.SALES NO DIV.NO.SALES NO.
42668 13213 122131 13213 12213
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE DUE DATE
Invoice 10/02/15
## PRINTED 2015 09- 16 19:21:06
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 11L 12 1 19.. 71 19. 71 19. 71 19. 71
95344 GJ41 COURVOISIER VS 80 750M 12 1 27. 76 _27. 76 . 00. ' 00 . 00
125889
5413 RH03 JACK DANIELS BLK WHSKY 1L 12 1 32. 92 32. 92 32. 92 32. 92
4020 RC22 JIM BEAM WHT 80 f ,J ^� IL 12 1 20. 38 20. 38 20. 38 20. 36
0 0 00 218 "125889
97083 RA03 MAKERS MARK 90 1L 12 2 37. 35 37.' 5 37. 35 74. 70
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LIOU0R LITERS GALS. WINE LITERS . 'BEER LITERS/
GALS.
B-picking
Error
or
0-0d not order GToo Eary/fo
o late
2-Pricing Error D-Damaged on Truck
6 6 6
3-Oof Business E-No Money15: RETURN CODES: A-Out of Stock
'
4-Duplicate F-Office Cancel 147. 71
6-Won't scan or not authored H-Defective CHECK N
HI H WIN LITER ALS. L W'WINE AL. PARKLIN LITER AL. J-S it on Truck
ACCEPTED,
RECEIVED BY CHECK AMOUNT
as the licensee,ag nt of this licensee,or gmployee thereof of th business accept the merchandise
shown on the invoice and certify that to th9 best of my knowledge there has been no change in PAGE 1
ownership of this business without notifica on to the State=Board and is the holder of an DATE: TIME:
r , effective permit/license.There will be a$50 service charge for any dishonored check.We are not 1'
responsible for breakage, loss, or damage to merchandise after delivery or acceptance by C'' 7
' • • Common Camer. ) 17 13
DRIVER SIGNATURE
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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))
09/17/15 2070886 Wine&Spirits $147.71
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
$147.71
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 2070886 I 42-390.40 $147.71 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, September 18, 2015
Director, Brooks Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund