250546 10/20/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 364942
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: S'.""""327.05'
CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 250546
INDIANAPOLIS IN 46225-1447 CHECK DATE: 10/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 2091586 327.05 FOOD & BEVERAGES
nw:�OOKSHJRE 001-F CLUB' REP0BLIC NH110NHL - 22
$ CUSTOMER CUSTOMER P.O.NUMBER BER
NO.
o INVOICE
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ID NO.
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PE. 411�� �D 41�
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4 16 02 2 D,1)1 WP'L 113, 1W1, 46,22S-144-7
.6 ROUTE STOP EXPIRATION JERMS,N D T
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0 1 613 6--4 Fj 8
SPECIAL INSTRUM SHIPMENT NO. DIV.NO..,SL�Sp DIV.NO.P
,� � DIV.NO..S
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DELIVERY.NOTES: VENDOR ID.NUMBER jN,�0,1QEjY yE,DA P
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PRINTED 2-'OiS J I E S 0' 4 i?
ITEM NUMBER LINE LOC. DESCRIPTION SIZE PACK CASES BOTTLES LIST DISCOUNTUN'IT COST NET BOTTLE NET PRICE
BULK LOC. U PC VINTAGE RC RETURN RETURN PRICE DEAL# COST
:3 4 0 GC22 DEWARS WHIF LBLI/ 1L 12 i 32. 11 7 f1 31. 24 3 i. 2 z 11. 2 4
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2 0 8S 6 13 4
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LIQUOR LITERS I GALS. WINE LITERS GALS. BEER LITERS(GALS. &-PickngError
O-Did not order C-Too Earlyffoo Late
2-Pricing Enol D-Damaged on Truck 3 27. 0 S
3-Out of Business E-No Money TO
4-Duplicate` F-Office Cancel TAL
6-won't scan or not authorized H-Defective
HIGH-WiNE LoTEW- -UA-L—s 77W- LITERINE F/TA- -LT-—SPARKLING UTE-R-T/-6A-Ls I CHECK#
J-Shod on Truck
ACCEPTED x
RECEIVED BY v CHECK AMOUNT
[:as the licensee,agent of this icensee,oremployee PACE 1•
best
thereof of th�busine�s the merchandise
shown on the invoice and c rt I y I n a there=en no change in
ownership of this D.-i—, r. f an DATE:
Stale TIME:
effective permit/license.There will be a$50 service charge for any dishonored cIre-c"k."W-i-e-are not �Vvl I. UIV I 0r L/Ily
responsible for breakage, loss, or damage to merchandise after delivery or acceptance by
DRIVER S�q*Tql�E. jr i j na n r,i n
VOUCHER NO. WARRANT NO.
ALLOWED 20
Republic National Distributing Company
IN SUM OF $
P.O. Box 1602
Indianapolis, IN 46206
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
r
1207 I 2091586 I 42-390.40 I I 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
Monday, October 19, 2015
Director, Brooks re Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
10/09/15 2091586 Wine and Spirits $114.51
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
120
Clerk-Treasurer