256506 03/15/16 4a ul..��gyf
v! CITY OF CARMEL, INDIANA VENDOR: 364942
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: $*«.««««166.32*
°+; ,a; CARMEL, INDIANA 46032 INDIANAPOLIS00 W SNT46225-1447 CHECK NUMBER: 256506
iron�O' CHECK DATE: 03/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239099 2210728 166.32 OTHER MISCELLANOUS
1111Jill111 IL11111111111Hfd! �� HIPUBLIC N[ITIONHI ,�. 11111111111
D '` r:""` �' _ DISTRIDUTING CDMPflNV LLC �M hfslf.7l'r";;� CUSTOM4R N0. CUSTOMER P.O.NUMBER INVOICE NUMBER
D t'2- %rJ BR1-10 51.11 IRI F'?"F'?" sr ORDER NO. PERMIT/LICENSE NO. TYPE INVOICE DATE
1'1G+T'7":s IL ��'t:rE'E"'G T 1 '2T 0 .'.��%� AIL r4li
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STOP EXPIRATIONDAT
y TERMS
( --9--`rf--C7o 4.. .i rr�r' 6--4�i 80 7 lS alt tl•.�'y fix. r'•�.f MET 1S �AYS
_ .a i a=!? �'1 �i�'i�.1 I:� `?""r`+ 13'-� =SHIPMENTLES NO.DIV.N0.SALES NO.DIV.N0.SALES N0. DIV.N0.SALES N0.
SPECIAL INSTRUCTIONS: ?2..I, 1221313210 +221:3
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE i DUE DATE
52: 10
2-1
ITEM NUMBER LINE LOC. DESCRIPTION SIZE PACK CASES BOTTLES LIST DISCOUNT NET BOTTLE
BULK LOC. UPC VINTAGE PRICE DEAL# UNIT COST COST NET PRICE
73E233 F."r"()31 (-iC:r'•sC.DT '6*U'i• RI(!R 1 LE! a Z,_ i.� 1. fly. '71 19. 71 1?. 71 1T. 'Z
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+` 1(#7r,, RI') :; MAKERS MARK S! ya._ Lr 1. 37. Jl37-1.1 -- 3S
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GALLONAGELITERS
RETURN CODES: A-Out of Stock
LIQUOR LITERS/GALS. WINE LITERS/GALS. BEER LITERS/GALS. B-Picking Error
0-Did not order C-Too Early/roo Late
2-PHcing Error D-Damaged on Truck =
3-Oul of Business E-No Money . 16l •32
• =-+- 4-Duplicate F-0tfice-Gar�cel 'l`-
6-Won't scan or not autho zed {�-0efed v
HIGH WINE LITERS GALS. LOW WINE LITERS/GPARKLING L
ALS. SITERS GALS. j J-Sho n Truck CHECK#
ACCEPTED , f� J�
RECEIVED BY� �� � CHECK AMOUNT
I,as the licensee,age of this licensee,o emplp eelthereof of the business accept the merchandise r I
shown on the invoice and certify that to the best of my knowledge there has been no change in DATE: TIME: 1'ftL r
ownership of this business without notification to the State Alcohol Board and is the holder of an
effective penniNicense.There will be a$50 service charge for any dishonored check.We are not „f
responsible for breakage, loss, or damage to merchandise after delivery or acceptance by
Hill L •]:ffeT@Tfl Common Carrier. G! 7
escribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
hom, rates per day, number of hours, rate per hour, number of units, price per unit,etc.
Payee
Purchase Order No.
Terms
Date Due
voice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
02/25/16 I 2210728 I Wine&Spirits I $166.32
1207 101
hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance
Pith IC 5-11-10-1.6
, 20
Clerk-Treasurer