258513 05/10/16 CITY OF CARMEL, INDIANA VENDOR: 364942
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY CHECK AMOUNT: S*******360.60*
CARMEL, INDIANA 46032 700 W MORRIS ST CHECK NUMBER: 258513
INDIANAPOLIS IN 46225-1447 CHECK DATE: 05/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
..1207 4239040 2272390 360.60 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO.
ALLOWED 20
REPUBLIC NATIONAL DIST COMPANY
700 W MORRIS ST
IN SUM OF$
INDIANAPOLIS, IN 46225-1447
$360.60
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Course
PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members
2272390 42-390.40 $360.60 1 hereby certify that the attached invoice(s), or
1207 I 101
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, May 05, 2016
ZZA-V
Cost distribution ledger classification if
claim paid motor vehicle highway fund
rescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
m 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
nvoice Date invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
05/05/16 I 2272390 I SpiritsI $360.60
1207 101
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
1111111111111111111111111111111 REPUBLIC NHTIUNHI 1i I IIIII 11111111111111
BROOKSH RE GOLF CI UL4DISTRIBUTING CDMPflNY LLC �.1 CUSTOMER N0. CUSTOMER P.O.NUMBER INVOICE NUMBER
CITY OF c:,t 0%MEl_ ZI',1VOICE 7916 ;`272`390
1.2120 iSfiQWKSOHIRE P14W)' ORDER NO. PERMIT/LICENSE NO. TYPE INVOICE DATE
7ti0I.v. IICJFFIB 'i.FGE?1 i'R._J'F-0354R ALLt)5/05i, 16
CARMEL 1114 46032 II'•IDIAPdAPOLIS, IN 46L2;-1447 ROUTE STOP EXPIRATION DAT TERMS
E 317)--291-9042 t317)-636-4680 612 002 f)7/13/16 NET 15 Ds--)Y8
SPECIAL INSTRUCTIONS: STATE PERMIT 6,4$9-0913? SHIPMENT NO. DIV.NO.SALES NO.DIV.NO.SALES NO.DIV.NO.SALES N0. DIV.NO.SALES NO.
50363 13213 12213 1323.3 12 13
DELIVERY NOTES: VENDOR ID NUMBER INVOICE TYPE DUE DATE
n VC) f y5, ;2 C'. 16
it-x- PRINTED 2016 05 04 1.^: 19: 28
ITEM NUMBER LINE LOC._ DESCRIPTION SIZE PACK CASES BOTTLES LIST DISCOUNT NET BOTTLE
BULK LOC. UPC VINTAGE PRICE DEAL# UNIT COST COST NET-PRICE
5413 2H*03 JflI,K watt!LL�I [tl_I; W111SKY IL 1L 430. ?a 30. 92 ?0. 92 123. 68
4020 11:22 .111`1 BEIAA i UHT 80 IL I 4 21: aE3 2:1. 88 21. C-38 87. 5=
97033 =A03 'IAKERS MARK 90 1L. 12 4 37. 35 37. 35 •'_•7. 3S 149. 40
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005246139424
ro 1:C?D I"eN17C be Ui(131`e rP 7 i.t:t.T'Q Tr U`e n•i a I .-eTt f=3.t.dF,,('S le£ _o b tk�7cl='i:7
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• RETURN CODES: A-Out of Stock
LIQUOR LITERS t GALS. WINE LITERS I GALS. •'BEER LITERS I GALS. B-Picking Error
0-Did not order C-Too Early/Too Late
2-Pricing Error D-Damaged on Truck 1 "� 12 12'
3-Out of Business E-No Money •
4-Duplicate F-Office Cancel 36 (�C!
HIGH WINE LITERS/GALS. LOW WINE LITERS/GALS. PARKLING LITERS/GALS. 6-Won't scan or not authorized H-De}Nrz CHECK#
�J Sh t on Truck
ACCEPTEDvj/
RECEIVED BY A CHECK AMOUNT
I,as the licensee,agent of this licensee,or employee thereof of the business accept the merchandise
shown on the invoice and certify that to the best of my knowledge there has been no change in PAG3E 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$50 service charge for any dishonored check.We are not r
responsible for breakage, loss, or damage to merchandise atter delivery or acceptance by
• •, _ • •
=Carrier.