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259737 06/15/16
(9, CITY OF CARMEL, INDIANA VENDOR: 359294 CHECKAMOUNT: $*******571.10* ONE CIVIC SQUARE MID AMERICA BEVERAGE INCCARMEL, INDIANA 46032 PO BOX 2856 CHECK NUMBER: 259737 KOKOMO IN 46904-2856 CHECK DATE: 06/15/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 061516 571.10 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) MID AMERICA BEVERAGE INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 2856 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service KOKOMO, IN 46904-2856 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $571.10 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Brookshire Golf Course Terms — - — Date Due J PO# DATE INVOICE# DESCRIPTION DEPT# INVOICE# aL Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 652204 4 certify that the attached invoice(s),or 6/16/16 652204 Beer $571.10 1207 I Q 1207 101 (are)true and correct and that the ils or services itemized thereon for v,,,,.-.,.-:harge is made were ordered and received except Monday,June 20,2016 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- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer MIWAMERICA i1CITY OF CARMEL INVOICE BEVERAGE dba BROOKSH IRE GOLF 'CLU'. INCE 12120 BROOKSHIRE PARKWAY CARMEL IN 460)2 2755 Commerce Dr. P.O. Box 2856 Kokomo, IN 46904-2856 1 6:3 JTZ E!' ' J 7 /'1•J/ V 765-459-3117 800-382-0675 Fax: 765-457-7967 BEER W3409212 INVOICE DATE. INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE 06/16/16 652204 Dustin Smith 13 800 13 FRODUCT QUANTITY DESCRIPTION PRICE DEPOSIT AMOUNT CODE BASE September 23, 2015 PROMO #0616A Wine:W3428870 109 8 ---- Bud 24 Lse Can 18. 50 148.E0 209 15 --' Bud Lt. 24 Lse Can 18. 50 277.50 408 21-- B Lt Lime 2/12 Can 21 .60 43.20 1516 2 Shock Lemon 16 Oz 6/4 CN 31 .80 63.6f) 909 2 Bich Ultra 24 Lse Can 19 .40 38.80 Cases '29 PROD.CODE DESCRIPTION TOTAL SALE 10303 EMPTY'AB 1/6. 30.00 T 10304 EMPTY AB 1/2 30.00 H 10405 EMPTY AB 1/4 30.00 A 10301 EMPTY CROWN 1/4 BBL 30.00 N 9230 PUMP DEPOSIT 9270 IMPORT PUMP DEPOSIT K 571 . 10 RETURNS • Y CREDITS ❑ Cash ❑ EFT ❑ Escrow © Check Number Driver ZZe—,01 'A Received By r BIER BREWERY&TAP ROOM INVOICE - �� 5 t33 E. 65TH STREET INDIANAPOLIS, IN 46220 DATE INVOICE:# 6/15/2016 5840 PHONE: 317-253-2437qp BILL TO SHIP TO Brookshire Golf Club Brookshire Golf.Club 12120 Brookshire Pkwy. 12120 Brookshire Pkwy. Carmel, IN 4.6033 CarmeljN 46033 1 3 7-580=0375 (Kathy) P.O.NUMBER: TERMS REP: DELIVERY DATE Escrow: RC: :6/15/2016 QUANTITYSIZE DESCRIPTION PRICE-EACH AMOUNT 3 Case Special K Kolsch 31.00 93.607 5 Case PDG.PaIe 31.00 155.00T . 000 SIGNATURE: : .1 Puzr&you cwt&Mineso. TOTAL $249.00 HTTP:✓/WWW.BlERBREWERY.COM