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301653 08/08/16
. ;4.'yf,C�q�f i ,� . CITY OF CARMEL, INDIANA VENDOR: 361189 ONE CIVIC SQUARE COCA COLA REFRESHMENTS INDPLS SAIdKK AMOUNT: $****""569.04* s r� CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE CHECK NUMBER: 301653 9.y«oN�` CHICAGO IL 60674 CHECK DATE: 08/08/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 3341510405 569.04 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) COCA COLA REFRESHMENTS INDPLS SALES ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2329 PAYSPHERE CIRCLE IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60674 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $569.04 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Course Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 3341510405 42-390.40 $569.04 1 hereby certify that the attached invoice(s),or $/4/16 3341510405 Soda $569.04 1207 101 1207 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,August 04,2016 7Z 72-,�A 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer LULA-L.ULA htt'=hMCIVIJ INVOICE SHIP TO: REMIT TO: BROOKSHIRE GOLF CLUB COCA-COLA REFRESHMENTS CITY OF CARMEL INDIANAPOLIS SALES CENTER 12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE CARMEL IN 460333314 CHICAGO, IL 60674-2329 317-243-3771 OUTLET 1866466 INVOICE# 3341510405 AR# 1866466 RTE- 376 DRIVER- 3525 LOAD- ISL01 SEQ- 00005 DATE : 08/04/16 DOC# 33415104059 PL- 101 TIME: 08:20:53 CHARGE NET 15 PROK SHELL SAME 790- 8/01/16 PALLET BALK 0 8/02/16 SALES DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED 20OZ 24L PET CSD-MM-NT 20LSPETS CNTR CLASSIC 5788 1 36.00 3678 -9.84 26.16 26.16 20LSPETS CNTR DIET COKE 5789 3 36.00 3678 -9.84 26.16 78.48 20LSPETS MI:LI-0 YELLO 5855 1 36.00 3678 -9.84 26.16 26.16 20LSPETS PIOD XTRA 5871 1 36.00 3678 -9.84 26.16 26.15 20LSPETS FANTA ORANGE 5845 1 36.00 3678 -9.84 26.16 26.16 SUBTOTAL 7 183.12 20OZ POWERADE 2UPTLWI,; POWERADE LL 5994 3,4[.00'3704 i-18,72 23.28 69.84 20PTLWM POWERAOE PUNCH 599;; 3 42.00 3704 -18.72 23.'28 69.84 20PTLWM PADE ORANGE 6938 2 42.00 3704 -18.72 23.28 46.56 20PLWM PA GRAPE 8042 2 42.00 3704 -18.72 23.28 46.56 20PTLA POW MOUNTAIN BLA 4035 3 42.00 3704 -18.72 23.28 69.84 20PET8P PA ZERO FRT PNCH 1285 1 42.00 3704 -18.72 23.28 23.28 SUBTOTAL 14 325.92 CUPS/LIDS/SLEEVES CUPSICS 24Z CCIM PAP1000 8316 1120.00 3187 -60.00 60.00 60.00 SUBTOTAL 1 60.00 DEPOSITS ON SALES DESCRIPIIUN ART# QTY PRICE ADA RATE NET EXTENDED SHELLS 16120 OZ 0606 7 0.00 «IMPLIED>> 0.00 SUBTOTAL 7 0.00 - - - - - i - - - - - - - - - - - - - i - - - - - - - - - - - - - - - - - - - - NET PRODUCT QTY 22 TOTAL PRODUCT 960.00 TOTAL ADJUSTMENTS -390.96 SUB-TOTAL 569.04 0031201550 ------------------- AMOUNT DUE 569 .04 THE UNDERSIGNED CONFIRMS AGREEMENT TO'THE TERMS AND CONDITIONS AND IS AUTHORIZED TO SIGN. ROUTEPERSON CUSTOMER