HomeMy WebLinkAbout304162 10/12/16 CITY OF CARMEL, INDIANA VENDOR: 359294
S } ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $i w. w 140.85R
CARMEL, INDIANA 46032 PO BOX 2856 CHECK NUMBER: 304162
KOKOMO IN 46904-2856 CHECK DATE: 10/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 101216 140.85 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
MID AMERICA BEVERAGE INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 2856 IN SUM OF$ 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.
$140.85 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
667475 42-390.40 $140.85 1 hereby certify that the attached invoice(s),or 10/13/16 667475 Beer $140.85
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, October 13,2016
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
MIWAMERICA INVOICE
BIIMI AGE CITY OF .CARMEL
INC. dba BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL I Id 46032
P.O. Box 2856
-459-3117 11469042856
765-459-3RR2903542 EXP. 07/ /17
76
800-382-0675 .
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER. SALESMAN NUMBER CUSTOMER NUMBER ROUTE
10/13/16 667475 Dustin Smith 13 800P1109INUU1 I QUANTITY DESCRIPTION PRICE DEPOSIT AmOUNT
1•?
•D
BASE September 26, 2016
PROMO #1016
Wine: W3428870
109 .' 4 Bud 24 Lse Can . , 19.00 76.00
468 1 � B Lt Lime 2/12 Can 22.25 22.25
90? 2Mich Ultra 24 Lse Can 21 .30 42.60
Cases 7
• ' TOTAL SALE 140.95
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 K
9270 IMPORT PUMP DEPOSIT 140.85
RETURNS 'TOTAL Y
A CREDITS
❑ Cash ❑ EFT ❑ Escrow Check Number � ® U
Driver ����� Received By