HomeMy WebLinkAbout330031 09/19/18 Q
CITY OF CARMEL, INDIANA VENDOR: 359294
CHECK AMOUNT: $********99.00*
ONE CIVIC SQUARE MID AMERICA BEVERAGE INCCARMEL, INDIANA 46032 Po BOX 2856 CHECK NUMBER: 330031
KOKOMO IN 46904-2856 CHECK DATE: 09/19/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 99.00 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 359294 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
MID AMERICA BEVERAGE INC IN SUM OF$ CITY OF CARMEL
PO BOX 2856 An 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.
KOKOMO, IN 46904-2856
Payee
$99.00
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
10040310 42-390.40 $99.00 1 hereby certify that the attached invoice(s),or 9/20/18 10040310 Beer $99.00
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
Tuesday, September 25,2018
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
MID-AMERICA BEVERAGE INC
2755 COMMERCE DRIVE
KOKOMO, IN 46902
(765) 459-3117
Thu Sep 20, 2018 10:02 AM
Account: 00800 Invoice#: 10040310 PO#:
CITY OF CARMEL License : RR2903542 Expires Oct 13, 2018
BROOKSHIRE GOLF CLUB Load : 4041
12120 BROOKSHIRE PARKWAY Terms : CASH/CHECK
CARMEL, IN 46032 Driver : 024 - BILL HART
(317) 846-7431 Salesrep: 0113 - KIMBERLY FOREM
THURSDAY DELIVE
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ITEM# QTY DESCRIPTION PRICE DISC DEP DPRICE EXT
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10109 1 BUD 24/12 OZ CN 19.80 0.00 0.00 19.80 19.80
10209 4 BUD LT 24/12 OZ CN 19.80 0.00 0.00 19.80 79.20
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Cases: 5
Bottles: 0
Gallons: 11.25
Kegs: 0
Misc: 0
Credits: 0
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Total Sales 99.00
Total Discount -0.00
a --------------
Total Content 99.00
Total Deposit 0.00
Total Credits 0.00
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Invoice Total 99.00
PAYMENT
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INVOICE# PAYMENT TYPE AMOUNT
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10040310 Check 330031 99.00
PAYMENT TOTALS
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PAYMENT TYPE AMOUNT
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Check 330031 99.00
TOTAL CASH/CHECK 99.00
CUSTOMER SIGNATURE : DRIVER SIGNATURE
Irvi 10040010 190.00
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310 GI.I.F4iT
Final