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HomeMy WebLinkAbout330657 10/02/18 %'��p"� CITY OF CARMEL, INDIANA VENDOR: 359294 ® ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $*******102.45* s. � CARMEL, INDIANA 46032 PO BOX 2856 CHECK NUMBER: 330657 '4jd.oN�` KOKOMO IN 46904-2856 CHECK DATE: 10/02/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 102.45 FOOD & BEVERAGES .j VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 359294 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER MID AMERICA BEVERAGE INC IN SUM OF$ 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 $102.45 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 10042096 42-390.40 $102.45 1 hereby certify that the attached invoice(s),or 10/4/18 10042096 Beer $102.45 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 Friday,October 05,2018 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 MID-AMERICA BENERA6E INC 2755 COMMERCE DRIVE KOKOMO, IN 46902 (765) 459-3117 Thu Oct 04, 2018 9:50 AM :count: 00800 Invoice#: 10042096 PO#: [TY OF CARMEL License : RR2903542 Expires Oct 13, 2018 ZOOKSHIRE GOLF CLUB Load : 4041 ?120 BROOKSHIRE PARKWAY Terms : CASH/CHECK ML, IN 46032 Driver : 024 - BILL HART 317) 846-7431 Sal esrep: 0113 - KIMBERLY FOREM iURSDAY DELIVE ...............---------------------------------------------------............. [TEM# QTY DESCRIPTION PRICE DISC DEP DPRICE EXT -------------------- ---------------------------------------------------------- 10109 2'BUD 24/12 OZ CN 19.80 0.00 0.00 19.80 39.60 10209. 2 BUD.LT 24/12 OZ CN 19.80 0.00 0.00 19.80 39.60 12007 1 MICH ULTRA 2/12/12 OZ CN 23.25 0.00 0.00 23.25 23.25 ------------------------------------------------------------------------------- :ses: 5 )tt 1 es: 0 %l ions: 11.25 f .gs: 0 i sc: 0 -edits: 0 •----------- ---------------------------------------------------------------- Total Sales 102.45 Total Discount -0.00 -------------- Total Content 102.45 Total Deposit 0.00 Total Credits 0.00 j -------------- Invoice Total 102.45 I PAYMENT •------------------------------------------------------------------------------ IVOICE# PAYMENT TYPE AMOUNT ------------------------------------------------------------------------------- 1042096 Check 330657 102.45 PAYMENT TOTALS -----=------------------------------------------------------------------------ PAYMENT TYPE AMOUNT -----------------------------=-------------.................................... Check 330657 102.45 TOTAL CASH/CHECK 102.45 ISTOMER SIGNATURE : DRIVER SIGNATURE scvs iea¢o¢ u¢i,u ou•ailMr Final