183592 03/23/2010 ,d CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $468.00
CARMEL, INDIANA 46032 PO Box 2856
KOKOMO IN 46904 -2856
CHECK NUMBER: 183592
CHECK DATE: 3/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 468.00 FOOD BEVERAGES
(t
WMI A VIERICA
INVOICE
B BROOKSH I RE FIRST MORTGAGE
INC. d ba HROOKSH I RE GOLF 'CLUB'
12!.20 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
KokomoIN469042856
765 459 3117 RR2903542 EXP. 07/13/10
f
800 -382 -0675 Tinursday Delivery
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
03/25/10 411425 Dustin Smith 13 800 1.3
,PRODUCT 6UANTITY DESCRIPTION' PRIC DEP IT AMOUNT
C OD E
BASE February 2, 2010A
PROMID #0310A
PUMP $40/$33 REFUNDABLE
109 10-" Budweiser 24 Lse Can 16.40 164.00
209 10 Bud Lt 24 Lse Can 16.40 164 -00
760 2 Goose Wheat 312 1/6 BBL 55.00 30.00 170.00
Cases 20 1/4 Barrels 2
TOTAL SALE 498.00
10303 EMPTY AB 1/6 30.00 00 T
10304 EMPTY AB 1/2 30.00 r H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00
9230 PUMP DEPOSIT 33.00 N
9270 IMPORT. PUMP DEPOSIT 33.00 4x18.00
TOTAL RETURNS
CREDITS
Cash EFT Escrow Check Number U
Driver Received By
t VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
$468.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# I Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members
1207 411425 42- 390.40 $468.00 1 hereby certify that the attached invoice(s), or
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, March 25, 2010
Director, Broo shire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts Citv_'orm No. 201 (Rev. 199=
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
03/25/10 411425 Beer $468 -0
1 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
Clerk- Treasurer