184622 04/21/2010 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
i 4 CHECK AMOUNT: $101.85
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 184622
CHECK DATE: 4/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 101.85 FOOD BEVERAGES
X MONARCH BEVERAGE CO.'INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 11:06
AZ GOLF MANAGEMENT CORP. Invoice#: 0393380 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 04- 22-2010
12120 BROOKSHIRE PKWY Terms B.0001W.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846-1431 Salesman: 16 J CHAPMAN 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10110 1 LITE 03410057306 16.35 0.00 0.00 16.35
24 LSE CAN
Cases: 1 Beer$: 16.35 Content$: 16.35
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 2.2
Total Sales 16.35
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 16.35
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0393380 Cash /Check 16.35
Total Cash /Check 16.35
PAYMENT TYPE AMOUNT
Check# 3 16.35
L,v 1: 0393380 16.35
1111: 039338! 0.UO
Customer's Signature Driver's Signature
'Your signature is acceptance that allthe product listed above was received
and delivered in good condition"
"Drivers cannut pickup product unless proper pickup form has been cuopleled.
Not Responsible for shortage or breakage after merchandise is delivered and
accepted
VALID
Monarch Beverage Co., Inc.
9347 East Pendleton Pike Permit Nos:
Indianapolis, IN 46236 W49-08938
7 rZ (317) 612-1310 W49-87358
IN-P-1983
DUNS NO. 00-054-0534
LOAD SALESMAN �ACCOUNT NO.� INVOICE DATE INVOICE NO-
T
7
PA
DESCRIPTION'
LESS
TOTAL
CREDITS
PAYMENT
1 T 'A E-- C r
Z L I CASH/CHECK
rv
T OTAL CREDIT
F
X
CUSTOMER'S
)M
SIGNATURE
DRIVER'S SIGNATURE ACCEPTAN
RE TS ACCEP TANCE 01
AR E ASIF CHE OUR DRIVERS CANNOT PICK UP PRODUCT UNLESS PICK;,UP IS PRINTED,61N INVOICE.
NOTE: NOT RESPONSIBLE FOR SHORTAGES OR BR.EAKAGE AFTER MERCHANDISE
CUSTOMER COPY
'IS DELIVERED.
VOUCHER NO. WARRANT NO.
V ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #MTLE AMOUNT Board Members
1207 396596 42- 390.40 0 1 hereby certify that the attached invoice(s), or
lo-8 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, April 23, 2010
Director, Bro shire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 199E
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))
04/23/10 396596 Beer $85.5
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
Clerk- Treasurer