185616 05/25/2010 a CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $435.20
KOKOMO IN 46904 -2856
CHECK NUMBER: 185816
CHECK DATE: 5/25/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 435.20 FOOD BEVERAGES
ANIWAMERICA INVOICE
B BROOKSH I RE FIRST MORTGAGE
dba BROLOKSHIRE GOLF CLUB
INC, 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN .46032
P.O. Box 2856
Kokomo, IN 46904 2856 RR290 3542 EXP 07/13/10
765- 459 -3117
800 382 -0675 Thursday Delivery
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
05/27/10 417214 Dustin Smith 13 800 13
'PRIC POST AMOUNT
BASE April 5, 2010A
PROMO #0510A
PUMP $40/$33 REFUNDABLE
1.08 8 Budweiser 2/12 Can 15.40 131.20
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
f
Cases 18 1/4 Barrels 2
DE.SCRIPTIO PRIGE.-,. AMOUNT TOTAL SALE 465 .20
10303 EMPTY AB 1/6 30.00 a T
'10304 EMPTY AB 112 30.00
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT—' 33.00
.9270 IMPORT PUMP DEPOSIT 33.00 465.20
RETURNS TOTAL'CRED'[�T
r CREDITS 70-00
Cash EFT Escrow Check Number U
Driver Received B
VOUCHER NO. WARRANT NO.
'Mid America Beverage Inc. ALLOWED 20
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
$435.20
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1207 417214 42- 390.40 $435.20 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
Friday, May 28, 2010
Director, Brooks ire 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. I W
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))
05/27/10 411214 Beer $435.2
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