185496 05/18/2010 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $114.45
a CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 185496
CHECK DATE: 5/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 114.45 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 11:53
AZ GOLF MANAGEMENT CORP. Invoice#: 0426273 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 05 -20 -2010
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846 -7431 Salesman: 16 J CHAPMAN 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 3 COORS LIGHT 07199031600 16.35 0.00 0.00 49.05
24 LSE CAN
10110 4 LITE 03410057306 16.35 0.00 0.00 65.40
24 LSE CAN
Cases: 7 Beer$: 114.45 Content$: 114.45
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 15.7
Total Sales 114.45
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 114.45
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0426273 Cash/Check 114.45
Total Cash/Check 114.45
PAYMENT TYPE AMOUNT
Check# 6 114.45
1-1; 0426273 114.45
Customer's Signature Driver's Signature
'Your signature is acceptance that allthe product listed above was received
and delivered in good condition'
"Drivers cannot pickup product unless proper pickup form has been completed.-
Not Responsible for shortage or breakage after merchandise is delivered and
accepted
VALID
Il�s rle•I I
VOUCHER N.O. WARRANT NO.
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
$114.45
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 0426273 42- 390.40 $114.45 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
Monday, May 24, 2010
Director, BrookshA 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. 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))
05/20/10 0426273 Beer $114.4
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