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186163 06/08/2010 1 3ITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1 ONE CIVIC SQUARE MONARCH BEVERAGE CO INC l CARMEL, INDIANA 46032 3737 WALDEMERE AVE CHECK AMOUNT: $516.95 INDIANAPOLIS IN 46241 CHECK NUMBER: 186163 CHECK DATE: 618/2010 DEPARTMENT' ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 516.95 FOOD BEVERAGES .1 MONARCH BEVERAGE CO. INC. PERMIT #W4908938-INP1983 y 9347 E PENDLETON PIKE INDIANAPOLIS, IN 46236-0000 (317)612-1310 Account B9924> License R2903542 Time: 09:30 AZ GOLF MANAGEMENT CORP. Invoice#: 0450971 PO# BROOKSHIRE GOLF CLUB Load 4040 Date: 06-10-2010 12120 BROOKSHIRE PKWY Terms B.000IW.CHARGE CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C (317)846 -7431 Salesman: 16 J CHAPMAN 16 ITEM# OTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT 20610 12 COORS LIGHT 07199031600 16.35 0.00 0.00 196.20 24 LSE CAN 30771 0 CORONA LIGHT 08066095621 OUT 2012 CANS 30975 2 HEINEKEN 07289000020 27.00 0.00 0.00 54.00 12 CAN 10110 15 LITE 03410057306 16.35 0.00 0.00 245.25 24 LSE CAN Cases: 29 Beer$: 495.45 Content$: 495.45 Btls: 0 Wine$: 0.00 Deposit$: 0.00 Kegs: 0 Soda$: 0.00 Discount$: 0.00 Misc: 0 Misc$: 0.00 Gals: 65.2 Total Sales 495.45 Total Credits 0.00 Total Tax 0.00 INVOICE TOTAL 495.45 PAYMENT INVOICE# PAYMENT TYPE AMOUNT 0450971 Cash/Check 495.45 0450972 Cash/Check -4.50 Total Cash/Check 490.95 PAYMENT TYPE AMOUNT` Check# 3 490 ;95 L1vY: 04509'11 495. Inv 0450992 -4.50 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 Y MONARCH BEVERAGE CO. INC. PERMIT #W4908938-INP1983 9347 E PENDLETON PIKE INDIANAPOLIS, IN 46236 -0000 (317)612-1310 Account 89924 License R2903542 Time: 09:30 AZ GOLF MANAGEMENT CORP. Invoice#: 0450972 PO# BROOKSHIRE GOLF CLUB Load 4040 Date: 06- 10-2010 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 24569 1 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 85.50 LAGER 116 BBL 31164 -3 MISC KEG DEPOS 01003116400 0.00 0.00 30.00 -90.00 $30 EMPTY KEG Cases: 0 Beer$: 85.50 Content$: 55.50 Btls: 0 Wine$: 0.00 Deposit$: -60.00 Kegs: 1 Soda$: 0,00 Discount$: 0.00 Misc: 0 (-3) Misc$: 0.00 Gals: 5.1 Total Sales 85.50 Total Credits -90.00 Total Tax 0.00 INVOICE TOTAL -4.50 PAYMENT INVOICE# PAYMENT TYPE AMOUNT 0450971 Cash/Check 495.45 0450972 Cash/Check -4.50 Total Cash/Check 490.95 PAYMENT TYPE AMOUNT Check# 3 490.95 Inv:: 0450971 495.45 I- 0450972 -4.50 0�, (P Customer's Signature Driver's Signature 'Your signature is acceptance that alllhe 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 VOUCHER NO. WARRANT NO. ALLOWED 20 'Monarch Beverage Inc. IN SUM OF 9347 E. Penleton Pike Indianapolis, IN 46236 -0000 $490.95 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 0450971 42- 390.40 $490.95 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, June 11, 2010 Director, Brookshire 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. 19f 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)) 06/10/10 0450971 Beer $490.'. 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