187967 07/21/2010 ,a CITY OF CARMEL, INDIANA VENDOR: 360973 Page 1 of 1
ONE CIVIC SQUARE NATIONAL WINE SPIRITS
CARMEL, INDIANA 46032 P 0 BOX 660357 CHECK AMOUNT: $158.49
INDIANAPOLIS IN 46266 -0357 CHECK NUMBER: 187967
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 375184 -9 158.49 FOOD BEVERAGES
NATIONAL WINE SPIRITS CORPORATION INDIANAPOLIS
P.O. BOX 16 02 INDIANAPOLIS INDIANA 46206 ORDER DESK (317) 636 -48FA 1 -890 -772 -7347
IN LIQUOR PERMIT IN WINE PERMIT ADMINISTRATION (317) 636 -6092 1 -800- 562 7359
INDIANAPOLIS W49 -09 W49 -15036 i
CROWN POINT W49 -09133 W49.15036 EVANSVILLE (812) 867 -7441 1- 800 742 -3910
SOUTH BEND W71 -87478 W71 -87478
CROWN POINT (219) 661 -9970 1- 800 -552 -4085
OUST 007"? 16 W q f /yy��yyyr�tion SOUTH BEND (219) 232 -3001 1 -800- 552 -2571
LICENSE RR29 -03542 {W l�V��/i /iu 4i/Pl
CUSS'. NAME C 1 Of CARMEt PAGE: INVOICE NUMBER
OUST. D.B.A 133°:ODASHIPE GCji -F CLUB i
ADDRESS 12 120 ROGA HIPF PKW
7 3 10 0236 f 29 10 37SI8 i-•-9
00 1 6 IIN ACCORDANCE WITH INDIANA LAW
CARMEL 23: 46032 i SS4 1556 1
TO ASSURE PROPER CREDIT PLEASE SALESMAN'S
SPECIAL INCLUDE INVOICE NUMBER WITH PAYMENT i SS 6 1 J" 56 1 554 1 1
INSl RU CTIONS 1 S.56- 1 556 1 S56
556
-DESCRIPTION AMOUNT
INDICATES TOTAL
038C IL 12 74R-rm UT CI
'€'#z'ON VODKA G0FIF 19573 520 .00 .00 .00 00.,
464.7 /C /000 3 Y
244 1L 12 UT VO KA 80 FAR 2 019:303'3678 27.26: .00 27.26 1 09.04
4647 /C/000 .33 Y
A093 I 10Z 1 EVERFRESH CRANBERRY JUICE 09 32257 134 18.05 .00 18.05 18.05
18. 05 Y
A 13 6 1 10z 1 EVERFRESH ORANGE AGE JU I CE 09 32247 228 18 U's .00 18. OS 18 os
18. 05 Y
A376 1 1L I F AYGO TON 0 2 70123 1.42 1.7. 35 .00 13.35 13. 3a
f3.35 Y
UTA 158.49*
IL.. 1Oz
0/ S 0/ 0
FULL CASES: 3 007 5 1 6/ C I „a Y OF C AR MEL DUE: 07 -CY -10
TIV C)T C E: 375118
T AMT E?. 4? WINE .00 LIGUOR r 109, 04
Y' NON A.LC 49.45
RECEIVED BY r CUSTOMER'S INVOICE PLEASE REMIT PAYMENTS TO:
ALL CLAIMS FOR DAMAGES MUST BE MADE ON RECEIPT OF GOODS P.O. BOX 660357. INDIANAPOLIS, IN 46266 -0357
VOUCHER NO. WARRANT NO.
ALLOWED 20
National Wine Spirits Corp.
IN SUM OF$
P.O. Box 1602
Indianapolis, IN 46206
$158.49
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 375184 -9 42- 390.40 $158.49 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
Wednesday, July 14, 2010
Director, Brookshir olf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
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))
07/14/10 375184 -9 Wine $158.49
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