188153 07/22/2010 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
4 ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
0 CHECK AMOUNT: $409.50
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 188153
CHECK DATE: 7/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 409.50 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938 I NP 1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 13:05
AZ GOLF MANAGEMENT CORP. Invoice#: 0510311 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 07- 30-2010
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846-743 Salesman: 15 J CHAPMAN 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 10 COORS LIGHT 07199031600 16.35 0.00 0.00 163.50
24 LSE CAN
11069 2 LEINENKUGEL 03410072902 26.50 0.00 0.00 53.00
SHANDY 2112CAN
Cases: 12 Beer$: '216.50 Content$: 216.50
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 27.0
Total Sales 216.50
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 216.50
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0510311 Cash/Check 216.50
0944572 Cash/Check 193.00
Total Cash/Check 409.50
PAYMENT TYPE AMOUNT
Check# 8 409.50
Im/: 0510,11 211.50
Inv1: 09645]2 193.00
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 ur breakage after merchandise is delivered and
accepted
VALID
r
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938- INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236.0000
(317)612-1310
Account 89924 License R2903542 Time: 13:05
AZ GOLF MANAGEMENT CORP. Invoice 0944572 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 07.30 -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# CITY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 2 LITE KEG 03410057154 41.00 0.00 30.00 142,00
LITE 114 BBL
24569 2 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 171.00
LAGER 116 BBL
31164 -4 MISC KEG DEPOS 01003116400 0.00 0.00 30.00 •120.00
$30 EMPTY KEG
Cases: 0 Beer$: 313.00 Content$: 193.00
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 4 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-4) Misc$: 0,00
Gals: 25.8
Total Sales 313.00
Total Credits -120.00
Total Tax 0.00
INVOICE TOTAL 193.00
Ref Voided Invoice# 0510312
PAYMENT
iNVOICE# PAYMENT TYPE AMOUNT
0510311 Cash/Check 216.50
0944572 Cash/Check 193.00
Total Cash/Check 409.50
PAYMENT TYPE AMOUNT
Check# 8 409.50
Inv 05!0311 216.50
Inv1: 0944" 193.00
B� A�
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
$409.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 0510311 42- 390.40 $216.50 1 hereby certify that the attached invoice(s), or
1207 0944572 42- 390.40 $193.00 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, July 30, 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. 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))
07/30/10 0510311 Beer $216.5C
07/30/10 0944572 Beer $193.0C
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer