188474 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF COL�g
CARMEL, INDIANA 46032 C/O M LISTER CHECK AMOUNT: $99.85
PA
CHECK NUMBER: 188474
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CHECK DATE: 813/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 99.85 FOOD BEVERAGES
MIWAAERICA INVOICE
B BROOKSHIRE FIRST MORTGAGE
d ha BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr, CARMEL I N 46032
P.O. Box 2856
Kokomo, IN 469042856 H1 L-XFI. V 13 11
765- 459 -3117 Thursday De
800 382 -0675 y
Fax: 765 -457 -7967 pu 5 MTS
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
07/29/10 422601 Dustin Smith 13 B00 13
RO
PDUCT QUANTITY DESC
BASE April 5, 2010A
PROMO #0710A
PUMP $40/$33 REFUNDABLE
209 10 Bud Lt 24 Lse Can 16.40 164.00
225 2 Bud Lt 1/4 BBL 41.50 30.00 143.00
405 2--' Bud Lt Lime 2/12 Can 20.15 40.30
760. 2 Goose Wheat 312 1/6 BBL 55.00 30.00 170.00
Cases 12 1/4 Barrels 4 L� ►V
PR TOTAL SALE 517
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 1/4 30.00 �j A
9230 PUMP DEPOSIT 33.00 N
9270 IMPORT PUMP DEPOSIT 3100
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1z CREDITS
El Cash EFT El Escrow kCheckNumber 9 4:f>� ;7
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995}
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))
Total
I 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
39 6 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
20
i�; 0 k
Signati
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund