188925 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 360973 Page 1 of 1
ONE CIVIC SQUARE NATIONAL WINE SPIRITS
i CARMEL, INDIANA 46032 P 0 BOX 660357 CHECK AMOUNT: $178.63
INDIANAPOLIS IN 46266 -0357
CHECK NUMBER: 188925
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 397536 -4 178.63 FOOD BEVERAGES
NATIONAL WINE SPIRITS CORPORATION INDIANAPOLIS
P.O. BOX 1602 INDIANAPOLIS INDIANA 46206 ORDER DESK ''(317) 66 -4880 1- 800 772 -7347
IN LIQUOR PERMIT IN WINE PERMIT ADMINISTRATION (317) 636 -6092 1- 800 -562 -7359
INDIANAPOLIS W49 -09133 W49 -15036
CROWN POINT W49 -09133 W49 -15036 EVANSVILLE (812) 867 -7441 1 -800- 742 -3910
SOUTH BEND W71 -87478 W71 -87479 NATIONAL CROWN POINT (219) 661 -9970 1- 800- 552 -4085
CUST 1 `�i I II I
SOUTH BEND (219) 232 -3001 1- 800 552 -2571
LICENSE t F. v' G7 4 l i
CUST. NAME'S 3 OF I'J "�i3
INVOICE NUMBER
CUST: D.B.A
BR`OOKSHIRE GOLF I. UB PAGE: a
ADDRESS 1212!3 BROOK-SHIRE I~V.WY 3 10 0234
000 s JN ACCORDANCE WITH INDIANA LAW
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r r Kit r. -rte T �4 1 556 155
rri., ems, s 31t_
TO ASSURE PROPER CREDIT PLEASE. SALESMAN'S 1 556 11556 155 {4 11
SPECIAL INCLUDE INVOICE NUMBER WITH PAYMENT
INSTRU I SS6 15 'S b I SS
D ESCRIPTI O N
INDICATES T6TAL
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p 0 7.r. 1,? 12 w'IL.BEYS GIN 4RD) 0 11 11.61 ti }O 11.61 It 6
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9F I 1 1 'S L~rLiN 901='F )2 04413 673 33: 713 00 78 67.S6
y
259b 750M 12 VENDANGE u'HAR DOh7P+iAY 2 005 15 i6 25941 950 23 CIO 6. 2 18.69
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78. 63*
r I.JUL. CA DES': Cl 007916. CITY CI CARME DUE: 0.8-1 8-10 I
VOI C 397 .76 -4 Awr ;-t 'E nTE Iii, Wi LI OUOR 1 4
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RECEIVED BYE- PLEASE REMIT PAYMENTS TO:
CUSTOMER'S INVOICE
ALL CLAIMS FOR DAMAGES MUST BE MADE ON RECEIPT OF GOODS P.O. Rny (i6n .q67 INRIANAP011. IN 4RPA6 n357
VOUCHER NO. WARRAN"F NO.
ALLOWED 20
National Wine Spirits Corp.
IN SUM OF
P.O. Box 1602
Indianapolis, IN 46206
$178.63
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1207 397536 -4 42- 390.40 $178.63 1 hereby certify that the attached invoice(s), or
bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Wednesday, August 04, 2010
Director, Brook re 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))
08/03/10 397536 -4 Spirits $178.63
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