189435 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $211.80
KOKOMO IN 46904 -2856
CHECK NUMBER: 189435
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 211.80 FOOD BEVERAGES
INVOICE
MI WAERICA
IR
BEVERAGE' BROOKSHTRE. F4.RST MORTGAGE
IN INC dba BROOKSHIRE GOLF CLUB
CE BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR2903542 EXP. 07/13/11
800 -382 -0675 Thursday Delivery
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
09/02!1(7 426272 Dustin Smith 13 Boo 13
-••r
r
•r
BASE April 5, 2010A
PROMO #Oe10A
PUMP $40/$33 REFUNDABLE
109 3 Budweiser 24 Lse Can 16.40 49.21
209 5 Bud Lt 24 Lse Can 16.40 62.00
408 4 Bud Lt Lime. -2/12 Can 20.15 80.60
i
Cases 12
CIT
PROD. CODE y DESCRIPTION PRICE AMOUNT
TOTAL SALE 211.
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
9230 PUMP DEPOSIT 33.00. N
9270 IMPORT PUMP DEPOSIT 33.00 K
211.e0
NW
t x u
CREDITS
Cash ❑EFT ❑Escrow Check Number
Driver Received-By
I
VOUC NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
$211.80
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 426272 42- 390.40 $211.80 I 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
Thursday, September 02, 2010
Director, Brookshir 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))
09/02/10 426272 Beer $211.80
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