189917 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
1. 3737 WALDEMERE AVE CHECK AMOUNT: $314.45
CARMEL, INDIANA 46032
INDIANAPOLIS IN 46241 CHECK NUMBER: 189917
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 314.45 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 07:29
AZ GOLF MANAGEMENT CORP. Invoice 0568622 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 09. 17-2010
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846.7431 Salesman: 16 J CHAPMAN 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 1 LITE KEG 03410057154 41.00 0.00 30.00 71.00
LITE 114 BBL
24569 1 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 85.50
LAGER 116 BBL
31164 -4 RISC KEG DEPOS 01003116400 0.00 0.00 30,00 120.00
$30 EMPTY KEG
Cases: 0 Beer$: 156.50 Content$: 96.50
Btls: 0 Wine$: 0.00 Deposit$: -60.00
Kegs: 2 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-4) Misc$: 0.00
Gals: 12.9
Total Sales 156.50
Total Credits -120.00
Total Tax 0.00
INVOICE TOTAL 36.50
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0568621 Cash/Check 277.95
0568622 Cash/Check 36.50
Total Cash/Check 314.45
PAYMENT TYPE AMOUNT
Check# 2 314.45
I.- 0566623 277.95
Imo: 0568622 36.50
3
Cus_ tomer's Signature Driver's Signatur e
`Your signature is acceptance that a I I the 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
MONARCPERMEI BEVERAGE NP1983 C O. INC.
T
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0(00
(317)612
Account 89924 License R2903542 Time: 07:29
AZ GOLF MANAGEMENT CORP. Invoice#: 0568621 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 09-17-2010
12120 BROOKSHIRE PKWY Terms B.0001W.CHARGE
CARMEL, IN 46032 -0000 Driver V8 PHILLIPPO,C
(317)846-7431 Salesman: 16 J CHAPMAN 16
ITEM CITY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 12 COORS LIGHT 07199031600 16.35 0.00 0.00 196.20
24 LSE CAN
10110 5 LITE 03410057306 16.35 0.00 0.00 81.75
24 LSE CAN
Cases: 17 Beer$: 277.95 Content$: 277.95
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 38.3
Total Sales 277.95
Total Credits 0,00
Total Tax 0.00
INVOICE TOTAL 277.85
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0568621 Cash/Check 277.95
0568622 Cash/Check 35.50
Total Cash/Check 314.45
PAYMENT TYPE AMOUNT
Check# 2 314.45
lnv�: 0568621 2]9.95
Inv1: 0568622 36.50
I
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`""
VOUCHER NO. WARRANT NO.
Monarch Beverage Inc. ALLOWED 20
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
$314.45
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# 1 Dept. INVOICE NO. ACCT #1TITLE AMOUNT Board Members
1207 0568622 42- 390.40 $36.50 1 hereby certify that the attached invoice(s), or
1207 0568621 42- 390.40 $277.95 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
Monday, September 20, 2010
Director, Bro kshire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City f=orm 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))
09/17/10 0568622 Beer $36.50
09/17/10 0568621 Beer $277.95
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
1 20
Clerk- Treasurer