190390 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
0 I ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $815.80
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
o� Loy INDIANAPOLIS IN 46241 CHECK NUMBER: 190390
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCR
1207 4239040 815.80 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236 -0000
(317)612-1310
Account 89924 License R2903542 Time: 07:53
AZ GOLF MANAGEMENT CORP. Invoice#: 0585449 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 10-01-2010
12120 BROOKSHIRE PKWY Terms B.COD /W.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846.7431 Salesman: 16 J CHAPMAN 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 1 LITE KEG 03410057154 41.00 0.00 30.00 71.00
LITE 114 BBL
24569 0 SAM ADAMS KEG 00000000000
LAGER 116 BBL
Original Qty: 1 Reason: 08 WAREHOUSE WRONG PRODUCT
Cases: 0 Beer$: 71.00 Content$: 41.00
Btls: 0 Wine$: 0.00 Deposit$: 30.00
Kegs: 1 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 7.8
Total Sales 71.00
Total Credits 0.00
Total Tax 0.00
INVOICE 71.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0585448 Cash/Check 689.30
0585449 Cash/Check 71.00
Total Cash/Check 750.30
PAYMENT TYPE AMOUNT
Check# 2 760.30
Inv1: 0585448 689.30
Inv 0505449 Z 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 fur shortage or breakage after merchandise is delivered and
accepted'``
VALID
Ink MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 07:53
AZ GOLF MANAGEMENT CORP. Invoice 0585448 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 10 -01 -2010
12120 BROOKSHIRE PKWY Terms B.CODlW.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
20610 15 COORS LIGHT 07199031600 16.35 0.00 0.00 245.25
24 LSE CAN
20627 4 COORS LIGHT 07199030104 18.10 0.00 0.00 72.40
219116OZ ALUM
30975 2 HEINEKEN 07289000020 27.00 0.00 0.00 54.00
12 CAN
10110 15 LITE 03410057306 16.35 0.00 0.00 245.25
24 LSE CAN
10117 4 LITE 03410057023 18.10 0.00 0.00 72.40
2191160Z ALUM
Cases: 40 Beer$: 689.30 Content$: 689.30
Btls: 0 Wine$: 0:00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 90.0
Total Sales 689.30
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 689.30
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0585448 Cash/Check 689.30
0585449 Cash/Check 71.00
Total Cash/Check 750.30
PAYMENT TYPE AMOUNT
Check# 2 760.30
[nv f15B544B 689. 3U
Inv1: 0985449 'I1. 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 or breakage after merchandise is delivered and
accepted
VA I D
n
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ma` larch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
$760.30
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Goff Club
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1207 0585449 42- 390.40 $71.00 I hereby certify that the attached invoice(s), or
1207 0585448 42- 390.40 $689.30 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, October 01, 2010
Director, Brook Y e 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))
01/10110 0585449 Beer $71.00
10101/10 0585448 Beer $689.30
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