190707 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 361189 Page 1 of 1
1I ONE CIVIC SQUARE COCA COLA REFRESHMENTS INDPLS CH�p�
ECK AMOUNT: $897.90
CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE
CHICAGO IL 60674 CHECK NUMBER: 190707
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 3316312714 897.90 FOOD BEVERAGES
COCA -COLA REFRESHMENTS
INVOICE PAGE 1 OF 3
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB COCA-COLA REFRESHMENTS
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674 -2329
317 243 -3771
OUTLET 1866466 INVOICE# 3316312714
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL10 SEQ- 00013 DATE 1 O 06 1 0
DOC# 33163127146 PL- 101 TIME: 10:05:46 CHARGE NET 15 PROX
SHELL BALANCE 286 10/04/10
PALLET BALANC 0 1044/10
DEBBIE
SALES
DESCRIPTION ART# OTY PRICE ADJ# RATE NET EXTENDED
DASANI -24 BOTTLE CASE
20PET24L DASANI WATER 5n63 10 34.00 9017 -15.40 14.60 146.00
9019 -4.00
SUBTOTAL 10 146.00
20OZ PET LS CSD W /TEA (NO /DEP)
20LSPSPRTY OT SPRITE ZRO 4806 2 34.00 9017 -10.20 19.60 39.60
9019 -4.00
20LSPTSPRPTY SPRITE 4320 2 34.00 9017 -10.20 19.80 39.60
9019 -4.00
20LSPETS CNTR CLASSIC 5788 3 34.00 9017 -10.20 19.80 59.40
9019 -4.00
20LSPETS CNTR DIET COKE 5789 3 34,00 9017 -10.20 19.80 59.40
9019 -4.00
SUBTOTAL 10 198.00
20OZ PET LS POWERADE (NO /DEP)
20PTLWM POWERADE LL 5994 5 34.00 9018 -8.90 21.10 105.50
9020 -4.00
20PTLWM POWERADE FPUNCH 5995 5 34.00 9018 -8.90 21.10 105.50
9020 -4.00
20PTLWM PADE ORANGE 6938 3 34.00 9018 -8.90 21.10 63.30
9020 -4.00
20PTLWM POW MOUNTAIN BLA 4035 5 34.00 9018 -8.90 21.10 105.50
9020 -4.00
SUBTOTAL 18 379.80
PST BIB -2.5G
BIB/2.5 GP SWT BLK TEA 5343 1 55.00 9017 -14.30 35.70 35.70
9019 -5.00
BIB12.5 GP PREM USW BL T 7269 1 55.00 9017 -14.30 35.70 35.70
CONTINUED
COCA -COLA REFRESHMENTS
I NVO I CE PAGE 2 OF 3
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB COCA -COLA REFRESHMENTS
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674 -2329
317- 243-3771
OUTLET 1866466 INVOICE# 3316312714
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL10 SEQ- 00013 DATE 1 O 06 1 0
DOC# 33163127146 PL- 101 TIME: 10:05:46 CHARGE NET 15 PROX
SHELL BALANCE 286- 1044/10
PALLET BALPS 0 10/04/10
DEBBIE
SALES
DESCRIPIION ART# QTY PRICE ADJ# RATE NET EXTENDED
9019 -5.00
BIB/2.5 BARQS ROOTBEER 8206 1 55.00 9017 -14.30 35.70 35.70
9019 -5.00
SUBTOTAL 3 107.10
SGL _POSTM I X
BIB /5.00 DIET COKE 7627 1105.00 9017 -28.00 67.00 67.00
9019 -10.00
SUBTOTAL 1 67.00
DEPOSITS ON SALES
DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED
SHELLS 16/20 OZ 0606 10 0.00 <<IMPLIED» 0.00
SUBTOTAL 10 0.00
1
CONTINUED
COCA -COLA REFRESHMENTS
INVOICE PAGE 3 OF 3
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB COCA -COLA REFRESHMENTS
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317-243-3771
OUTLET 1866466 INVOICE# 3316312714
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL10 SEQ- 00013 DATE 1 0 06 I 1 O
DOC# 33163127146 PL- 101 TIME: 10:05:46 CHARGE NET 15 PROX
SHELL BALANCE 288- 10/04/10
PALLET BALANC 0 1044/10
DEBBIE
NET PRODUCT QTY 42 TOTAL PRODUCT 1,562.00
TOTAL ADJUSTMENTS 664.10
SUBTOTAL 897.90
0031201550
AMOUNT DUE 897.90
THE UNDERSIGNED CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.
ROUTEPERSON CUSTOMER
LAST PAGE
VOUCHER NO. WARRANT NO.
V q ALLOWED 20
T Bo a#es -Coca -Cola ttli t Yvn4a, q
�V"&ka,�a.� uU z IN SUM OF
2329 Paysphere Circle a1
Chicago, IL 60674 -2329
$897.90
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 3316312714 42- 390.40 $897.90 1 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, October 07, 2010
eA
Director, BroAAire 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))
10/06/10 3316312714 Pop $897.90
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