197822 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 364765 Page 1 of 1
ONE CIVIC SQUARE SOUTHERN WINE SPIRITS INDIANA CHECK AMOUNT: $167.11
CARMEL, INDIANA 46032 PO BOX 278350
MIRAMAR FL 33027 -8350
CHECK NUMBER: 197822
CHECK DATE: 5/26/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1132138 167.11 FOOD BEVERAGES
'sal
f
SOUTHERN WINE &SPIRITS REMIT T0: I I I i f i( I
OF Comma SOUTHERN WINE SPIRITS INDIANA f IIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII{IIIIIII IIIIIIIIIIIIIIIIIIIIIIIII NUM 1132138
800 Commerce Parkway West Dr. PO BOX 278350
I IIIIII VIII VIII VIII VIII IIII IN II VIII VIII VIII IIII IIII ccouuT
Suite D MIRAMAR FL. 33027 -8350 NUMBER 1653
Greenwood, IN. 46143-
Permits: W41 -27133 W41 -27134 9 9 1-800- 276 -5148
SCITY OF CARMEL S BROOKSHIRE GOLF CLUB ROUTE 116 STOP 4
012120 BROOKSHIRE PKWY H 12120 BROOKSHIRE PKWY IIIIIHIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
LCARMEL IN 46033 1 CAMEL IN 46033
P D
T T
0 0 PAGE 1 OF 1
2500 751
1 3 Exp: 7/13/20,11 Night Bill
SALES PERSON PERMIT NUMBER DELIVERY INSTRUCTIONS P.O.# PHONE NUMBER INVOICE DATE
992 29 -03542 317 846 -7431 5/11/2011
PRODUCT NET CASE NET BTL. UNIT DIV UNIT
LOC CASES BTLS SIZE DESCRIPTION PACK W -LOC. B -LOC. CODE PRICE PRICE PRICE COE DISCOUNT NET AMOUNT
1 1 -0L CROWN ROYAL CANADIAN 80 YRC 12 7601 360.12 31.51 31.51 001 31.51
1 750ML ABSOLUT VODKA CITRON 80 12 10952 237.10 21.26 21.26 002 21.26
2 750ML ABSOLUT VODKA 80 12 15403 237.10 21.26 21.26 002 42.52
1 750ML GLENLIVET SCO SM 12YR 80 YRC 12 15502 388.86 33.91 33 -91 002 33 -91
1 1.OL CAPT MORGAN RUM SPICED 70 12 123773 225.36 20.28 20.28 001 20.28
1 750ML JOSE CUERVO TEQ ESP GOLD 60 12 300271 193.50 17.63 17 -63 001 17,63
UNIT DELIVERY CHARGE 1 126161 001
1
L'q OT A $100 INIMUM O DER IS R QUIRED
.SOU HE NEONLINE;COM
CA ;ES
PAGE TOTAL ORDER TOTAL PAGE TOTAL ORDER TOTAL WINE GALLON CUSTOMER PAGE GROSS TOTAL TOTAL DISCOUNT PAY THIS AMOUNT
LnUOR GALLON 1.52
7 7 BEER GALLON BROOKSHIRE GOLF CLUB 1 67.11 167 I] 1,
CARTON DRIVER LOADED TH M LLavPilcne�e G Laws T aNa s Rewiaro 5 BE NSTOME.SNALDLBERW INVOICE NO. CUSTOMER NO. NET AMOUNT DUE DATE servenenergaof l2E. OOwillbechergsd «nn,neeniebopneenAne�l.
SIRLE FOR ALL SALES TAX DUE O N SALES OF OODG. IN THE EVENT O loose sxemine goads balers signing. All cleans, inclutling braeeega or shortage, must
T INDEBTEDNESS CREATED RY THE 5ALES OF GOODS. S r Wade i OF GOOD upon r W E s 1. OUR PE ITYER' RIUTY FOR SAFE
ACTION TO COLLEC D TO RECOVER F DE LIVERY OF NT SIG CEAS WHEN GOODS ARE BUYER'S POSSESSION OR
UTHERN WINE SPIRITS OF INDIANA SHALL BE ENTITLE
DYER'S AGENT SIGNS DELIVERY RECEIPT. Such e. ceplence of gppda confirms
OM Thf CUSTOMER HEREIN THE PRINCIPAL AMOUNT OF THE 1 gresm ant lM1el this Invoice is poYebe of lha add,esa above and 1he11M1e 1ptel invoice
UERTEDNESS, ALL ACCRUED AND ACCRUING SERVICE CHARGES AS Of T s due end ...able wilM1in fillean1151 days el the invoice date pi invoice included,
ATE OF THE SALE OF THESE GOODS. ANY W WSUIT INVOLVING ANY D 1132 16 5 16711 '5/25/2011 1 not Tan fully paid, Tie end ell prior invoices will, es permitted by few, beer Interest
PUT UP 'CHECK BY SPUTE BETWEEN THE COMPANY AND THE LICENSEE MAY RE FILED IN J DELIVERY RECEIPT:NO UN CLAI S FOR SHORTAGES WILL BE ALLOWED UNLESS INSPECTED AND N6TED AT TIM OP DELIVERY ce charges from date of punh..s e1 1.5% p., month sad w ll rasull in lose al
OR MARION COUNTY AT SOUTHERN WINE SPIRITS' OPTION. y M/ >J r y di.—.1 end may result In lees of ore Ill privilegsa. Psa.anable caste end
X
Ys' lees will be added.
INiNVOic Customer Copy Print NRm� Slgnaiure
VOUCHER NO. WARRANT NO,
ALLOWED 20
Southern Wine Spirits Indiana
IN SUM OF
P.O. Box 278350
Miramar, FL 33027 -8350
$167.11
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 1132138 42- 390.40 $167.11 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, May 12, 2011
L
Director, Broo hire 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. 199:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or biil 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))
05/11/11 1132138 Wine and Spirits $167.1
I 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