198339 06/15/2011 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
CARMEL, INDIANA 46032 3737 WALDEMERE AVE CHECK AMOUNT: $494.60
INDIANAPOLIS IN 46241 CHECK NUMBER: 198339
CHECK DATE: 6/15/2011
DEPA RTMENT ACCO PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1207 4239040 494.60 FOOD BEVERAGES
acceptea
DUPLICATE
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 09:51
AZ GOLF MANAGEMENT CORP. Invoice#: 0394214 PO#
BROOKSHIRE GOLF CLUB Load 2040 Date: 06-14-2011
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 1 LITE KEG 03410057154 45.00 W0.00 30.00 75.00
LITE 114 BBL
24569 1 SAM ADAMS KEG 00000000000 58.00 0.00 30.00 88.00
LAGER 116 BBL
31164 -3 MISC KEG DEPOS 01003116400 0.00 0.00 30.00 -90.00
$30 EMPTY KEG
Cases: 0 Beer$: 163.00 Content$ 103.00
Btls: 0 Wine$: 0.00 Deposit$: -30.00
Kegs: 2 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-3) Misc$: 0.00
Gals: 12.9
Total Sales 163.00
Total Credits -90.00
Total Tax 0,00
INVOICE TOTAL 73.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0394213 Charge 391 0
0394214 Charge 3.0
Total Charge 464.60
Inv 0394213 391.60
luv 0394214 13.00
Customer's Signature Driver's Signature
"Your signature is acceptance that allthe product listed above was received
and delivered in good condition"
"Drivers cannot pickup product unless pruper pickup form has been completed.
Not Responsible for shortage or breakage after merchandise is delivered and
accepted
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 69924 License R2903542 Time: 09:51
AZ GOLF MANAGEMENT CORP. Invoice#: 0394213 PO#
BROOKSHIRE GOLF CLUB Load 2040 Date: 06- 14-2011
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM CITY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 10 COORS LIGHT 07199031600 16.80 0.00 9.00 168.00
24 LSE CAN
11069 4 LEINENKUGEL 03410072902 26.50 0.00 0.00 106.00
SHANDY 2112CAN
10110 7 LITE 03410057306 16.80 0.00 0.00 117.60
24 LSE CAN
Cases: 21 Beer$: 391.60 Content$: 391.60
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0,00
Misc: 0 Misc$: 0.00
Gals: 47.3
Total Sales 391.60
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 381.60
PAYMENT
—u INVOICE# PAYMENT TYPE a AMOUNT
0394213 Charge 391.60
0394214 Charge
e
Total Charge 464.60
Inv 0394213 391. e0
InvY: 0394214 73.00
Customer's Signature Driver's Signature
"Your signature is acceptance that alllhe 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
Prescribed by State Board of Accounts City Form No. 201 (Rev. 199`.
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))
06!14/11 0394214 Beer $73.0
06/14/11 0394213 Beer $391.6
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
VOUCHER NO. WAR N
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO41 Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1207 0394214 42- 390.40 $73.00
materials or services itemized thereon for
1207 0394213 42- 390.40 $391.60
which charge is made were ordered and
received except
Wednesday, June 15, 2011
4
Director, Brookshl Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund