HomeMy WebLinkAbout198646 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CHECK AMOUNT: $261.00
CARMEL, INDIANA 46032 Po eox 2656
KOKOMO IN 46904 -2856 CHECK NUMBER: 198646
CHECK DATE: 6122/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 261.00 FOOD BEVERAGES
M INVOICE
B BROOKSH.I -RE F.I.R,ST MORTGAGE
dba BROOKSHIRE GOLF CLUB
ANC. 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 mitt vJ 74L E 1 J 1 1
765- 459 -3117
800 382 -0675 Thursday Delivery
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
06/23/11 452241 Dustin Smith 13 800 13
PRODUG 1. QUANTITY D �RICE DEPOSIT AMOUNT
BASE March 28, 2011A
PROMO #0611A
Pump $40/$33 Refundable
209 10 Bud Lt 24 Lse Can 16.80 168.00
225 Bud Lt 1/4 BBL 46.50 30.00 153.00
Cases 10 1/4 Barrels 2
TOTAL SALE 32 1 00
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 1/4 30.00 30i� A
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 N
321.00
s s jTS II
CREDITS
Cash El EFT El Escrow Check Number U
Driver Received By
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))
06/23/11 452241 Beer $261.0
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
UU
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
1207 452241 42 390.40 $261.00
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, June 23, 2011
Director, BrookshirgOGolf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund