198655 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
1 CARMEL, INDIANA 46032 3737 WALDEMERE AVE CHECK AMOUNT: $568.30
INDIANAPOLIS IN 46241 CHECK NUMBER: 198655
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 568.30 FOOD BEVERAGES
j� J0
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE •4
INDIANAPOLIS. IN 45236-0000
(317)612 -1310
Account 89924 License R2903642 Time: 07:34
AZ GOLF MANAGEMENT CORP. Invoice#: 0944769 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 06-24 -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# OTY DESCRIPTION y U.P.C. PRICE DISC DEP AMOUNT
10180 2 LITE KEG 45,00 0.00 30.00 150.00
LITE 114 BBL
24569 1 SAM ADAMS KEG 00000000000 58.00 0.00 30.00 88.00
LAGER 116 BBL
31164 -1 MISC KEG DEPOS 01003116400 0.00 0.00 30.00 -30.00
$30 EMPTY KEG
Cases: 0 Beer$: 238.00 Content$: 148.00
Btls: 0 Wine$: 0.00 Deposit$: 60.00
Kegs: 3 Soda$: 0.00 Discount$: 0,00
Misc: 0 (-1) Misc$: 0.00
Gals: 20.7
Total Sales 238.00
Total Credits -30.00
Total Tax 0.00
INVOICE TOTAL 208.00
Ref Voided Invoice# 0409389
PAYMENT
INVOICE# v PAYMENT TYPE AMOUNT _Y
0409388 Charge 336.00 —Y
0944769 Charge 208.00
Total Charge 544.00
Inv#: 0409388 336.00
Inv,: 0944769
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'
VALID
MO BEVERAGE GO. INC.
PERMIT #W4908938- INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903642 Time: 07:34
AZ GOLF MANAGEMENT CORP. Invoice#; 0409388 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 06 -24 -2011
12120 BROOKSHIRE PKWY Terms B.COD /W.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM# QTY DESCRIPTION —_W U.P.C. PRICE DISC DEP AMOUNT
20610 10 COORS LIGHT 07199031600 16.80 0.00 0.00 168.00
24 LSE CAN
10110 10 LITE 03410057306 16,80 0.00 0.00 168.00
24 LSE CAN
10117 0 LITE 03410057023 OUT
219116OZ ALUM
Cases: 20 Beer$: 336.00 Y Content$: 336.00 Y
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 45.0
Total Sales 336.00
Total Credits 0,00
Total Tax 0.00
INVOICE TOTAL 336.00
PAYMENT
Y INVOICE# PAYMENT TYPE AMOUNT
0409388 Charge 336.00
0944769 Charge 208.00
Total Charge 544.00
Inv 0409388 336.00
Inv1: 0944769 208.00
V
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
VALID
VOUCHER NO. WARRANT NO.
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
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
bill(s) is (are) true and correct and that the
1207 0944769 42- 390.40 ($30.00)
materials or services itemized thereon for
1207 0409388 42- 390.40 $336.00
1207 0944769 42- 390.40 $238.00 which charge is made were ordered and
received except
Friday, June 24, 2011
t
tA
Director, Brooks re olf 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 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))
06/24/11 0944769 Beer ($30.0
06/24/11 0409388 Beer $336.0
06/24/11 0944769 Beer $238.0
1 hereby certify that the attached invoice(s), or bili(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer