199172 07/06/2011 1
a CITY OF CARMEL, INDIANA VENDOR: 364942 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC NATIONAL DIST COMPANY
l CARMEL, INDIANA 46032 PO BOX 660357 CHECK AMOUNT: $111.60
INDIANAPOLIS IN 46266 -0357
CHECK NUMBER: 199172
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 812474 -5 111.60 FOOD BEVERAGES
REPUBLIC NATIONAL DISTRIBUTING COMPANY
INDIE`?VAPOLIS
P.O. BOX 1602 INDIANAPOLIS, INDIANA 46206
IN LIQUOR PERMIT IN WINE PERMIT r ORDER DESK (317) 636 =4880 1-800-772-7347
INDIANAPOLIS W49 -09133 W49.15036 f H.1 ADMIN ISTRATIONS (317) 636 -6092 1- 800, 562 -7359
P CROWN POfNT W49 03133 W44 -1503fi LLJJ IIILLL I ttJJ II/��� I ONA I EVANSVILLE 812 867 7441 1 -800- 742
SOUTH BEND W71 -87478 W71- 87479 pp p�� 1
®I�T1���lD��� �0���� CROWN POINT (219) 661-9970 1- 800 5524085,
CUST 0079 SOUTH BEND
(574) 232 -3001 1- 800 552 -2571
LICENSE R1129-03542
FT. WAYNEICROWN POINT /SOUTH BEND 1
CUSTOMER SERVICE 1` -877- 552 =257:1
CUST. NAMEC I T Y OF CAR MEL
INVOICE NUMBER
CUST. D.B.ABR OOKSHIRE GO LF CLUB PAGE: i
ADDRESS 12120 BROOKSHIRE PAWY 777 024f3 7 8 1 1 812 474 --5
i
0016 IN ACCORDANCE WITH INDIANA LAW
CARMEL IN 46032 1150 1151 1150 I
TO ASSURE PROPER CREDIT PLEASE SALESMAN'S 115 1 i 5 1 1 150 I I
SPECIAL INCLUDE INVOICE NUMBER WITH PAYMENT
INSTRUCTIONS 1 151 1150 11 S i
QUANTITY AMOUNT
N M BE LOCATION DISCOUNT NET PRICE INDICATES TOTAL
0018 2 1L. 12 BELLOWS VODKA 2 11 1623 4e3 '9.13 .00 9,::18 18. 3 z ,5
147A 1 1L 12 CASTILLO RVIII SPICE 01 1 22S403 1444 10.72 .00 10.72 10.72
y
:335n 3 IL 1,2 FINEST CALL. BLOODY MARY: 8 2B3 73 4071 S. 39 .00 5.38 16.:14
Y
268ta i i L. 12 F I NEST CALL MARGARITA 1 08 128263 4 009 5.313 00' S'38 5. 38
Y
039B 2 IL 12 JACK DANIELS BLACK LABEL 01 208573 428 30 o .00 30.50 X11.00
Y
ON THURSDAY, ..DUNE 30TH, OUR OFFICES WILL CL SE T 5: 00Pfl EASTERN TIME
OUR OFFICES .(HALL BE CLOSED MONDAY, J 1LY 4TH TO OBSERVE DA
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FULL CASES: O 007916 CITY OF CARMEL DUE: 07- -08 -11
INVOICE: 812$74•- AMT 11.1.60 €DINE .00 LIQUOR. s r0. UB
NON -ALC 21:52
I
RECEIVED BY
CUSTOMER'S INVOICE PLEASE REM& PAYMENTS TO:
f
ALL CLAIMS FOR DAMAGES MUST BE MADE ON RECEIPT OF GOODS P.O. BOX 660357, INDIANAPOLIS, IN 46266 -0357
VOUCHER NO. WARRANT NO,
ALLOWED 20
Republic National Distributing Company
IN SUM OF
P.O. Box 1602
Indianapolis, IN 46206
$111.60
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1207 812474 -5 42- 390.40 $111.60 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
Friday, June 24, 2011
Director, Brook Kre 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 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 812474 -5 Alcohol $111.6
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
20
Clerk- Treasurer