158533 04/15/2008 i
CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
s 0 CHECK AMOUNT: $107.00
CARMEL, INDIANA 46032 PO Box 2856
KOKOMOIN 46904 -2856 CHECK NUMBER: 158533
CHECK DATE: 4115/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4239040 346830 135.00 FOOD BEVERAGES
j 905 4239040 346831 242.00 FOOD BEVERAGES
`M WAME RCA I NVOICE
BEVERAGE BROOKSH I RE FIRST MORTGAGE
INC. dba.BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR29035 EXP. 07/13/08
800- 382 -0675
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
nzrhorno ZALOR'1 n ^t)Tn u111 (=V hz onn z
•OD DEPOSIT
C OD E QUANTITY DESCRIPTIO
BASE FEB 4, 2008A
PROMO MARCH 0308A
PUMP $40/$33 REFUNDABLE
61015 1 MONSTER LOCARB 24/16 CA 28.00 26.00
B1016 1 MONSTER ENERGY 24/16 CA. 28.00 28.00
169 3 BUD LSE CANS .15. 46.50
209 6 'BUD LT LSE CANS 15.50 93..00
1109 3 BUD. SELECT LSE CAN 15.50 46.50
00
Beer. Cases 12
Soda., Cases 2
TOTAL SALE
10303 EMPTY AB 1/6 30.00 T 242.00
10304 EMPTY AB 1/2 30:00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00
T RETURNS
242. 0C)
Y CREDITS
O
Cash EFT Escrow Check Number U
j Driver y Received By f
Ml m ICA INVOICE
BEVERAGE BROOKSHIRE FIRST MORTGAGE_
INC. .dba BROOKSHIRE GOLF C LU B
12120 BROOKSHIRE PARKWAY
Epsom 2755 Commerce Dr. CA13MEL IN 46032 1
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR2903542 EXP. 07/13/08
800- 382 -0675
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER. CUSTOMER NUMBER ROUTE
!1Z /r27 Z^n CALO -rn n/X(iTr% U111 CC'V 1 7
DEPOSIT AMOUNT
DESCRIPTION PRICE
BASE FEB 4, 2008th
PROMO MARCH'0308A
PUMP $40/$33 REFUNDABLE
109 -4 BUD LSE CANS 15.00 60.00
209 -5 HUD LT LSE CANS 15.00 75.00
T
V
Cases -9
IIIIIIIIIIIIINHellwWWAIM l
TOTAL SALE
10303 EMPTY AB 1/6 30.00 T —135.00
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 112 30.00 N
9230 PUMP DEPOSIT 33.00 K
-9270 IMPORT PUMP DEPOSIT 33.00
135.00
T OTAL RETURNS
Y
O CREDITS
Cash EFT Escrow Check Number
Driver i,�%1 Received By
I
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
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))
3a?.DD 3 6 ?3i
3&, cro
Total 7 d
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
//j
A) 7�
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
905 3 V6 9,31 3 9v V9 d W bill(s) is (are) true and correct and that the
DS 3V&830 3 9D YD 135, o0 materials or services itemized thereon for
which charge is made were ordered and
received except
7 g 200
e.`
�atu!��"�
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund