198888 07/05/2011 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: $514.10
INDIANAPOLIS IN 46241 CHECK NUMBER: 198888
CHECK DATE: 7/5/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 514.10 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 08:10
CITY OF CARMEL Invoice#: 0427287 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 07- 08-2011
12120 BROOKSHIRE PKWY Terms B.CODlW.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
10180 1 LITE KEG 03410057154 45.00 0.00 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 -2 MISC KEG DEPOS 01003116400 0.00 0.00 30.00 -60.00
$30 EMPTY KEG
Cases: 0 Beer$: 163.00 Content$: 103.00
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 2 Soda$: 0.00 Discount$: 0.00
Misc: 0 2) Misc$: 0.00
Gals: 12.9
Total Sales 163.00
Total Credits -60.00
Total Tax 0.00
INVOICE TOTAL 103.00
PAYMENT
INVOICE# V PAYMENT TYPE AMOUNT
0427286 CashlCheck 405.40
0427287 Cash/Check 103.00
Total Cash/Check 508.40
t
PAYMENT TYPE AMOUNT
Check# 2 508.40
Inv 04 7266 403.40
Inv1: 042]28] 303.00
Customer's Signature Driver's Signature
"You signature is acceptance that alllhe product listed above was received
and delivered in good condition'
"Drivers cannot pickup product unless proper pickup funn has been curnpleted.
"Not Responsible for shortage or breakage after merchandise is delivered and
accepted'
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4906938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236.0000
(317)612-1310
Account B9924 License R2903542 Time: 08:10
CITY OF CARMEL Invoice#: 0427286 PO#
BROOKSHIRE GOLF.CLUB Load 5040 Date: 07 -08 -2011
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(311)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 8 COORS LIGHT 07199031600 16.80 0.00 0.00 134.40.
24 LSE CAN
30975 3 HEINEKEN 07289000020 27.00 0.00 0.00 81.00
12 CAN
10110 7 LITE 03410057306 16.80 0.00 0.00 117.60
24 LSE CAN
10117 4 LITE 03410057023 18.10 0.00 0.00 72.40
219116OZ ALUM
Cases: 22 Beer$: 405.40 Content$: 405.40
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 49,5
Total Sales 405.40
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 405.40
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0427286 Cash/Check 405.40
0427287 Cash /Check 103.00
Total Cash /Check 508.40
PAYMENT TYPE AMOUNT
Check# 2 508.40
Inv 042920e 405.40
mgr. o4z•rze� tua.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 proper pickup form has been completed.
"Not Responsible for shortage or breakage after merchandise is delivered and
accepted'
t
VALID
VOUCHER NO. WARRANT NO.
Monarch Beverage Inc. ALLOWED 20
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
o k --`1
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 0427287 42- 390.40 $103.00
materials or services itemized thereon for
1207 0427286 42- 390.40 $405.40
which charge is made were ordered and
received except
Tuesday, July 12, 2011
Director, Brooks e 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))
07/08/11 0427287 Beer $103.0
07/08/11 0427286 Beer $405.4
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