200262 08/16/2011 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH
EB E BEVERAGE CO INC CHECK AMOUNT: $1,127.00
A
CARMEL, INDIANA 46032 INDIANAPOLIS IN 46241 CHECK NUMBER: 200262
CHECK DATE: 8/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1,127.00 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 09:50
CITY'OF CARMEL Invoice 0944808 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 08-19.2011
12120 BROOKSHIRE PKWY Terms B.CODlW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM QTY DESCRIPTION U.P.C. 'PRICE DISC DEP AMOUNT
20610 10 COORS LIGHT 07199031600 16.80 0.00 0.00 168.00
24 LSE CAN
30975 2 HEINEKEN 07289000020 27.00 0.00 0.00 54.00
12 CAN
10110 15 LITE 03410057306 16.80 0.00 0.00 252.00
24 LSE CAN
10117 5 LITE 03410057023 18.10 0.00 0.00 90.50
219f160Z ALUM
40215 4 NEW BELGIUM 75452700161 26.50 0.00 0.00 106.00
FAT TIRE 12CAN
Cases: 36 Beer$: 670.50 Content$: 670.50
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 81.0
Total Sales 670.50
Total Credits 0.00
Total Tax 0,00
INVOICE TOTAL 670.50
Ref Voided Invoice# 0481033
PAYMENT INVOICE# PAYMENT TYPE AMOUNT
0481034 Charge 208.00
0481035 Charge 252.00
0944808 Charge 670.50
Total Charge 1130.50
Inv/: 0481034 208.00
In 0481035 252.00
Invl: 0944808 670.50
C
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
MONARCH BEVERAGE CO. INC.
PERMIT #W4906938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 09:50
CITY OF CARMEL Invoice#: 0481034 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 08-19 -2011
12120 BROOKSHIRE PKWY Terms B,COOlW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 2 LITE KEG 03410057154 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
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0481034 Charge 208.00
0481035 Charge 252.00
0944808 Charge 670.50
Total Charge 1130.50
Inv 0491034 200.00
Inv 0401035 252.00
Inv1: 09gg909 6]0.50
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 pruper pickup form has been completed...
"Not Responsible for shortage or breakage after merchandise is delivered and
accepted
VALID
MONARCH BEVERAGE CO. INC
PERMIT #W4967358- 9P2003
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 09:50
CITY OF CARREL Invoicesâ–ş: 0481035 POp
BROOKSHIRE GOLF CLUB Load 5040 Date: 08 -19 -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# QTY DESCRIPTION U.R.C. PRICE DISC DEP AMOUNT
131000 2 BAREFOOT 08500004536 25.20 0.00 J 0.00 50.40
187X24 CHARD
131010 1 BAREFOOT 08500004521 25.20 0.00 0.00 25.20
187X24 CAB SAUV
131020 1 BAREFOOT 08500004546 25.20 0.00 0.00 25.20
187X24 MERLOT
131050 2 BAREFOOT 08500004531 25.20 0.00 0.00 50.40
187X24 WHT ZIN
131330 1 BAREFOOT 08500004528 25.20 0.00 0.00 25.20
187X24 PINOT GRIGIO
131340 3 BAREFOOT 08500004559 25.20 0.00 0.00 75.60
187X24 MOSCATO
Cases 10 Beer$: 0.00 Content$ 252.00
Btls: 0 Wine$: 252.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 11.9
Total Sales i 252.00
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 252.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0481034 Charge 208.00
0481035 Charge 252.00
0944808 Charge 670.50
Total Charge 1130.50
Inv 0461004 206.00
Inv 0461035 252.00
0944808 6]0.50
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 pruducl unless pruper pickup fuim has been completed.
Not Responsible fur shurtaye ur breakage alter merchandise is delivered and
accepted
vn 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
/v30 Sd
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
l i I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1207 0944808 42 390.40 $670.50
materials or services itemized thereon for
1207 0481034 42 390.40 $208.00
1207 0481035 42 390.40 $252.00 which charge is made were ordered and
received except
o,4 (,S6-
Monday, August 22, 2011
Director, Brooksh 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))
08/19/11 0944808 Beer $670.5
08/19/11 0481034 Beer $208.0
08119/11 0481035 Beer $252.0
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