159028 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 355333 Page 1 of 1
ONE CIVIC SQUARE PEPSI -COLA GEN BOT IN
CARMEL, INDIANA 46032 75 REMITTANCE DRIVE SUITE 1884 CHECK AMOUNT: $387.72
CHICAGO IL 60675 -1884 CHECK NUMBER: 159028
CHECK DATE: 4130/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4239040 8404010823 387.72 FOOD BEVERAGES
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PAqE 1 PEPSI COLA GEN. BOT.
5411 WEST 78TH STREET
INDIANAPOLIS, IN, 46261
(317) 876-3464-
INIOICE 8404010823 DRIVER: 608923 Bender,Joseph
PO/DSD: Brookshire Golf Club DELIVERY: 2008-04-17 9:29:17
SlTURE: 12120 Brookshire Pkwy DUE DATE: 2008-05-17
DIaT PT: 7961141 Carmel, IN, 46033-3314 ORDER#
CUST ID: 614649 ROUTE: 701
TAX ID: 0091201550 ASM: 402237
VENDOR/DUNS:
GROSS PRICE DISCOUNTS NET DEPOSIT NET
lTEN DESCRIPTION UPC QTY UNIT EXT UNIT EXT PRICE UNlT EXT AMOUNT
169 PEPS[ COLA 200Z NR PL 0'1200HO129'1 2 CS 3V.V0 6LVO N.89 21.78 19.11 0.00 0.00 38.22
170 0T PEPSI 200l NR P1 01200000130'7 3 CS 30.00 90.00 10.8Y 32.67 19.11 0.00 0.00 S7.33
721 AQUAFlNA 20O7 NR PL 01200008968 6 CS 3V.00 150.00 0.63 9166 i1A7 V.00 LOB 6136
246 0T PEPSI N CHK 200Z NR PL 0'1200000679-4 2 CS 3100 6L00 10.89 21.78 19.11 0.08 0.00 38.22
1626 FRE 8T [KT PUN NN 2NZ MR 042000328WV 2 CS 0.00 0.00 0.00 0.00 B.oV 0.00 Loo 0.01)
4400 FREE A0UAFlNA 2NZ NR PL 512000V0169-8 1 CS 0.00 V.V0 0.00 L80 L00 0.00 V.0V K00
SU8TOTAL 200ZNKPLS24 8 191.12 16 CS
!774 GAT RED 08lV[ .S L NR PL B'5200063036' 6 CS 30.0O 160.00 10.34 61.70 19.66 0.00 9.00 98.3V
17 N 8AT C00L FUS .6 L NR PL 0'52000SU36- S CS 30.00 160.00 10.34 61.70 19.66 0.00 0.00 98.30
SUBTOTAL .6LNKPLS24 8 196.60 N CS
TOTAL SALES 307.72 CS
P�-2�-Pr ~~1'OP
PLEASE REMIT PAYMENT T8:
PEPSI COLA GEN.BOT'IM
75 REMITTANCE DRIVE
SUITE 1884
CHICAGO, IL 60675-1884
TOTALS
SALES QTY 25 CS SALES AMOUNT 660.00
RETURN QTY 0 CS RETURN AMOUNT 000
EMPTIES QTY 0 CS MISC AMOUNT 0.00
ALLOWANCE AMOUNT -272.28
DEPOSIT AMOUNT 0.00
TERMS: CHARGE NET 30 DAYS NET DUE 387.72
THANK YOU
CUSTOMER SIGNAT RE
148013S0078184O401O823079611412108119 1480235807018404018823079611412188119
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
355333 Purchase Order No.
Pepsi Cola Gen Bot M
75 Remittance Dr Ste 1884 Terms
Chicago IL 60675 -1884
Date Due
I
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
l ?-o$ oyv J o 1 3 X38 7z
Total 397 72—
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
355333 IN SUM OF
Pepsi Cola Gen Bot IN
75 Remittance Dr Ste 1884
Chicago IL 60675 -1884
s '�3 9 7 *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
O5 3q0 1 -/0 3g .7�2- 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
20��
`rgna ur���
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund