156428 02/14/2008 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF COURT
CARMEL, INDIANA 46032 C/O PAUL BLOCKOMS CFfECK AMOUNT: $609.51
CHECK NUMBER: 156428
CHECK DATE: 2/14/2008
DEPATMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4238900 84.90 OTHER MAINT SUPPLIES
905 4239040 524.61 FOOD BEVERAGES
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ALL CLAIMS FOR DAMAGES MUST BE MADE ON RECEIPT OF GOODS P.O. BOX 2146, INDIANAPOLIS, IN 46206
5b44 =4 �i M Beverage Co., Inc.
3737 Waldemere Road Permit Nos:
Indianapolis, IN 46241 W49 -08938 W49 -87358
BROOKSHIRE GOLF CLUB (317) 612 -1310 IN -P -1983
AZ GOLF MANAGEMENT CORP. PAGE 1
12120 BROOKSHIRE PKWY DUNS NO. 00-054-0534 DUE DATE 0/00
CARi'!EL IN 46032 LOAD SALESMAN ACCOUNT NO. INVOICE DATE INVOICE NO.
R2903542 317 846 -7431 4040 16 B9924 2/14/08 64424
SPECIAL INSTRUCTIONS TERMS
B. COD /W. CHARGE
KEG
DESCRIPTION LOC CASE /BTLS CODE PRICE AMOUNT
K LL I AN K 2 BB L RED 0 5 95. 00
LITE KEG 1/2 BBL FLOOR 1 10175 100.00 100.00
M rSC DOMESTIC H. P. RACK C _G "70027 65.00 130.
.,E 2 KEGS 0 BOTT 2 M I SG
195.00 BEER$ .00 WINE$ .00 SODA$ 130.00 MISC$ 325.00
180.00 DEP$ 145.00 CONT$ 31.00 GALL
LESS
TOTAL
HORSE TROUGH 311 2 100. 0 CREDITS
MPTY BARREL 31162 10.00 DRFT TUB 00 2 10. 0 MENT
GUN I NESS GAS 311 1 50. 0 CAS /CHECK
:MTY KEG NEW 31164 30.00 HAND PUMP 7002- 60. 0
GUINESS PUMP 100,13 120. 0
NOVELTY BOX 11 *79 200. O
:MPTY CASES 111 6 1.20
TOTAL CREDIT P-
X f� CUSTOMER'S X
SIGNATURE
DRIVER'S SIGNATURE YOUR SIGNATURE IS ACCEPTANCE OF ALL
M ABOVE ITEMS. PLEASE CHECK CAREFULLY.
I CUSTOMER COPY
564425 Monarch Beverage Co., Inc.
3737 Waldemere Road Permit Nos:
Indianapolis, IN 46241 W49-08938 W49-87358
BROOKSHIRE GOLF CLUB (317) 612-1310 IN-P-1983
AZ GOLF MANAGEMENT CORP. PAGE 1
12120 BROOKSHIRE PKWY DUNS NO. 00-054-0534 DUE DATE 0/00/00
CARMEL IN 46032 LOAD SALESMAN ACCOUNT NO. INVOICE DATE INVOICE NO.
R2 317 646-7431 �4040 16 B9924 2/14/08 64425
SPECIAL INSTRUCTIONS TERMS
B. COD /W. CHARGE
KEGS
DESCRIPTION -OC ASE /BTLS CODE PRICE AMOUNT
75OX12 COPPER 750ML CHARD D2705 1 108004 46.99 46.99
75O 12 COPPER MERLOT H:)9G8 1 08044 4 6. 94 46. 99
F
2 CASE 0 KEGS 0 BOTT 0 MISC
.00 BEER$ ?3.98 WINE$ .00 SODA$ .00 MISC$ 93.98
.00 DEP$ 93.98 CONT$ 4.76 GALL
W.
LESS
TOTAL
HORSE TROUGH 211 2 100.. 0 CREDITS
:MPTY BARREL 31162 10.00 DRFT TUB 700 2 10, 0
0
0 P YMENT
GUNINESS GAS 11 1 50. 0 /CHECK
:MTY KEG NEW 31.64 30.00 HAND PUMP 700-7 60. 0
LESS-
TOTAL
HORSE TROUG 11
DRFT TUB /00
GUN I NESS GAS 11
t.j PUMP e
An,J
GUI NESS PUMP 70033 120. 0
NOVELTY BOX '—:1179 200. 0
'i 7U-
'MPTY CASES 31166 1.20 1 Mw
TOTAL CREDIT
X CUSTOMER'S x
SIGNATURE
DRIVER'S SIGN URE YOUR SIGNATURE IS ACCEPTANCE OF ALL
ABOVE ITEMS. PLEASE CHECK CAREFULLY.
CUSTOMER COPY
LUMBER LE CUSTOMER COPY
llnRTER
A'division of Larioga Corporation
1f 17 W WASHINGTON ST CASH REGISTER 10?
06595
INDIANAPOL IN 46 222 DATE 2111120+$ 2 0 5 1 PM 1
(317) 639 75431
S CASH REGISTER S, TRICE ffi
0
S
L
D P
CJ y t O
ACCOUNT; 7- 0+1.t8rz91,2 000
SELLING 87'7 SHIPPING 87'7 SALES .3 jZ1 E�ARRY HEI GHTON OUR 0306595 CUST
STORE STORE PERSON ORDER P.O.`
_a_ .I g:_ r o .i
QUANTITY QUANTITY LOCATION ITEM NUMBER DESCRIPTION UNITi /`UM °UNIT,PRICE -EXTENDED PRICE
ORDERED SYiIPPED
3�,_
1B BOA!' 29 201141 1# 8D 'BRIGHT FINISH 2.06 c% 136 T
lEl B5.12 032WI 16' 20136 -B -CR ARM CROW 4 -1/4 19.52 19.52 T
1 0615 03r 01409 16' 2 2168 -CB PRIME BASE 5 -1 /4 2 3.68 23.68 T
IS t 'y 9 s' .rFF -�j u t.. x i.:.. Yc- .r' .err
�,11�4� 1e it 7.2
.1�-163 0G 5 5
RECEIVED w NET SALE TAXABLE AX TAX TOTAL
DATE 2/ 11/2008 X G 1#
DELIVERED BY
LOADED T CHECKED_ 45. 26 5. 26 IM 2a 72 47.98
DELIVERED
BY BY X BY X `.SEE REVERS ORTERMS OF SALE
��U_Mt mo 01
TERMS OF. SALE
All charge purchases pare due for payment within 30 days Q TOZ au 17® ®6 �M(E l u ®6d1 IF
following the billing date as shown on the monthly statement. This 1. Wo ®dl dust may ..cause Riot g, a pper. oesjpAxatory
credit is offered as convenience that will allow you to make one tfsasett, eye, Sad &L m hTAttasttsom. Some wood spe
payment for all charge purchases made during the previous May' cause der malttiiL a M611eri ae��n$as� a�Aerz�ae
month. This credit is not a•monthly payment plan or a revolving effects. The Hmttenmalfn®maR Agency ffbir. on
credit Ian: cCasmcerr (I1A Rc) hass ellasooLmedl Uood elunstt a s ai
type p E mown bums= cIassefimopm. u ms EettcesmAinast tom iio
returns must be returned within 60 days of original sale bmsedl on evidlemce Unastt ]Prrenom6ed ezy®bunrle to'dinc
All cash returns
y imitnaillalUGM off ffo ®dl dust iimdrreasses the ft6t of'
and must be accompanied by a sales receipt. •masaR easmeerr.
WhileV a FINANCE CHARG is added to your account if balance �ase�H�, sin pg or smalc hAmlr4 wood pa macho easm
prroolunee W®eCs dust t Naits emm 6&mse .a flammable blle or
is not paid within 30 days, such .extensions of credit are: not e>Il ®save ffiad.
encouraged. To avoid these- CHARGES and to comply
with the Lanoga Corporation credit policy, your balance must be Measures to minimize potential risk include:
paid in full'within'30 days.
Avoid dust contact with ignition source.
Sweep or vacuum dust` for recovery 6r'.disposa1.
FINANCE CHARGES are computed by a periodic rate of '1'/s% Use appropriate personal protective equipment,
per month which is an ANNUAL PERCENTAGE RATE of 16 Avoid repeated or prolonged breathing of wood dust.
Avoid dust contact with eyes and skin.
This FINANCE CHARGE will be made on any unpaid' balance Uilrat Aid: Eye and skin. contact flush with water. If
after deduction of current payments, credits and allowances from irritation persists, call a physician. Inhalation remove
to fresh' air. Get medical attention if persistent
the prior billing. A minimum 'monthly FINANCE CHARGE of 500 irritation, severe coughing of breathing difficulty
will be assessed. occurs.
For additional information, see the Wood Dust .Material
Safety Data Sheets.
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.
RR Payee
,JRoo�5 ��-F" �`•�(.j Purchase Order No.
C(L.C_ Terms
r s Date Due.
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))'
t 03 t 4) q j 0 rC,o,J Prk_ W1JC
J G£.. S r-P Cis
L4 oS 5 lkt4 \one W-C- v" A<-,6 C 6 ill WPa
o� Z.S Kos 4 3.
L1 1P 0i
S J$
31 aZ 4 Z T
Total O 1.. 5
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
V =R NO. WARRANT NO.
ALLOWED'! 20
IN ,SUM OF
ON ACCOUNT OF APPROPRIATION FOR
P
G( ms`s c� ri
O
t Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
C_ILC 42a L4. bill(s) is (are) true and correct and that the
2.I o4o 3? .oO` 'materials o`r services itemized�thereon for
C.f- Z.3 g�,g?�; -which charge is made were ordered and
$9 o v received except
iLC 00
C.
20
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund