HomeMy WebLinkAbout200946 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $168.00
i r o CARMEL, INDIANA 46032 PO BOX 2856
KOKOMOIN 46904 -2856 CHECK NUMBER: 200946
CHECK DATE: 8/30/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 168.00 FOOD BEVERAGES
MI ERICA CITY OF CARMEL
INVOICE
BEVERAGE dba BROOKSH'I'RE' GOLF CLUB
INC■ 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL I N 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 RR 290354 2 E X F
765 459 3117 Thursday Delivery
800 382 -0675
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE j INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
09/01/11. 458876 Dustin Smith 13 800 13
PRODUCT AMOUNT
C OD E QUANTITY DESCRIP TION PR ICE DEPOSIT
BASE July 13, 2011
PROMO #0911A
Pump $40/$33 Refundable
209 10 Bud Lt 24 Lse Can 16.80 168.00
ys �N y vo
Cases 10
P ROD TOTAL SALE 168. 00
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
'9230 PUMP DEPOSIT 33.00 N
9270 IMPORT PUMP DEPOSIT 33.00 K
168.00
T RETURNS
0 CREDITS
Cash EFT Escrow Check Number
D
Driver �i Received By
VOUCHER NO. WARRANT NO,
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
/lob- 66
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
1207 458876 42- 390.40 $168.00 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
Wednesday, September 07, 2011
Director, Brooks i 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))
09/01/11 458876 Beer $168.0
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