201115 09/12/2011 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $924.80
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 201115
CHECK DATE: 9/12/2011
DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
1207 4239040 924.80 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 07:21
CITY OF CARMEL Invoice#: 0517236 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 09-16-2011
12120 BROOKSHIRE PKWY Terms B.CODlW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846-7431 Salesman: 16 JOE CLAWSON 16
ITEM QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 10 COORS LIGHT 07199031600 16.60 0.00 0.00 168.00
24 LSE CAN
10210 6 GENUINE DRAFT 03410017306 16.80 0.00 0.00 100.80
24 LSE CAN
10110 10 LITE 03410057306 15.80 0.00 0.00 168.00
24 LSE CAN
Cases: 26 Beer$: 436.80 Content$: 436.80
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Mlsc: 0 Misc$: 0.00
Gals: 58,5
Total Sales 436.80
Total Credits 0.00
Total Tax 0,00
INVOICE TOTAL 436.80
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0517236 Cash/Check 436.80
0517237 Cash/Check 110.00
0517238 Cash/Check 378.00
Total Cash/Check 924.80
PAYMENT TYPE AMOUNT
Check# 3 924.80
Inv 0519236 4 36.10
c
Inv 051'1239 110.00
Inv 0519230 390.00
rive
Customer's Signature -e- Driver's Signature
"Your signature is acceptance that all the 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 #W4987358-9P2003
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 07:22
CITY OF CARMEL Invoice#: 0517238 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 09 -16 -2011
12120 BROOKSHIRE PKWY Terms B.CODIW.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
131000 3 BAREFOOT 08500004536 25.20 0.00 0.00 75.60
187X24 CHARD
131010 2 BAREFOOT 08500004521 25.20 0.00 0.00 50.40
187X24 CAB SAUV
131020 1 BAREFOOT 08500004546 25.20 0.00 0.00 25.20
187X24 MERLOT
131050 4 BAREFOOT 08500004531 25.20 0.00 0.00 100.80
187X24 WHT ZIN
131330 4 BAREFOOT 08500004528 25.20 0.00 0.00 100.80
187X24 PINOT GRIGIO
131340 1 BAREFOOT 08500004559 25.20 0.00 0.00 25.20
187X24 MOSCATO
Cases: 15 Beer$: 0.00 Content$: 378.00
Btls: 0 Wine$: 378.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 17.8
Total Sales 378.00
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 378.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0517236 Cash/Check 436.80
0517237 Cash/Check 110.00
0517238 Cash/Check 378.00
Total Cash/Check 924.80
PAYMENT TYPE AMOUNT
Check# 3 924.80
Inv:: 051]236 136.80
Inv 051]23] 110.00
Inv:: 0517238 378.00
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
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938- INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 07:22
CITY OF CARMEL Invoice#: 0517237 PO#
BROOKSHIRE GOLF CLUB Load 5040 Date: 09 -16 -2011
12120 BROOKSHIRE PKWY Terms B.CODIW.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
10160 1 LITE KEG 03410057154 45.00 0.00 30.00 75.00
LITE 114 BBL
24569 1 SAM ADAMS KEG 00000000000 35.00 0.00 30.00 65.00
LAGER 116 BBL
31164 1 MISC KEG DEPOS 01003116400 0.00 0,00 30,00 30.00
$30 EMPTY KEG
Cases: 0 Beer$: 140.00 Content$: 80.00
Btls: 0 Wine$: 0.00 Deposit$: 30.00
Kegs: 2 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-1) Misc$: 0.00
Gals: 12.9
Total Sales 140.00
Total Credits -30.00
Total Tax 0.00
INVOICE TOTAL 110.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0517236 Cash/Check _Y 436.80
0517237 Cash/Check 110.00
0517238 Cash/Check 378.00
Total Cash/Check 924.80
PAYMENT TYPE AMOUNT
Check# 3 924.80
Lrv1:
16 ""u
Inv l: 061'/2]9 110.00
Inv 051923a 378.00
Customer's Signature Driver's Signature
"Your signature is acceptance that all the 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
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
I
bill(s) is (are) true and correct and that the
1207 0517237 42- 390.40 $110.00
materials or services itemized thereon for
1207 0517238 42- 390.40 $378.00
1207 0517236 42- 390.40 $436.80 which charge is made were ordered and
received except
Friday, September 16, 2011
Director, Bro shire 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. 199E
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))
09/16/11 0517237 Beer $110.0
09/16/11 0517238 Beer $378.0
09/16/11 0517236 Beer $436.8
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