172787 05/27/2009 CITY OFCARK8ELINDIANA «swoom 3611e9 Page 1 of 1
ONE CIVIC SQUARE COCA COLA ENTERPRISES BOTTLING
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CHICAGO /Leo4 CHECK NUMBER: 172787
CHECK DATE: menxoon
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I047 4239040 3366317802 928.15 FOOD BEVERAGES
East US CFS Group
521 Lake Kathy Drive
Brandon, FL 33510
0004451
CARMEL CLAY PARKS AND RECREATION
THE MONON CENTER TR
1411 E 116TH ST Q
CARMEL IN 46032 MAY 1 5 1009
Y.
STATEMENT OF ACCOUNT
Refer to: 0095143665
0095143665 09 May 2009 1 of 1
Invoice Invoice Due Date Purchase Item Amount
Number Date R Order/ Type Due
eference
Store No. MONON CENTER Sold To 0001632600
1195 CENTRAL PARK DR, CARMEL, IN
3366317802 04/10/2009 05/15/2009 IN 928.15
Sub Total 928.15
Past Due USD 0.00
Total Amount Due USD 928.15
Any questions or communications regarding this statement contact:
A/R Customer Service 1- 800 441 -3118
A COCA,CULA ENTERPRISES BOTTLER
7;:: 'i"NVO I PAGE 1 OF 2
REMIT TO:
MONON CENTER IRI-STATES COCA-COLA BOTTLING
CARMEL CLAY PARKS RECREATION INDIANAPOLIS SALES CENTER
1195 CENTRAL PARK DR 2329 PAYSPHERE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674-2329
317-243-3771
OUTLET 1632600 INVOICE# 3366317802
ARM 1632600
RTE- 375 DRIVER- 3898 LOAD- ISLO3 SEQ- 00002 DATE 04 1 0 09
DOCM 33663178029 PL- 101 TIME: 09:21:44 CHARGE NET 15 PROX
SHELL BALANCE 31- 4/08/09
PALLET BALANC Z- 4/88/09
SERRA GARSKE
SALES
DESCRIPTION ARIa QTY PRICE ADJM RAIE NET EXTENDED
DASANI -24 BOTTLE CASE
20PET24L DASANI WATER 5063 15 34.00 3544 -19.35 14.65 219.75
SUBTOTAL 15 219.75
20OZ PET LS.CSD W /TEA (NO /OEP)
20LSPTSPRPTY SPRITE 4320 5 34.00 3544 -14.30 19.70 98.50
20LSPETS CNTR CLASSIC 5788 6 34.00 3544 -14.30 19.70 118.20
20LSPSCTR ZERO COCA COLA 0377 4 34.00 3544 -14.30 19.70 78.80
20LSPETS CNTR DIET COKE 5789 2 34.00 3544 -14.30 19.70 39.40
20LSPETS VAULT 0347 5 34.00 3544 -14.30 19.70 98.50
SUBTOTAL 22 433.40
PST BIB -2.5G
BIB /2.5 VAULT 4072 2 55.00 3548 -19.25 35.75 71.50
BIB /2.5 MMAID LEMONADE 8037 2 55.00 3548 -19.25 35.75 71.50
SUBTOTAL 4 143.00
5GL POSTMIX
BIB /5.00 CLASSIC 7825 2105.00 3548 -39.00 66.00 132.00
SUBTOTAL 2 132.00
DEPOSITS ON SALES
DESCRIPTION ARfM QTY PRICE ADJM RATE NET EXTENDED
SHELLS 16120 OZ 0605 22 0.00 IMPLIED 0.00
SUBTOTAL 22 0.00
CONTINUED
A COCA COLA ENTERPRISES BOTTLER
INVOICE PAGE 2 OF 2
f
SHIP TO: REMIT TO:
MONON CENTER TRI- STATES COCA -COLA BOTTLING
CARMEL CLAY PARKS RECREATION INDIANAPOLIS SALES CENTER
1195 CENTRAL PARK DR 2329 PAYSPHERE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674 -2329
317.243-3771
OUTLET 1632600 INVOICE# 3366317802
ARM 1632600
RTE- 375 DRIVER- 3898 LOAD- SL03 SEQ- 00002 D ATE 04 10 09
DOCM 33663178029 PL- 101 TIME: 09:21:44 CHARGE NET 15 PROX
SHELL BALANCE S1- 4 /aNi
PALLET BALK Z• 4/06/01
SERRA GPOE
NET PRODUCI QIY 43 IOIAL PHODUCI 1,688.00
TOTAL ADJUSIMENIS 759.85
SUB-IOTAL 928.15
U119683083001
AMOUNT DUE 928.15
A P R 16 2009
BY:
IHE UNDEHSIUNEU CONFIRMS AGHEEMENI
10 THE TERMS AND CONDITIONS AND IS
AUTHORIZED 10 SIGN.
ROUTEPERSON CUSTOMER
LAST PAGE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
Coca Cola Purchase Order No.
361189 Tri- States Coca -Cola Bottling Center
2329 Paysphere Circle Date Due
Chicago, IL 60674 -2329
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/10/09 3366317802 Concessions 20426 928.15
Total 928.15
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.
Coca Cola Allowed 20
361189 Tri- States Coca -Cola Bottling Center
2329 Paysphere Circle
Chicago, IL 60674 -2329 In Sum of
928.15
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1047 3366317802 4239040 928.15_ 1 hereby certify that the attached invoice(s), or
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
22 -Apr 2009
Z?Z
Signature
928.15_ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund