171796 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 361189 Page I of 1
ONE CIVIC SQUARE COCA COLA ENTERPRISES BOTTLING RECK AMOUNT: $461.10
CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE
CHICAGO IL 60674 CHECK NUMBER: 171796
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239040 3366316804 461.10 FOOD BEVERAGES
C"— re? 0 0 W�
STATEMENT OF ACCOUNT
Refer to: 1 0095143665
CARMEL CLAY PARKS AND RECREATION
THE MONON CENTER
1411 E 116TH ST
CARMEL IN 46032
I
i
95143665 02 A ril 2009 1 of 1
Invoice Invoice Date Due Date Purchase Item Amount
Number Order/ Type due
Reference
Store No. MONON CENTER Sold To 1632600
1195 CENTRAL PARK DR CARMEL IN 46032
3366314803 02/27/2009 03/15/2009 INV 452.20
3366315303 03/06/2009 04/15/2009 INV 1,077.60
3366316304 03/20/2009 04/15/2009 20344 INV 442.75
3366316804 03/27/2009 04/15/2009 20587 INV 461.10
Sub Total 2,433.65
Past Due LISD 452.20
Total Amount Due LISD 2,433.65
Any questions or communications regarding this statement contact:
Bernie Mencos
t
CARMEL CLAY PARKS RECREATION INDIANAPOLIS SALES CENTER CARMEL CLAY PARKS RECREATION INDIANAPOLIS SALES CENTER
1195 CENTRAL PARK DR 2329 PAYSPHERE CIRCLE 1195 CENTRAL PARK DR 2329 PAYSPHERE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674 -2329 CARMEL IN 46032 CHICAGO, IL 60674 -2329
317-243 -3771 317 243 -3771 R.
OUTLET 1632600 INVOICE& 3366316804 OUTLET 1632600 INVOICE& 3366316804;:
AR# 1632600 AR# 1632600
PO# 20587 PO# 20587
RTE- 375 DRIVER- 3707 LOAD- ISL02 SEQ 00003 DATE 03 12 7 l 09 RTE- 375 DRIVER- 3707 LOAD- ISLD2 SEQ 00003 DATE 03 2 7 1 09
DOC# 33663168046 PL- 101 TIME: 07:58:12 CHARGE NET 15 PROX DOC# 33663168046 PL- 101 TIME: 07:58:12 CHARGE NET 15 PROX
SHELL BALANCE 27- 3/25/09 SHELL BALANCE 27- 3/16/09
PALLET BALANC 2- 3/26/09 PALLET BALANC 2- 3/25/09
SARA SARA
SALES
DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED NET PRODUCT QTY 23 TOTAL PRODUCT 782.00
TOTAL ADJUSTMENTS 320.90
DASANI -24 BOTTLE CASE
20PET24L DASANI WATER 5063 10 34.00 3544 -18.15 15.85 158.50 SUB TOTAL 461.10
SUBTOTAL 10 158.50
0119683083001
20OZ PET LS CSD WITEA (NO }DEP)
20LSPETS CNTR DIET COKE 5789 4 34.00 3544 -12.80 21.20 84.80 AMOUNT DUE 461.10
SUBTOTAL 4 84.80
2002 LS GLACEAU
20PTLWM GLA VWTR MULTIN 6465 3 34.00 3535 -6.80 24.20 72.60
1330 -3.00
20PTLWM GLA VWTR POWER 6508 3 34.00 3535 -6.80 24.20 72.60
1330 -3.00
20PTLWM GLA VWTR XXX 6526 3 34.00 3535 -6.80 24.20 72.60
1330 -3.00
SUBTOTAL 9 217.80 THE UNDERSIGNED CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
DEPOSITS ON SALES AUTHOR I ZED TO SIGN.
DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED
SHELLS 16/20 OZ 0606 4 0.00 <<IMPLIED>> 0.00
SUBTOTAL 4 0.00
ROUTEPERSON CUSTOMER
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind f serfice, units, price performe e dates service rendered, by
whom, rates per day, number of hours, rate per hour,
Payee Purchase Order No.
Coca Cola
361189 Tri- States Coca -Cola Bottling Center
Date Due
2329 Paysphere Circle
Chicago, IL 60674 -2329
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s)) PO
Date Number 20587 461.10
3127109 3366316804 Concessions
Total 461.10
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
Voucher No. Warrant No.
Coca Cola Allowed 20
361189 Tri- States Coca -Cola Bottling Center
�e 2329 Paysphere Circle
Chicago, IL 60674 -2329 In Sum of
u
461.10
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 3366316804 4239040 461.10 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
Signature
461.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
R
3