168419 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 361189 Page 1 of 1
ONE CIVIC SQUARE COCA COLA ENTERPRISES BOTTLING Co
CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE CFIECK AMOUNT: $442.00
ti oN CHICAGO IL 60674 CHECK NUMBER: 168419
CHECK DATE: 2/412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AM DESCRIPTION
1047 4239040 3366310201 442.00 FOOD BEVERAGES
V- 0 4
STATEMENT OF ACCOUNT
Refer to: 0095143665
CARMEL CLAY PARKS AND RECREATION
THE MONON CENTER
1411 E 116TH ST
CARMEL IN 46032
b_ Date Page
95143665 05 January 2009 1 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
3356318502 12/05/2008 01/15/2009 INV 156.50
3356319004 12/12/2008 01/15/2009 INV 220.50
3356319902 12/26/2008 01/15/2009 INV 496.70
3366310201 12/31/2008 01/15/2009 INV 442.00
Sub Total 1,315.70
Past Due USD 0.00
Total Amount Due USD 1,315.70
i
Any questions or communications regarding this statement contact:
Bruce Lint
A COCA COLA.ENTERPRISES BOTTLER
E'• I NVO I CE PAGE 1 OF 2
SHIN TO: REMIT TO:
MUNUN CENTER TRI- STATES COCA -COLA BOTTLING
CARMEL CLAY NARKS RECREATIUN INDIANAPOLIS SALES CENTER
1195 CENTRAL PARK OR 2329 PAYSPHEHE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674-2329
317- 243-3771
OUTLET 16326011 I NVO I CE# 33663
AR# 1632600
HIE- 375 DRIVER- 3707 LUAU- ISI-03 SEQ- 00001 DATE 12 /3'1 08
DOC# 33663102011 PL- 101 TIME: 08:32:39 CHARGE NET 15 PROX
ALL 6ALNNEE 17. 12/29/08
PALLET BALK D 12291"18
MICHELLE
SALES
DESCHIPIION AHI# QTY PRICE ADJ# RAZE NET EXIENUED
PST BIB -2.5G
BIB /2.5 VAULT 4072 3 45.00 3548 -12.00 33.00 99.00
BIB/2.5 MMAID LEMONADE 6U37 3 45.00 3548 -12.00 33.00 99.00
SUBTOTAL 6 198.00
5GL POSTMIX
81B /5.00 CLASSIC 7825 2 90.00 3548 -29.00 61.00 122.00
BIB/5.00 SPRITE 7833 2 90.OU 3548 -29.00 61.00 122.00
SUBTOTAL 4 244.00
NET PRODUCI QTY 10 [DIAL PHODUCI 630.00
TOTAL ADJUSTMENTS -188.00
SUBTOTAL 442.00
0119683083001
AMOUNT UUE 442.00
CONTINUED
A COCA COLA ENTERPRISES BOTTLER
INVOICE PAGE 2 OF 2
SHIP TO: REMIT TO:
MONON CENTER TRI-SIATES COCA-COLA BUTILING
CARMEL CLAY PARKS RECREAIION INDIANAPOLIS SALES CENTER
1195 CENTRAL PARK DR 2329 PAYSPHERE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674-2329
317-243.3771
OUTLET 1632600 INVOICE# 3366310201
AR# 1632600
RTE- 375 DRIVER- 3707 LOAD- ISLO3 SEQ- 00001 DATE 1 2 3 1 00
DOC# 33663102011 PL- 101 TIME: 08:32:39 CHARGE NET 15 PROX
SHELL 6ALAMEE 17- 12/29/08
PALLET 6HLAHC Z 121291088
MICHELLE
t
s
T
THE UNDERSIGNED CUNFIRMS AGREEMENT
10 THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.
ROUTEPERSON CUSTOMER
r
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. 19075 P
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)) Amount
12/31/08 3366310201 Concessions 442.00
Total 442.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Coca Cola Allowed 20
361189 Tri- States Coca -Cola Bottling Center
r
2329 Paysphere Circle
Chicago, IL 60674 -2329 In Sum of
442.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members
Dept
1047 3366310201 4239040 442.00 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
2 -Feb 2009
Signature
442.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund