207324 03/21/2012 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
0 ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $468.20
CARMEL, INDIANA 46032 PO Box 2856
•c, o KOKOMO IN 46904 -2856 CHECK NUMBER: 207324
CHECK DATE: 3/21/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 468.20 FOOD BEVERAGES
MIWAMERICA I NVOICE
B CITY OF' C'ARMEL
INC■ .dGa BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
L 2755 Commerce Dr. CARMEL I N 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR2903542 EXP. 07/13/12
800- 382 -0675
Fax: 765-457-7967
BEER W3409212 r'
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMB ER:= ,'i„ ROUTE
477795 nu tin Smith 13 800 13
PRODUCT 06ANTITY DESCRIPTION PRICE DEPOSIT AMOUNT
BASE March 5, 2012
PROMO #0312
PUMP $40/$33 REFUNDABLE
109 8' Budweiser 24 Lse Can 17.20 137.60
209 15 Bud Lt 24 Lse Can 17.20 258.00
225 1''' Bud Lt 1/4 BBL 46.50 30.00 76.50
909 "3'.%L Mich Ultra 24 Lse Can /1jr'1/YI� 56.10
RECEIVED'
MAR 21 2012
BY:
Date
Init.
Account L
Account
Account
Account
Cases 26 1/4 Barrels 1
TOTAL SALE 528.20
10303 I EMPTY�AB 1/6 30.00 %G�� T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 3� O�
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 N
r j CREDITS 11 1 'z2 /7)
❑Cash El EFT ❑Escrow Check Number 7 u /J
Driver �N Received By
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF
P.O. Box 2856
Kokomo, IN 46904 -2856
$449.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. I ACCT #/TITLE I AMOUNT Board Members
1207 I 477795 I 42- 390.40 I $449.50 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
Friday, March 23, 2012
Director, Brook ire 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. 1995)
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))
03/22/12 477795 Beer $449.50
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