180293 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00353399 Page 1 of 1
ONE CIVIC SQUARE TRI -STATE COCA COLA BOTTLING CHECK AMOUNT: $297.00
1, CARMEL, INDIANA 46032 INDPLS SALES CENTER #114
2329 PAYSPHERE CIRCLE
CHECK NUMBER: 180293
CHICAGO IL 60674 -2329
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 3386314907 297.00 FOOD BEVERAGES
COCA COLA ENTERPRISES BOTTLER
NVO ICE PAGE 1 OF 2
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB IRI-SIAIES CUCA -COLA BOITLING
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674 -2329
317 243-3771
OUTLET 1666466 I NVO 1 CE& 3386314907
AR# 1865466
RIE- 375 DRIVER- 3707 LOAD- ISL01 SEQ- 00007 DATE 1 2 02 09
DOC# 33863149077 PL- 101 TIME: 08:35:35 CHARGE NET 15 PROX
SHELL BALANCE 180- 11/30/09
PALLET BALK 0 11/30/09
PM LISTER
SALES
UESCRIPIION ARI# QTY PRICE AUJ# RAIE NET EXIENDEU
2002 PEI_ LS CSO W T NO /DEP
20LSPSPRtY OT SPRITE ZRO 4806 5 34.00 9017 -15.15 14.85 74.25
9019 -4.00
20LSPTSPRPTY SPRITE 4320 5 34.OU 9017 -15.15 14.85 74.25
9019 -4.00
20LSPETS CNTR CLASSIC 5788 5 34.00 9017 -15.15 14.85 74.25
9019 -4.00
2nLSPEIS C'NTR DIET COKE 5769 5 34.00 9017 -15.15 14.85 74.25
9019 -4.00
SUBTOTAL 20 297.00
.DEPOSITS ON SALES
DESCRIPTION ART# QIY PRICE ADJ# RATE NET EXTENDED
SHELLS 16120 OZ 0606 20 0.00 <W MPLIED>> 0.00
SUBTOTAL 20 0.00
CONTINUED
A COCA COLA ENTERPRISES BOTTLER
INVOICE PAGE 2 OF 2
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB TRI-STATES COCA -CULA BUITLING
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674 -2329
317 243-3771
OUTLET 11366466 I NVO I CE# 3386314907
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISLO1 SEU 00007 DATE 12 02 09
DOC# 33863149077 PL- 101 TIME: 08:35:35 CHARGE NET 15 PROX
SALL BALANCE I80. 11/30/09
FALLET BALF1iC 0 11/30/09
PM LISTER
NET PRODUCT QTY 20 TOTAL PRODUCT 680.00
TOTAL ADJUSTMENTS -383.00
-SUB-TOTAL 297.00
0031201550
AMOUNT DUE 297.00
THE UNUERSIGNEU CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN,
ROUTEPERSON CUSTOMER
LAST PAGE
Prescribed by State Bo. 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.
o '7'�l �PA1W&f2t eieez Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice or
/Q6 '7 3,?, 96 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
C 20
Si nature vo
Cost distribution ledger classification if Tltl
claim paid motor vehicle highway fund