174083 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00353399 Page 1 of 1
p ONE CIVIC SQUARE TRI -STATE COCA COLA BOTTLING
CARMEL, INDIANA 46032 INDPLS SALES CENTER #114 CHECK AMOUNT: $752.08
2329 PAYSPHERE CIRCLE CHECK NUMBER: W4083
rrop
CHICAGO IL 60674 -2329
CHECK DATE: 612412009
!DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1207 4239040 3376312606 358.41 FOOD BEVERAGES
1207 4239040 3376313110 393.67 FOOD BEVERAGES
v A COLA CULA ENTERPRISES BUIILER
I NVO I CE PAGE 1 OF 2
S TO: REMIT f0:
BH UUKSHIRE GI.II.F•CLUU 1R1-STAIES CUCA-CULA HUIILING
CIIY OF CARMEL INDIANAPOLIS SALES CENTER
1211 HRUOKSHIRE PKWY 2329 PAYSPHEIE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317 243-3771
1 u 1 LE 7 1 066 -166 1 NVO I CE# ;3370312(3 06
AR# 1866466
RI& 315 URIVER- 3707 LLIAII- ISLO4 SEQ- 00005 OA I E 06 1 1 109
DUC# 33753126068 PL- 101 MME: 10:28:41 CHARGE NET 15 PROX
;HELL BALANCE !99• V99/09
raLLE16AlnNi 9 6'9Snt?
AN!iA rJ!ERN
SALES
UESCRIPITUN AIII✓t UTY PRICE ADD RAIE NEI EXIENUED
OASAN 1 -24 EJO 1 1 I_E CASE
20PE124L OASANI WATER 5UG3 Ill 34.00 9017 -20.10 9.90 99.00
9019 =4.00
SUBTOTAL 10 99.00
20OZ PF I 1-S I:SU W I EA NO /OEP
20I.SPEIS CNTR CLASSIC 5788 5 34.00 9017 -15.15 14.85 7415
9019 -4.00
20LSPETS CNTR DIET COKE 5789 4 34.00 9017 -15.15 14.85 59.40
9019 -4.00
SUBTOTAL 9 133.65
GLAC:EAL1 2002 241 -S
ZIJPILWM GI.A VWTR Ill ESSN 2294 6 34.UO 9018 -9.04 20,96 125.76
9020 -2.00
1321 -2.00
SUBTOTAL 6 125.76
OEPOS I 1 S ON SALES
UESCHIPIIUN AHI# QIY PRICE AUJ# RAIE NET EXIENUED
SHELLS 16/211 OZ 0606 9 0.00 IMPLIED 0.00
SUBTOTAL 9 0,00
CON I I NUEO
A COCA COLA ENIERPRISES_fUTIL
I NVOICE PAGE 2 OF 2
SHIP TO: REMIT TO:
HHUUKSHIHE GULF CLUB IRI- SIAIES COCA -CULA HUIILING
CIIY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674.2329
317-243.3771
OU 1 1 -E1 '1666400 1 NVO I CEO 33 76312606
AR# 1866466
HIE- 375 URIVEH- 3707 LOAD- ISL04 SEQ 00005 O A l E 06 1 1 Os�)
UUC# 33763126068 PL 101 TIME: 10:28:41 CHARGE NEI 15 PROX
'HELL EALrJi[E 1& 6'99/99
PALLET FkRk 9 9S/05
Fill TA MR
NEI PRODUCI UIY 25 IOIAL PRODUCT 850.00
TOTAL ADJUSTMENTS -491.59
SUB -TOTAL 358.41
IN ST TAX 7.00% ON 259.41 16
AMOUN 1 IJUE 376.57
IHE UNUERSIGNEU CONFIRMS AGREEMENT
TO IHE TERMS AND CUNDIIIUNS AND IS
AUTHORIZED TO SIGN.
ROUTEPERSUN CUSTOMER
LAST PAGE
A I, :UCA CULA EN I EHPH I5ES OU I I LER
I NVO I I :E PAGE 1 OF 3
SHIP TO: REMIT 10:
URU(JKSHIfiL GLIL! CLUB IHI CULA-I;ULA H0I11-ING
CIIY OF CAHMEI. INDIANAPOLIS SALES EWER
12120 UHUOKSHIRL PKWY 2329 PAYST'HLftL CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674 -2329
317-243-3771
1111J I I -I_ I '1066 /166 1 NVU 1 L :L 33763 13 1 '10
AR# 1866466
HIL- 375 UkIVER- 3'4 LUAU- ISI 14 Sf_iJ- 0111110 UA fE Ilu l45 /t111
DOC# 337631311110 PL- 101 IIML: 10.17:11 CHARGE NEI 15 PROX
SHEII. EI AHLE leg• E% MD
PALLET EnlneC 0 S'lo %119
LI:;A HtE;nRI CLEF PiU STF'lIE AHP pi ':F:'flF f r;,�E P�y1G
SALES
DESCHIPIIUN AHI# UIY PRICE ALIJ# HAIL NEI LXILNDEU
IJASAN 1 -24 E301 1 L[_ CASE
2UPE1241. DASANI WATER 5063 14 34.IIU 9017 20.10 9.911 13o.60
9019 -4.00
SUBTOTAL 14 138.60
2002 PE I 1 -:S I aIJ W 117- A NO IUt
ZOLSPETS C'NIR CLASSIC 5788 1 4 34.IIU 9017 Ii. 15 14.85 59.40
9019 4.00
201 ZERU COCA CULA 036' 1 34.00 9U17 15.15 14.65 14.65
9019 4.00
ZOLSPEIS CNIR DIET CUKE 5789 14 34.00 9017 15.15 14.66 ZI17.9U
9019 4.00
SUBTOTAL 19 262.15
2OOZ PE 1 8PK NO OEP
ZoPE16PK PA ZERO GRAPE 7619 1 34.UU 9018 -13:90 16.10 16.10
9020 -4.00
SUBTOTAL 1 16.10
20OZ L -S GI -ACEAU
20PTl.WM GLA VWTR XXX 65 2 34.U(I 9U 16 -9.04 2'1.96 45.92
9020 -2.00
SUBTOTAL 2 45.92
RE TURNS
UESCHIPIIUN AHI# UIY PHICF. AUJ# HATE NLI EXILNUEU
2t1C1% Pt_ I' I_S l :S11) W 1 EA NU /IJt P
2(ILSPISPRPIY SPRITE 4321) 6 34.110 9017 15.15 14.85 89.10
9019 -4.00
SUBTOTAL 6 89.10
CONT I NUELI
A COI :A CULA ENTERPRISES BOTTLER
NVO I CE PAGE 2 OF 3
SHIP 10: REMIT 10:
HHOLIKSHIRL GULF CLUB IHI SIAIES CULA-CULA UUIILiNG
CIIY 11F CARMEL INDIANAPOLIS SALES CENIEH
12120 HHUUKSHIRE PKWY 2329 PAYSPHEHL CIRCLE
CARMEL IN 460333314 CHICAGO, IL 6(1674
317
I)UTLI_ I 1 t366 41i6 1 NVO 11':L" 3 3 %t33 13 1 '1
ARW 1866466
NIL 375 UHIVLk- 3707 LUAU- ISI.14 SEU- 00010 1 JA I E-_ 06 '16 09
UOCN 33763131100 PI.- 101 IIMF: 10:17:11 CHANGE NEI 15 PROX
SHELL ktmlc[ hI i;IE.n
PkIEi EALPob: 0 Siltau9
LISA HkAR1 L(`E/ P/U SMIE �l1U DI SMIE C`.' UFti FK@
RETURNS
UESCRIPIIUN AKIN UIY PRICE AWO RAIL= NEI LXILNUEU
UE-POSITS ON SAL-E'--;
OLSCHIPIIUN AHI# IJIY PHICL AWN HAIE NLI L
SHELLS 16/2(1 OZ 06(16 19 11.00 W MPLIED>? (1.00
SUBTOTAL 19 0.00
LIL I 1 S ON RE I URNS
UESCH I P 111 IN AHI# U I Y Pk I CE AL)J# H A I E NL I f_X I ENUEU
SHELLS 16/20 UZ 0606 6 0.00 <':REIURNEU 0.00
SUBTOTAL 6 0.00
NEI PRUUUCI UIY 30 1UTAL PRUIJUC1 1,020.00
TOIAL ADJUSTMENTS 626.33
SUB TOTAL 393.67
IN Si TAX 7.0U% ON 255.U7 17.
AMOUNT OUE -111.52
(-0 N, I NUELI
A COLA LOLA LN I I.RPH I SES BU I I LEH
t
1
Y I NVO I CE PAGE 3 OF 3
SHIP 10: REMIT 10:
HHOUKSHPOt GULL CLUU IHI SIAILS CIICA CULA HUI ILING
CIIY Of CAHMEI INDIANAPOLIS SALES CENIER
020 HHITUKSHIHL PKWY 23241 PAYSPIIL CIRCLE
CARMEL IN 460333 CHICAGO, IL 60674-2329
317-243-3771
Ou I LL 1 1 4L.6 1 NVI`I I L :L" ",_.5;3 /t:i 3'1.31 '1 1.1
ARs 1866466
HIE t ti IIHIVLH 3707 LUAU ISL14 U. 00010 0 11_ t16 'Its /119
UUCA J3763131101) PL- 101 11 ME: 10:17 11 CHANGE NEI 15 PHUX
:HELL EninliCE IU9•'S••L'- -tl9
FnILEi ;v+LAIR c /1�U9
LN HJFHr'1 Ltl: P'J M'11I AND N
I HI. UNI11161 GNLLI CU•NI I NMS AGHLLMLN I
I IHE ILHMS ANU CONOIIIDNS AND IS
AWHOHI7.ED 10 SIGN.
ROUIEPERSON CUSIOMEH
LAST PAGE
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
4 ,,r•� Purchase Order No.
3a 9 S �E �i2ClF Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)-or bill(s))
►r
J9 5
8
Total by
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with 1C 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 DEPT. INVOICE NO. ACCT /TITLE AMOUNT 1 hereby certify that the attached invoice(s), or
Jve
1 2 -d 11 S-f d bill(s) is (are) true and correct and that the
31 j 6 3 5'Q -4/6) fir/ s- materials or services itemized thereon for
which charge is made were ordered and
received except
0
20
gU@ture
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund