173578 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 00353399 Page 1 of 1
ONE CIVIC SQUARE TRI -STATE COCA COLA BOTTLING
CARMEL, INDIANA 46032 INDPLS SALES CENTER #114 CHECK AMOUNT: $325.36
qon
2329 PAYSPHERE CIRCLE CHECK NUMBER: 173578
CHICAGO IL 60674 -2329
CHECK DATE: 6/10/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 3376312114 325.36 FOOD BEVERAGES
il
L
A COGA,COLA ENTERPRISES BOTTLER
I I NVO I CE PAGE 1 OF 2
SHIP TO:' REMIT TO:
BROOKSHIRE GOLF.CLUB .TRI-STAIES COCA-COLA BOILING
'CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 'CHICAGO, IL 6067 .1-2329
317-243-3771
OU i Le I 'I 6664615 INVOICE# 337631-2114
AD# 1866466
NIL` )75 11RIVER- 311 LUAD- ISI-02 SEU- 00013 DA I I_ ;3 /0.1 /09
DOC# 33"163121143 PL- 1111 LIME: 12:16:1.11 CHARGE NEI la
SHELL BALntlCE IEZ
PALLET BALAtIC p XIL bB
AHITA MEN
SALES
ULSCH I P I I UN Mi 19 UIY PH I CL AIJ,J9 HA I L Ni 1 Y11-1.1
DASAN I ?_4 I 1 11_1= l-A:-:I
ZOPEI24L IWANI WAIER 5i1b3 12 34.1111 901; 2n.lU 9 ti
9U19 -4.00
SUBIOIAL 12 116 GU
2001- F'1_ I I-.i I -;'-il I w/ 11_A NO /ULP
20LSPETS CNIR CLASSIC ;i766 2 34 1111 9017 -15.15 "14.65 2931!
9019 4.00
ZUSPSCIR ZERO WCA CULA 1131/ 2 34 UU 901l 15.15 14.65 29.%11
9019 4.00
2111 -SPEI S C N I H U I E I i;IJKL 5769 7 34.1111 91117 15.15 14.65 1113.95
9019 4.00
20LSPE I S UMUS HU l l-il R 61156 Y 34.110 9W/ 15.15 14.65 29.711
9019 4.00
SUBIOTAL 13 193.05
1 1 5 1 N SALLti
ULSCHIPIION AHI# UIY PHICL AIJJ# HAIL NLI LXIL
SHELLS 16120 LQ i16u6 13 0.00 c <IMPLIEII» 0.00
SU810TAL 13 U.00
LAN 'I I U
A COCA CULA ENILHPHISES UUIILLH
I NVU 11:P PAGE 2 OF 2
SHIP 10: 1 f0:
UHOOKSHIRL GUIJ U1111 ttIFS U1CA-WIA IJUI ILINU
CITY OF CAHME1. 1 ANAPUI_IS SALES CENIEI?
12120 URUOKS11IIi1: PKWY AYSP10F CItiCLE
CARMEL IN 460333314 LHICAU0. IL 6U674.2329
317- 243-3171
IJU 1 I i 1 IlJG(:.4(56 1 NVU I I_( =tt a•i /6-i'I I•'1
AR# 166644;6
HIE 315 URM11- 3 /lll LUWI- ISLOZ SLU 1111113 UA 11 I1(i 1114 10
DOC# 33%63121143 PL 101 I IMl 12: 16:111 CHARGI: NLI I PliOX
SHELL BALPo4:E I`2 69? li
PALLET BALK u Ei ;bL1
AI11Tfi raEkli
NEI PHUUUCI UIY 25 IUTAI PHUUUCI 650.00
IUTAL AUJUSIMLNIS -538.15
SLID- TOTAL 311.65
IN Sr IAX 7.00! ON 193.05 I3.5i
AMUUN"I• DUE 3Z, 36
Pit- UNULRSIUNLII CUNT'IRX; AGHLLMI -NI
I IHE ILRMS ANU CONOI11UNS ANU IS
AUIHORIZED 10 SIGN.
ROUIEPERSON CUSTOMER
LAS'll Pi1GE
'Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
1 ri �zr5 Cow( -E O�c�.. IInn ►�c
Purchase Order No.
r
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 5 3
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
VP
VOUCHER NO. WARRANT NO.
ware
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
-r
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20
ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund