173064 05/27/2009 "BM 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: $2,031.47
2329 PAYSPHERE CIRCLE CHECK NUMBER: 173064
o x co
CHICAGO IL 60674 -2329
CHECK DATE: 5127/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUNT DESCRIPTION
1207 4239040 3376310803 2,031.47 FOOD BEVERAGES
i
A CUCA LU1 -A FN I EHPH SE5 BU 1 11_LH
I NVO l L'F_ PAGE 1 OF 3
SHI 10:' REMIT 10:
B10111KS111M_ GULF I I_UIi W1 CULA 1;01_A UU1 II ING
CITY OF CARMI_I. INOIANAPULIS SALES CENIER
121211 BROOKSHIRE PKWY 2:124 PAYSPHLHI CINUF
CARMEL IN 460333314 CHICAGO, IL 60674-2324
317 243 3771
UU I I_l- I 1 O j1, -.461 I NV1.1 11.:1 33 /6-3 1 11131 -1;:3
AR4 id'66166
HEL: 3!5 uWvI:! 3r0( I_I,IAlJ- ISL113 SLU- 111,11103 I.IA I L 0 5 /'2 1
BUCN 337631(181133 P1 IUI I IMI:: (17.5(1:42 CHAHGL NLI IS PHOx
SHELL Bd1nIiYE :4 S%IY4l9
FlUt'T EmL if ii S,' &py
Nil
SAI_1 =S
ULSCH I P I I ON AV. I UIY PH U' A11,10 HAIL Nf_ I 1:11 I OUL
1.1 AS AN I -24 LIU1 1 I-.1- C:AS[
ZUI'l_124L DASANI WAILR 6,63 2:j 34.110 0017 -'211, 10 40+.1
9U19 -4.00
SUBTUTAL 25 247.50
2e 7(3Z Pl- I I_,� Ctil I 1Y 1 I A NI _I 1I111- I'
?0I.SN I Y UT SPR I I L ZHU 4806 11 34.011 9017 15.15 14.85 163.3b
9019 -4.00
ZOLSPISPRPIY SPRITE 43271 12 34,00 9017 -15.15 14.85 170 20
9019 4.00
2ULSPEIS LNTR CLASSIC 5(811 211 31.11LI 41,117 -15. 15 14.Li: 24f.00
X019 -4.00
ZULSPFIS CNIR UID CUKE 5789 25 34,110 911'1'1 -15.15 14.65 3/115
9019 -4.00
SUBTOTAL 68 1,009.60
GLACEAU 2002.'- 241_S
ZOP II -WM GL A UWTR ill ESN 2254 34 ou1 w]6 4.04 t/ 96 22.96
9020 2.00
SUBTOIAL I 12.96
200L PL .I l_`., I- JLJVA- IiAI -1L NI_i /1.)17.P
2LjPTLWM POWERADE I.L 5994 15 34 ()0 90I8 -13.90 14.10 211.50
9020 -4,00
1320 2.00
20PI1WM PUWljJAOI: FPUNCH 5995 15 34.011 9015 -13.90 14.1 211.50
9020 -4.00
132.0 -2.00
2LIP11 -WM POW MUUNI A IN BLA 403:f 1!i 34.011 91116 -13.90 14. 10 21 1.50
9020 -4.00
1320 -2.00
CON I NUELI
A COCA 'COLA ENTERPRISES HOIILER
NVO I CE PAGE 2 UE 3
SHIP 10: HEMII 10:
U11UUK51iIHL GULF CLOU I1?I-S1All_S COCA COLA UUI II -ING
CITY OF- UAHMEL- INUTANAPOLIS SALES CENIN
12120 B11006HIHE PKWY 2329 PAYSPHERC CIRCLE
CARMEL IN 4603333/4 CHICAGO. IL W74 2-3
317-243.3771
OIJI LH 1 '11366/11.611; 1 NV() I CF" 3 e(j3 1 lj003
ARC+ 1666466
t {lk 375 OHIVLH 31111 U ISDI3 SI 01.4103 I JA I t 1:15 /2 1 (Y4
UUCA 337631081733 PI_- lilt 11ML 01:66:42 CHARGE NEI 1`i P1fON
SHELL E.ABil 59• Sil9.'�E
PkUl {H1L0 d Sii9i0c
FhH
SALES
OBUR I P I I ON AHI# LILY PHICL AIJJ✓f RAIL NU OILNUL-U
SUBTOTAL 45 634.50
CJEPOS I I S ON ,SALt `i
OESI "HIVlILiN All I# (JIY PRICL AIIJp RATE Nkl_ LKILNUEU
SHELLS 16/20 2 0606 68 UJIIJ 4CIMAILD:> 0.00
SUBIOTAL 68 0.00
NC=I PHODUC I UIY 134 101 AL PRUl IUC 1 1, 7K' (10
I01AL AJJUSIMENIS 2,811 24
SUB -IUTAL 1,914.76
IN ST IAX 7.00% ON 1,661 26 116.71
AMOUNT DUE L, 173 1. 4 7
[_:ON'I I N011
A WCA COLA ENIEHPRISES tit II_ER
NVO I C:E PAGE 3 OF 3
SHIP lo: HEM I 1 111:
BHUL.IKSHIRt- GIILF CLUB IHI I;UCA -CULA HUIl1 -ING
CITY OF CAIiMFL INIIIANAPULIS SALES CEN11-H
12120 HHOOKSHIRE PKWY 2329 PAYSPHEHE LIHI:LE
CARMEL IN 46(D33314 CHICAGO, IL 61)674 23Z9
3117 3771
UU1 L[ =1 123N,1�41�(� I NVO I Ca_# '_f'; /1_i i'I clo0 -1
AR# 1856466
HIT, 376 lll'flVt =H 3r'0/ I.DAU- IS1.03 SLU 0(10E13 1-)AI1= /2 "i /t1!w1
IJUC# 33 PL- 11) 1 11 ME U l "0 :42 1:1IARGE NI: 115 IRON
$AELI EnLHIICE R4. 5.19N�
PELLET FiLmIC E SI'iE9
?riM
IHL UNIJL I:UNt IHMS AGHLLMFNI
10 THE IEHMS ANU CONIIIII[INS ANU IS
AUIHOHIZEO TO SIGN,
1
ROUTEPERSUN CUSIOMER
I I_AS I PALL
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
a4q ?i Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5 171 09
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
11'66
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
42-0 33 3/D 390 a3/. zI7 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
i
Sinatufe
ex Cost distribution ledger classification if Title
claim paid motor vehicle highway fund