176960 09/02/2009 d CITY OF CARMEL, INDIANA VENDOR: 00353399 Page 1 of 1
ONE CIVIC SQUARE TRI -STATE COCA COLA BOTTLING CHECK AMOUNT: $601.13
s ��o CARMEL, INDIANA 46032 INDPLS SALES CENTER #114
2329 PAYSPHERE CIRCLE CHECK NUMBER: 176960
CHICAGO IL 60674 -2329
CHECK DATE: 9/212009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 3376317804 396.22 FOOD BEVERAGES
1207 42390.40 3376318314 204.91 FOOD BEVERAGES
A COCA COLA ENTERPRISES BOTTLER
INVOICE PAGE I OF 3
SHIP TO: REMIT TO:
BROOKSHIHF GOLF CLUB IHI-SIAItS COCA -CULA 801ILING
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674.2329
317-243-3771
OU I LET 1866466 I NVO I CE# 3376317804
AR# 1866466
RTE +75 DRIVER- 3707 LOAD- ISL23 SN L10004 DATE Oti /20 09
DOC# 33763178044 PL- 101 TIME: 08:22:52 CHARGE NET 15 PROX
SHELL`,brv!iuICE H4 B /IS✓U9
v
PdLLEi !n�Alf 0 S'i!b6,
ANITA
SALES
UESCHIPIIUN AHI# UIY PRICE AI1J# RAIE NEI EXIENIIED
OASANI -24 BOTTLE CASE
20PET24L DASANI 'WATER 5063 6 34.00 9017 -20.10 9.90 59.40
9019 -4.00
SUBTOTAL 6 59.40
20O2_ PET LS CSO W /IEA (NO /OEP)
20LSPETS CN'IR CLASSIC 5788 6 34.00 9017 -15.15 14.85 89.10
9019 -4.00
20LSPETS CNIR DIET COKE 5789 6 34.00 9017 -15.15 14.85 89.10
9019 -4.00
SUBTOTAL 12 178.20
20OL PIF LS POWF= I NO /DEP
20PTLWM POWERADE LL 5994 2 34.00 9018 -13.90 16.10 32.20
9020 -4.00
2UPTLWM POWERADE PUNCH 5995 2 34.00 9018 -13.90 16.10 32.20
9020 -4.00
2UPTLV POW MOUNTAIN BLA 4035 2 34.00 9016 -13.90 16.10 32.20
9020 -4.00
SUBTOTAL 6 96.60
20OZ POWERADE
20PE18PK PA ZERO GRAPE 7619 1 34.00 9018 -13.9U 16.10 16.10
9020 -4.00
SUBTOTAL 1 16.10
20OZ LS GLACEAU
20PILWM GLA VWTR ESSENTL 6451 1 34.00 9018 -9.04 22.96 22.96
9020 -2.00
20PILA GLA VWTR XXX 6526 1 34.00 9018 -9.04 22.96 22.96
9020 -2.00
CONTINUED
A COCA COLA ENTERPRISES BOILLER
NVO I CE PAGE 2 OF 3
SHIP 10: REMIT TO:
8HOOKSHIRE GULF CLUB IHI-STATES CULA -COLA BOTTLING
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317- 243 -3771
OU I LE I 1666466 1 NVO I CE# 3:3763 04
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL23 SEO- 00004 DATE 06 20 1 09
DOC# 33763178044 PL- 101 TIME: 08:22:52 CHARGE NET 15 PHOX
SHELL BALAliEE 144- 8119/6
PALLET BALK G 8 %13/09
MITA
SALES
DESCRIPTION ARI UIY PRICE ADA RAIE NET EXTENDED
SUBTOTAL 2 45.92
DEPOSITS ON SALES
DESCRIP -IJUN ART# _UlY PRICE AOJ>__RATEf__ NET EXTENDED
SHELLS 16/20 OZ 0606 12 0.00 IMPLIED» 0.00
SUBTOTAL 12 0.00
NEI PRODUCT UTY 27 TOTAL PRUDUCI 918.00
TOTAL ADJUSTMENTS -521.78
SUB-TOTAL 396.22
0031201550
AMOUNT DUE 396.22
CON 1 NUED
A COCA COLA ENTERPRISES BOTTLER
INVOICE PA Gf3 OF 3
SHIP TO: REMIT TO:
BROOKSHIRE GULF CLUB IRI-SIAIES CUCA -CULA HUIILING
LIIY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIHE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317- 243 -3771
OUT LET 'I6664Ci6 I NVO I CE# _3376:31 7604
AR# 1866466 1
RIF.- 375 DRIVER 3707 LOAD- ISL'Z3 SEU- 001104 OA 1 E 08 1
DOC# 33763178044 PL- 101 TIME: 08:22:52 CHARGE NET '15 PROX
ALL BALAI(E 144. MM.;
PALLET EALANC B 8 18
AVITA
THE UNDERSIGNED CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.
ROUT EPERSON CUSTOMER
LAST PAGE
A COCA COLA ENIERPHISES BOTTLER
I NVOICE PAGE 1 OF 2
SHIP TO: REMIT 10:
BROOKSHIRE GULF CLUB 1R1-SIAIES COCA-COLA BUTILING
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317-243-3771
OUTLET T 186(5 466 I NVO I CE# 33763163'14
AR# 1866466
:p
HIE- 375 IJRIVER- 3707 LUAU- ISL15 SEU- 00014 D ATE 08 2 7
DOC# 33763183143 PL- 101 IIME: 10:07:47 CHARGE NET 15 PROX
XL� 156. 3%:5/03
RLE1 SALidii 0 NN9
SALES
UESCHIPIIUN ARI# QIY PRICE AI)Jtt HAIE NET EXIENUED
2002 PET LS CSO W ITEA (NO /DEP)
20LSPSPRTY 01 SPRITE ZRU 4806 1 34.00 9017 -15.15 14.85 14.85
9019 -4.00
20LSPETS CNTH CLASSIC 5788 5 34.00 9017 -15.15 14.85 74.25
9019 -4.00
20LSPSCTR ZERO COLA COLA 0377 1 34.00 9017 -15.15 14.85 14.85
9019 -4.00
201-SPETS BARDS ROOIBEFR 5856 2 34.00 9017 -15.15 14.85 29.70
9019 -4.00
SUBTOTAL 9 133.65
GLACEAU 20OZ 24 LS
20PTLWM GLA VWTR 10 ESSN 2294 1 34.00 9U18 -9.04 22.96 12.96
9020 -2.00
SUBTOTAL 1 22.96
2062 PET LS POWEF3AIJE NO /ULP
20PTLWM POWERADE LL 5994 1 34.00 9018 -13.90 16.10 16.10
9020 -4.00
2UPTLWM POWERADE FPUNCH 5995 1 34.00 9018 -13.90 16.10 16.10
9020 -4.00
20PTLWM POW MOUNTAIN BLA 4035 1 34.OU 9018 -13.90 16.10 16.10
9020 -4.00
SUBTOTAL 3 48.30
DEPOSITS ON SALES
OESCRIPIION AHIp OIY PRICE AUJ# HATE NEI EXIENUED
SHELLS 16/20 OZ 0606 9 0.00 IMPLIED 0.00
SUBTOTAL 9 0.00
CONTINUED
A COCA COLA ENTERPRISES BOIILEH
INVOICE PAGE 2 OF 2
SHIP TO: REMIT TO:
BHUOKSHIRE GOLF CLUB IRI-SIAIES COCA -COLA HOIILING
CITY OF CARMEL INDIANAPOLIS SALES CENIER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317 243 -3771
OUTLET 186646(5 INVOI 33763 "14
ARa 1866466
HIE- 375 DRIVER- 3707 LOAD- ISL15 SEU- 00014 0 ATE 08 2 7 09
DOC# 33763183143 PL- 101 TIME: 10:07:47 CHARGE NET 15 PROX
ALL EKWE 153• 8/
PALLET kfil( 0 S /H/6
NET PRODUCT OTY 13 TOTAL PRODUL'T 442.00
TOTAL ADJUSTMENTS -237.09
SUB-TOTAL 204.91
0031201550
AMOUNT DUE 204 -91
i
IHE UNDERSIGNED CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.
ROUTEPERSON CUSTOMER
LAST PAGE
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
T,�Y✓ Purchase Order No.
Terms
�I.cJ1`��
e 3a 9 Date Due ci
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
l g
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
/ago 7
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
SignaturO
Cost distribution ledger classification if
tle
claim paid motor vehicle highway fund