175247 07/23/2009 CITY OF CARMEL, INDIANA VENDOR: 00353399 Page 1 of 1
ONE CIVIC SQUARE TRI -STATE COCA COLA BOTTLING
i 0 CHECK AMOUNT: $3.00
CARMEL, INDIANA 46032 INDPL5 SALES CENTER #114
vN 2329 PAYSPHERE CIRCLE CHECK NUMBER: 175247
CHICAGO IL 60674 -2329
CHECK DATE: 7/23/2009
DEPARTMENT ACCO PO NUMBE INVO NUMBE AM DESCRIPTION
1207 T 4239040 3376315212 3.00 FOOD BEVERAGES
I A COCA COLA ENTERPRISES BOTTLER
I NVO I PAGE 1 01: 2
SHIP 10: REMI1 IU:
UMMSHIM: GULF CLUH 1111-SIAII C111:0.111-A R)))ILING
C I T Y uf i'AIM 1. INUIANAPIJLIS ;ALL'S I:FNIFI?
12121) 13HUOKSHM PKWY 2324 PAYoPHERI CIRCLE
CARIArl. IN 461133;1314 CHICAGO, IL 60614-2329
317-243-3771
k-IIJ 0- 1 '1 666/166 1 NVI-I I 1<3 /6,3 1 52 '12
AR# 1866466
R1E S75 III(M-li- 3101 LIJAIJ- 1,)L 19 510 (1111)111 UA I Iz 111 '16
1,52 IZY PI. 11) 1 11 ME: 09:64:40 0 IAH6I_ NE I IS PHUX
„NEIL PLrXE
PALO EA i:
MUM ft1pk
SAII-ES
11 IJN Af? I u I y PH I Ih AI),J# HAIL NI-I [,XII:NUW
I I A`.-; AN I -24 0L) 111 CASE
ZWEIV.41- DkjANI WATER 6063 6 34.00 91117 -ZI). 10 9.111 59.0
9019 -4.00
SUBTOTAL 6 59.40
201 IL I W 117 A NI -I
2111. CNIR CLASSIC 5788 6 3111.110 9111 1b. I, 111.65 89. 11)
4019 -4.00
V,uL,YDS I:NIR DILI 1:01(1� tj/69 6 34.1W 9017 15, 1b 14.6 1 18.81)
9019 -4.00
ZOLSPUS 11MUS HIJ01111111 bh,A 1 34.1)11 911/ 15.1'; 14.116
9019
SUHICITAL Is 22235
(31_A(:1=AI_I 2 c,
20PIL# GLA VWIR 11) 6`N I M. oll "Jolb -1. 114 22. 22 96
9020 -2-00
SU 10 f AL 1 22.96
2011Z PI- 1 I. 1- 11 NIJ /I -IF P
2IINLA POW MOUNTAIN 61-A 41135) 1 34 (ji I 1u 16 -1 3.90 I G. I I i I Iz. M
9020 -4.1)0
SUBTOTAL
?oOZ I-S GI_A0!_AIJ
PII_WM GLA VWIR XXX 65 Z 1) 1 34,1111 91116 -9.04 22.96 '!v. Q
9020 -2.00
SUBTOTAL 1 22.96
CON 1 I NLJI:_:I
A WCA I:ULA LN I 0WH I Y 1)1 -IM
I NVO I t':I:-: PAGE Z 01- 2
SHIP 10: HLMI I ILI:
BROOKSHIRE GOLI: Ct.113 4HI-SIAIES CfICA-1:0LA HUTILING
CIIY OF CAHM11 !NIJIANAPIII.IS SAUS CMILII
121211 HiMIJKS1114. PKWY 23A1 PAY,'410111 CIRIA-1-
CARMFL IN 4611133014 CHICAGO, 11. 506/4-'2j29
317-243-3771
I NVO 1 I_:I i�'i /6- 'I I
AD 1866466
Iffl:- 37") 11IIIVC.Ii- 3(07 LUAU- 1'.A. I H st:(J-. 1101110 1 JAI la 'I
DOIL9 337(13I521'22 PL- 101 11 MI_ 40 1) 11 4 61 NI' I Ib 1
'-HELL NMH Iii 1
PALLET kfiI( 6 I,14'l4
Nil TA AHEP[i
I 1`S ON 'iAI_117_'_i
U L S C H I P I I LI N All I U I Y PH I Ill Al 1,1# RA IL NI-I BIOUL11
SHELLS 16/211 OZ 0606 is 11,011 WMPLIFI D> A. L10
SUBTOTAL 1
NE I PHUDUCI 1) 1 Y 30 1111AI. PHOLIUCI 1,1120 .00
IOIAL AIIJUSIMENIS -579.23
SUB -TOTAL 440.77
IN ST FAX 7.00% ON 381.37 26.70
AMIJUN'l Ill IL 1 ](57
1111 UNIII-1610 1:11 I' INFINNIS AUNII
10 0' 11 AND!:I]N[JI I IIJNS ANIJ 1!;
AUMORIZE 10 SIGN.
6
ROU I EPEHSON CUS I 0MI__R
P ascribed 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 I_
Purchase Order No.
0�3'aq Pa.( ne�� Ctr�e. Terms
CIULa% IL Date Due
Invoice Invoice Description Amount
Date Number note attached invoice(s) or bill(s))
3 31-,,2 `7
o �3��3iy VN_ it
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.
i�OWED 20
IN SUM OF
ON ACCOUNT OF A FOR
C
�0 C ILc
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
p7 -5 01 Z materials or services itemized thereon for
/o20r7 33? 3/ lg which charge is made were ordered and
received except
200
S ature
Cost distribution ledger classification if Tile
claim paid motor vehicle highway fund