HomeMy WebLinkAbout177023 09/09/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
s ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $247.20
CARMEL, INDIANA 46032 KOKO X 8 5 46904 -2856
CHECK NUMBER: 177023
i CHECK DATE: 9/9/2009
DEPART AC PO NUMBE I NVOIC E NUMBER AMO DESCRIPTION
1207 4239040 247.20 FOOD BEVERAGES
ERICA
INVOICE
B BROOKSH <I RE FIR ST MORT,GAGE�
I�� dba BRDO'KSHTR GOLF CLUB''
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765- 459 -3117
800 382 -0675
Fax: 765- 457 -7967 PICK UP 3 EMPTIES
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
09;10/09 394347 Dustin Smith 13 800 13
-•b DES
•D
BASE FEB 2, 2009A
PROMO #909A
PUMP $40/$33 REFUNDABLE
209 6--''� Bud Lt 24 Lse Can 15.95 95.70
225 1 Bud Lt 1/4 BBL 41.50 30.00 71.50
760 2 GAose"Wheat 31"2"1/6 BBL 55.00 30.00 170.00
.Cases 6 1/4 Barrels 3
PROD. CODE OT DESCRIPTION PRICE
TOTAL SALE
337.20
10303 EMPTY AB 1/6 30.00 Q (2" T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 t A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 337.
�r V CREDITS ?n 00
Cash EFT Escrow I; Check Number 71 U
7 2 r)
r
Driver Received By
i Prescrit`by State Board rf 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
Purchase Order No.
f_2eSE A /2• Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 0
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
y
1
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
0 3 !J o? 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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund