HomeMy WebLinkAbout176081 08/18/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $191.40
KOKOMO IN 46904 -2856
CHECK NUMBER: 176081
CHECK DATE: 8/18/2009
DEPARTM ACCOUNT PO NUMBER INVOIC NU MBER A MOUNT DESCRIP
1207 4239040 191.40 FOOD BEVERAGES
Mt ERICA INVOICE
BMMR�LGE BROOKSHIRE FIRST'MORTGAGE'`
INC. dba BROOK SHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904-2856
765 459 3117 RR2903542 EXP. 07 13 10
800 382 -0675
Fax: 765-457-7967
BEER W34.09212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
08/20/04 392414 Salesman 13 800 13
UANTITY DESCRIPTION DEPOSIT AMOUNT,
BASE FEB 2, 2009A
PROMO #809A
PUMP $40/$33 REFUNDABLE
109 6 Budweiser 24 Lse Can 15.95 95.70
209 6 Bud Lt 24 Lse Can 15.95 95.70
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Cases 12
TOTAL SALE 191.40
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 112 30.00
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N:
9230. PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 191.40
D IT
CREDITS
El EFT Escrow Check Number A 41,, Z'n
Driver /'�l Received B
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
IF
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 /ice Purchase Order No.
Terms
/1 6'tomo Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total Q
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
/9/ �o
ON ACCOUNT OF APPROPRIATION FOR
6,c >e
/.20 9
Board Members
PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
p 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
Aic u4 2 0 O
�Yl
Mature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund