HomeMy WebLinkAbout176005 08/12/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
4 ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $391.25
CARMEL, INDIANA 46032 PO BOX 2856
KOKOMOIN 46904 -2856 CHECK NUMBER: 176005
CHECK DATE: 8/12/2009
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DEPAR A PO NUMBE INVOICE NUMBER AMOUNT DES CRIPTION
1207 4239040 391.25 FOOD BEVERAGES
1WAMER1CA INVOICE
BEVERAGE' dba BR00
0RE FIRST MORTGAGE >I
'NC KSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 RR2903542 EXP. 07 13 10
765 459 -3117
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER' CUSTOMER NUMBER ROUTE
08/13/09 391787 David Hulsey 13 800 13
o AMO
BASE FEB 2, 2009A
PROMO #809A
PUMP $40/$33 REFUNDABLE
109 5 Budweiser 24 Lse Can 15.95 79.75
209 8.--- Bud Lt 24 Lse Can 15.95 127.60
225 1 Bud Lt 1/4 BBL 42.50 30.00 72.50
631 6 Busch Lt 30/12'0z Can 14.4Q 86.40
760 1 Goose Wheat 312 1/6 BBL 55.00 30.0.0 85.00
Cases 19 1/4 Barrels 2
TOTAL SALE 451.25
10303 EMPTY AB 1/6 30.00
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 f) 451.25
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Cash EFT Escrow .1' Check Number /G'�� U
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Driver v Received By
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
/V '0 A&2L Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
7e 76
X755' �nm f�Gi✓ r2
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3g/
gq� 9/, 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
AG 20 0�
SignALife
64l
Cost distribution ledger classification if itle
claim paid motor vehicle highway fund