HomeMy WebLinkAbout175804 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $262.35
CARMEL, INDIANA 46032 Po eox zsss
oN KOKOMO IN 46904 -2856 CHECK NUMBER: 175804
CHECK DATE: 8/6/2009
DE PART ME lJT ACCOU P O NUMBER INV OICE NUMBER AMOUNT DESCR IPTION
1207 4239040 262.35 FOOD BEVERAGES
MINIERICA I NVOICE
81MRAGE
BROOKSHIRE FIRST MORTGAGE 1.
1N� d ba BROOKSH I RE 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
08/06/09 391137 David Hulsey 13 800 13
QUANTITY DESCRIPTION PRICE DEPOSIT AMOUNT
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
760 1 Goose Wheat 312 1/6 BBL 55.00 30.00 85.00
Cases 13 1/4 Bar.rels 1
PROD. CODE CITY. DESCRIPTION I PRICE TOTAL SALE
NT
292.35
10303 f EMPTY AB 1/6 30.00
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 292.35
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CREDITS �D
Cash EFT Escrow Check Number U
Driver Received By 4�z
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
ei x7 1��7Jfi2 .ice Purchase Order No.
CIT
(�D�lin K `2 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
/,�Q 7
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
p -00 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 Opt
ignatur&
U Pir-
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund