HomeMy WebLinkAbout175022 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CHECK AMOUNT: $298.65
CA�ZMEL, INDIANA 46032 Po eox 2866
o KOKOMO IN 46904 -2856 CHECK NUMBER: 175022
CHECK DATE: 7/22/2009
D EPAR TME NT ACC OUNT PO NUMBER INV OICE NUMB AM OUNT DESCRIPT
1207 4239040 298.65 FOOD BEVERAGES
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MIR ►�1�IlERICA INVOICE
B BROOKSH.I,RE F`IiRST MORT 0
I�C dba BROOKSHIRE 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 W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
07/23/09 389877 David Hulsey 13 800 13
RICE AMOUNT
BASE FEB 2, 2009A
PROMO ##709A
PUMP $40/$33 REFUNDABLE
109 7 Budweiser 24 Lse Can 15.95 11 1-65
250 Bud Lt 1/2 BBL 75.00 30.00 Q .0
7065 1 Goose Wheat 312 112.00 30.00 4�'�A�-,O &A,110 142.0
l
L
A
Cases 7 1/2 Barrels 2� V
�b (-2
TOTAL SALE
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2. 30.00 H
10405 y EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT '33.00 -e ms
CREDITS
Cash EFT Escrow Check Number U
Driver Received By
Presqribed 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.
P e
(k UQ Purchase Order No.
Terms
(�b kmo I (N (v� o `A0 `Q Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
b '1 5
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
ON ACCOUNT OF APPROPRIATION FOR
4L h
ao C
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
LO 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
I1't
5 Wn a ture
/l4/"_
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund