HomeMy WebLinkAbout174599 07/15/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CHECK AMOUNT: $175.70
CARMEL, INDIANA 46032 Po sox 2856
KOKOMOIN 46904 -2856 CHECK NUMBER: 174599
CHECK DATE: 7/15/2009
DEPA ACCOUNT P O NUM INVOI NUMBE AMO UNT DESCRIPTION
1207 4239040 175.70 FOOD BEVERAGES
Mi NIERICA INVOICE
18ERAGE BROOKSHIRE FIRST MORTGAGE
'NC 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
07/15/09 389315 David Hulsey 13 800 13
AMOUNT
ON EPOSIT
BASE FEB 2, 2009A
PROMO #709A
PUMP $40/$33 REFUNDABLE
209 6 Bud Lt 24 Lse Can 15.95 95.70
760 2 'Goose Wheat 312 1/6 BBL 55.00 30.00 170.00
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Case's 6 1/4 Barrels 2
k
R OD. Q TOTAL SALE 2.65.70
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H;
10405 EMPTY AB 1/4 30.00
10310 EMPTY IMPORT 1/2. 30.00 1 9> N
9230 PUMP DEPOSIT 33.00 i`-
9270 IMPORT PUMP DEPOSIT 33.00. 265.70
CREDITS
Cash EFT Escrow O Check Number FV
Driver Received By
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Prescribed by Siete 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
09'erq Purchase Order No.
6 /77m (E <f Rd. 46 a� Terms
X Ax.j� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
a 3X9°3 /S E£rz
Total '7
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
mE�rC� z✓ c�ud4-��
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
1--
6CA) �-G
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1 p -5 3 6 -elb 1-7 5 76 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 0q
d Jazcc
VI I
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund