174146 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
`q ONE CIVIC SQUARE CHECK AMOUNT:
CARMEL, INDIANA 46032
CHECK NUMBER: 174146
CHECK DATE:
DE PARTMENT ACCOUNT PO NUM INVOICE N UMBER AMOUNT DE
��1 c -✓wt c A
AMERICA INVOICE
Iffi RAGE BROOKSHIRE--FIRST- MORTGAGE
dba BROOKSHIRE GOLF CLUB
1NC■ 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, 1
765 459 -319-3117 04 -2856 RR2903542 EXP. 07/13/09
800 382 -0675
Fax: 765 457 -7967 p u 3 m t s
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBERL ROUTE
07/02/09 3137804 David Hulsey Z3 800 13
e° UANtITY
�DESCRIPTION PRICE DEPOSIT AMO
c
BASE FEB 2, 2009A
PROMO #709A
PUMP $40/$33 REFUNDABLE
109 6 Budweiser 24 Lse Can 15.95 95.70
209 8 Bud Lt 24 Lse Can 15.95 127.60
225 1'' Bud Lt 1/4 BBL 41.50 30.00 71.50
760 2 Goose Wheat 312 BBL 55.00 30.00 170.,00
Cases 14 1/4 Barrels 3
e e DESCRIPTION TOTAL SALE 464.80
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 30.00. N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 464.
V
CREDITS
Cash EFT Escrow Check Number U
i
Driver Received By
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
Y 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
M I 16eV-LC'6L Purchase Order No.
P.0-� AslQ Terms
I* V.MQ I N L 4 (0 q `c Date Due
Invoice Invoice Description Amount
Date Number or note attached invoice(s) or bill(s))
*10A 3gi go 4 &-Lk- I_VlAkk '3 1.4,
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.
c 20
U O`' IN SUM OF
344 -.fib
ON ACCOUNT OF APPROPRIATION FOR
k) Y 6 C�
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
l avp l S 6 �9� 3 �d �,,,)ill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
I 1 20 D g
�m Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund