HomeMy WebLinkAbout173643 06/16/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $553.05
CARMEL, INDIANA 46032 PO BOX 2856
KOKOMO IN 46904 -2856
o ��o CHECK NUMBER: 173643
CHECK DATE: 6/16/2009
DEPARTMENT ACCOUNT P O NUM INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 553.05 FOOD BEVERAGES
MW1 A VIERICA P, INVOICE
BEVERAGE BROOKSHIRE FIRST MORTGAGE
dba BROOKSHIRE GOLF CLUB.
INC, 12120 BROOKSH3RE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 HH2V03b42 EXP. v// 1 S/ V v
765- 459 -3117
800 382 -0675
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
06/18/09 386513 D6vid Hulsey 13 800 13
I AMOUNT
DESCRIPTION
•r
BASE FEB 2, 2009A a
PROMO ##609A
PUMP $40/$33 REFUNDABLE'`
109 4 Budweiser.24 Lse Can 15.95 63'•80"
209 14 Bud Lt 24 Lse Can 15.95 223.30
225 2 Bud Lt 1/4 BBL 41.50 30.00 1.43.00
817 1 O'Doul's NA 4/6 Can 12.95 12.95
760 2 Goose Wheat 312 1/6 BBL 55.00 30.00 170.00
Cases 19 1/4 Barrels 4
TOTAL SALE 613.05
10303 EMPTY AB 1/6 30.00 10 T
10304 EMPTY AB 1/2 30.00 O C- H
10405 I EMPTY AB 1/4 30.00 A A
10310 EMPTY IMPORT 1/2 30.00 N
9230' PUMR.DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 613..05
1 ff@fflIb ou D II� y
�P CREDITS
Cash EFT Escrow Check Number
S-5 3b
Driver e l l 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
M W 4 f—e— I Purchase Order No.
.2- 601ntn >✓2eE P
Q� 2f,l& Terms
<y ?7d _�i �4' 90x &S Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total osS
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
S x'3.6 S'
ON ACCOUNT OF APPROPRIATION FOR
w�
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
oZ1S? 3 �O SS"3.d 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
§ilanature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund