HomeMy WebLinkAbout173146 06/02/2009 I
CITY OF INDIANA VENDOR: 359294 Page .1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $111.65
CARMEL, INDIANA 46032 PO BOX 2856
KOKOMO IN 46904-2856 CHECK NUMBER: 173146
CHECK DATE: 6/2/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 111.65 FOOD BEVERAGES
MIWAMERICA INVOICE
00MRAGE
BROOKSH I RE I RST 'NiORT GAGE
dba BROOKSHIRE GOLF CLUB.
1NC■. 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN A-6032
P.O. Box 2856
Kokomo, IN 46904 -2856 RR2903542 EXP 07/13/09
765- 459 -3117
800 382 -0675
Fax: 765- 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
06/03/09 385409 David Hulsey 13 800 13
•e
BASE FEB 2, 2009A
PROMO #609A
PUMP $40/$33 REFUNDABLE
209 7 Bud Lt 24/12 oz Can 15.95 111.65
Cases 7
f
TOTAL SALE 1
10303 EMPTY AB 1/6 30.00 T
10304 f EMPTY AB 112 '30.00. H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 111.65
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CREDITS
Cash EFT Escrow Check Number I A a
Driver Received By L���� �i�i��✓
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
�7/�
/j r) 1n d ac 4 2 ff ��g Purchase Order No.
oZ'7
S L rn M /LC �2-
f� Terms
/L Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
2-2 t:.-zeF- 0 12.
ON ACCOUNT OF APPROPRIATION FOR
6 (f k5e -6, -t' �c
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
lo707 39 5 9 Va 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
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund