HomeMy WebLinkAbout172660 05/20/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
s CHECK AMOUNT: $685.00
CARMEL, INDIANA 46032 PO BOX 2856
KOKOMO IN 46904 -2856 CHECK NUMBER: 172660
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CHECK DATE: 5/20/2009
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
'1207 4239040 685.00 FOOD BEVERAGES
biA MERICA INVOICE
RAGE BROOKSHIR FIRST MORTGAGE
dba BROOKSHIRE GOLF CLUB
1 N I C 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
RR2y 542 EXH.
765 459 -3117
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER
CUSTOMER NUMBER ROUTE
05/20/09 384193 David Hulsey 13 800 13
DEPOSIT AMOUNT
QUANTITY DESCRIPTION RICE
BASE FEB 2, 2009A
PROMO #0509A
PUMP $40/$33 REFUNDABLE
109 20 Budweiser 24/12 oz Can 15.75 315.00
209 20 Bud Lt 24/12 oz Can 15.75 315.00
760 1 Goose Wheat 312 1/6 BBL 55.00 30.00 85.00
.s
Cases 40 1/4 Barrels 1
PROD OTY i
TOTAL SALE. 715.00
10303 l EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2, 30.00 IN
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 715.00
O CREDITS ?0 0
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❑Cash ❑EFT L1 Escrow Check Number
Driver Received By
W 0jS tateBoard ofAccounts ACCOUNTS PAYABLE VOUCHER City Form NO. 201 (Rev. 1995)
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
iiL �&JJ ye
g6 l�,&ka4 e —Ti-ye, Purchase Order No.
2s'S e6 1 m &ez C d/e f •6, 5 Terms
L L 6'o� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
P ca2 CID
Total S U7
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
UCHER NO. WARRANT NO.
ALLOWED 20
pp- i
IN SUM OF
12 5�5 Worn m :f �/CE 40p
ON COUNT OF APPROPRIATION FOR
1 `2
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3? 1 7 1 193 3 96 216 6 ,P_5 ,66 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
J- d er
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund