HomeMy WebLinkAbout179320 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
>�4 ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $97.50
CARMEL, INDIANA 46032 PO BOX 2856
y oN �o KOKOMOIN 46904 -2856 CHECK NUMBER: 179320
CHECK DATE: 11/11/2009
DEPARTMERi f A CCOUNT PO N INVOICE NU AMOUNT DESCRIPTION
1207 4239040 97.50 FOOD BEVERAGES
INVOICE
BROOKSHIRE FIRST MORTGAGE=
>n d ba BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARM`L I 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR2903542 EXP. 071/1
800 382 -0675 Thursday R e l i v e y
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
i 1 /.1.2 4 f 30 =J %r i.,i i i m i i`= s i,`i
DD
BASF November 2, 2009A
PROMO 41109,
PUMP $40/`33 REFUNDABLE
225 Bud Lt 1/4 BBL 4 2 50 72. 50
Goose= Wheat 312 1/6 BBL 55.00 30.00 85.
1/4 Barrels 2
•DD OD P D O O
TOTAL SALE 0,
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 114 30.007
10310 EMPTY IMPORT 1/2 30.00 J
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 157.50
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x a a rt D�
P &C/ y CREDITS
Cash ❑EFT ❑Escrow iA Check Number U
river Received By
Prescribed by State Board of Accounts 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
3 tJf1P�4�P[� Purchase Order No.
k o. a ,�oS Terms
J� UIC 6 /yJD Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6
Total
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
O rOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
U7 (ZY
22 6 e, 1 0 97,<U 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 6t
ff Signatur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund