HomeMy WebLinkAbout177315 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $127.60
CARMEL, INDIANA 46032 PO BOX 2856
KOKOMOIN 46904 -2856 CHECK NUMBER: 177315
CHECK DATE: 9115/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 f 4239040 127.60 FOOD BEVERAGES
.-MiMER'CA INVOICE
B BROOKSHIRE FIRST" MORTGA GE
dba BROOKSHTRE' GOLF CLUB'
'NC■ 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr.
CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 RR2903542 EXP 0 7/13110
765-459-3117
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER
i CUSTOMER NUMBER ROUTE
09/17/09 394996 Dustin Smith 13 800 13
AmbILINT
•e
P CE DEPOSIT
BASE FEB 2, 2009A
PROMO-#909A
PUMP $40/$33 REFUNDABLE
209 B''� Bid Lt 24 Lse Can 15.95 127.60
Cases S
11 NOR
TOTAL SALE 127.60
10303 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 N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 127.60
gom
0 CREDITS
❑Cash El EFT El Escrow Lb Check Number 731 e
Driver l %�e�i` i� Received By
PiescrbedlitlState Board o (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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i JET
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
Po
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
7 ��gb- b 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 0 q
2
I
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund