HomeMy WebLinkAbout171224 04/28/2009 C11 r OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $416.85
KOKOMO IN 46904 -2856
CHECK NUMBER: 171224
CHECK DATE: 4/28/2009
DE PARTMENT ACC PO NU INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 416.85 FOOD BEVERAGES
MIWAMERICA INVOICE
B BROOKSHII RE F-I RST MORTGAGE
IN' db'a `BROOKSHIRE`,GOLF "CLUB
CE- BROO AY
KSHIIR PARKW
2755 Commerce Dr. CARMEL IN. 46032
P.O. Box 2856
Kokomo, 9- 31 17 904 2856
765- 459 RR2903542 EXP. 07/13/09
765 Or
800 382 -0675 0675 v
Fax: 765 457 -7967
o- e- e -e s e-
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,Cases, 15. 1/4 Barrels -3 d:
TOTAL SALE 473 g
10303 EMPTY AB 1/6 30.00 T``
1
0304 MPTY�AB 1/2� 30:00 H
10405 EMPTY AB 1/4 30.00
t0310� EMPTY IMPORT: 1/2 X30 ".00 r
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT`PUMP DEPOSIT 33 00
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O CREDITS j t
Cash EFT Escrow Check Number Z 7 1,;Z
Driver Received By
C a s�� 2��
1/4 Barrels 4
103W3 EMPTY AB 1/6
30.00 TOTAL SALE 711.95
10304 EMPTY AB 112 T
10405 EMPTY AB 1/4 30.00 H
10310 30.00 A
EMPTY IMPORT 112 30.00
9230 PUMP DEPOSIT N
9270 IMPORT PUMP DEPOSIT 33.00 K
33.00
y 711.95
CREDITS
MIWAMRRICA INVOICE
B M BROOKSHIRE FIRST MORTGAGE
dba BROOKSHIRE GOLF CLUB
'NCO 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL I N 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 3117 RR2903542 EXP. 07/1.3/09
800- 382 -0675
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
04/28/09 382077 David Hulsey 13 BOO 13
DESCRIPTION PRICE DEPOSIT -AMOUNT.
BASE FEB 2, 2009A
PROMO #409A
PUMP $40/`1;33 REFUNDABLE
225 1 BUD LT 1/4 BBL 41.50 30.00 71.50
318 3 MICH CAN 18 PK 14.70 44.10
418 3'" BUD LT LIME CAN 18PK 14.65 43.95
518 4 MICH LT CAN 18 PK. 14.70 59.80
1409 5 ROLLING ROCK CAN 24 PK `17.10 85.5
760 2� GOOSE 312 WHEAL 11/6 BBL 55.00 30.00 170.00
Cases 15 1/4 Barrels 3
TOTAL SALE 473.
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 1/4 30.00 00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 473.85
WFOL mom CREDITS
Cash EFT Escrow Check Number S/ 1 l
�i 9/
Driver Received B
V, Y
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
Purchase Order No.
Terms
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
Affli nco- W
(i IN SUM OF
t
ON ACCOUNT OF APPROPRIATION FOR
Po� L l n�v S
Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
0�1 C7 l(o, materials or services itemized thereon for
which charge is made were ordered and
received except
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund