HomeMy WebLinkAbout170702 04/14/2009 CITY OF CARMEL INDIANA—. VENDOR: -�-A294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CHECK AMOUNT: $711.95
CARMEN_, INDIANA 46032 PO BOX 2856
KOKOMO IN 46904-2856 CHECK NUMBER: 170702
AY'
CHECK DATE: 4/14/2009
DEP ARTMENT ACCOUNT PO NUMBER INV OICE NUM AM OUNT D ESCRIPTION
1207 4239040 711.95
MIWPMERICA INVOICE
BEVERAGE BROOKSHJRE F':I!RST-- MORTGAGE-
INC dba BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765 459 -3117 RR2903542 EXP. 07/13/09
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
04/14/09 380751 DAVID HULSEY 13 840 13
RICE DEPOSIT :AMOUNT
QUANTITY DESCRIPTION P
BASE FEB 2, 2009A
PROMO #409A
PUMP $40/$33 REFUNDABLE
109 12- BUD CAN 24 PK LSE 15.75 189.00
209 9 HUD LT CAN 24 PK LSE 15.75
225 2- BUD LT 1/4 BBL. 41.50 30.00 X14 E70:'
908 4 MI CH ULTRA CAN 12 PK 17.05
760 2 GOOSE 312 WHEAT B:BL 55.00 30..00 170.00
Cases 25 1/4 Barrels 4
•D •D TOTAL SALE 711.95
10303 EMPTY AB 1/6 30.00 j T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00
9230 PUMP DEPOSIT 33.00 K 9270 IMPORT PUMP. DEPOSIT 33.00 711. °`r
CREDITS
Cash EFT Escrow Check Number 2 71 1 u
r
Drive Received By Y
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
7
Purchase Order No.
A c Terms
U X G rnG i Z� �G 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
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
40 -e- 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
a-
C1�ign e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund