179016 09/09/2009 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE
•j; CHECK AMOUNT:
l; CARMEL, INDIANA 46032
CHECK NUMBER: 179016
CHECK DATE:
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
l a °7 z3 �o�o `f� oa r j 8✓
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236 -0000
(317)612
Account B9924 License R2903542 Time: 11:45
AZ GOLF MANAGEMENT CORP. Invoice 0210414 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 11 05 -2009
12120 BROOKSHIRE PKWY Terms C.O.D. ONLY
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846 Salesman: 16 T. WEBSTER 16
ITEM# OTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 1 LITE KEG 03410057154 41.00 0.00 30.00 71.00
LITE 114 BBL
31164 -1 MISC DEP. 01003116400 0.00 0.00 30.00 -30.00
$30 EMPTY KEG
Cases: 0 Beer$: 71.00 Content$ 41.00
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 1 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 7.7
Total Sales 71.00
Total Credits -30.00
Total Tax 0.00
INVOICE TOTAL 41.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0210414 Cash/Check 41.00
Total Cash/Check 41.00
PAYMENT TYPE AMOUNT
Check# 5 41.00
L rv1; 0210414 41.00
Customer's Signature Driver's Signature
'Your signature is acceptance that allthe product listed above was received
and delivered in good condition"
"Drivers cannot pickup product unless proper pickup form has been completed.
Not Responsible for shortage or breakage after merchandise is delivered and
accepted
VALID
Prescrib fJ 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
122 0' )aeati D ax Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0 2
OD
Total Y"
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
I
IN SUM OF
Z//, �v
ON ACCOUNT OF APPROPRIATION FOR
60
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3 U l/a 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 d �P
i nature
Cost distribution ledger classification if Ti e
claim paid motor vehicle highway fund