177771 09/29/2009 "MF CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of I
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $50.70
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 177771
CHECK DATE: 9/29/2009
DEPARTMENT ACC PO NUMBER IN VOICE NUMBER AMO DESCRIP
1207 4239040 50.70 FOOD BEVERAGES
9347 E PENDLETON PIKE
_INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account 89924 License R2903542 Time: 11:43
AZ GOLF MANAGEMENT CORP. Invoice#: 0944429 POu
BROOKSHIRE GOLF CLUB Load 4040 Date: 10 -01 -2009
s 12120 BROOKSHIRE PKWY Terms B.COD /W.CHARGE
CARMEL, IN 46032 -0000 Driver V8 PHILLIPPO,C
(317)846-7431 Salesman: 16 T. WEBSTER 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 6 COORS LIGHT 07199031600 16.35 0.00 0.00 98.10
24 LSE CAN
10110 6 LITE 03410057306 16.35 0.00 0.00 98.10
24 LSE CAN
31164 -2 MISC DEP. 01003116400 '0.00 0.00 30.00 60.00
$30 EMPTY KEG
Cases: 12 Beer$: 196.20 Content$: 196.20
Btls: 0 Wine$: 0.00 Deposit$: -60.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 2) Misc$: 0.00
Gals: 27.0
Total Sales 196.20
Total Credits 60.00
Total Tax 0.00
INVOICE TOTAL 136.20
Ref Voided Invoice# 0172426
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT J
0172427 Cash/Check 85.50
0944429 Cash /Check 136.20
Total Cash /Check 50.70
PAYMENT TYPE AMOUNT
CheckN 5 50.70_..._._---
nw�: onz4z� s. sn
Inv 0944429
13e.Y0
V
Customer's S1910 ture Driver's Signature
"Your sig "atud is acceptance that allthe product li0edabove was received
and deli uereci in good coedit ion"
Drivers caono tpickup p unless proper pickup farm has beencompleted,
"Not Responslblefor. shortage or breakage after merchandise is delivered and
accepted
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
1 9347 E PENDLETON PIKE
INDIANAPOLIS, IN 46236-0000
(317)612-1310
Account B9924 License R2903542 Time: 11:43
AZ GOLF MANAGEMENT CORP. Invoice#: 0172427 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 10 -01 -2009
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846.7431 Salesman: 16 T. WEBSTER 16
ITEM CITY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
24569 -1 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 -85.50
LAGER 1/6 BBL
Reason: 30 OUT OF DATE
Cases: 0 Beer$: -85.50 Content$: -55.50
Btls: 0 Wine$: 0.00 Deposit$: -30.00
Kegs: 0 -1) Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 0.0 (-5.1)
♦;4 4444 44444444444444444444444444444
"PICK UP THE FOLLOWING ITEMS
+44444 44444444 +444 +4 +4
OUT OF CODE INV. #148932
SAM ADAMS KEG LAGER 116 BBL
001 CASE OF ITEM# 24569 85.50
EXTENDED AMOUNT: 85.50
keg shipped with only 5 days
Total Sal 0.00
Total Credits -85.50
Total Tax 0.00
INVOICE TOTAL -85.50
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0172427 Cash/Check -85.50
0944429 Cash/Check 136.20
Total Cash/Check 50.70
PAYMENT TYPE AMOUNT
Check# 5 50.70
Invt: 0192427 -65.50
Inv0: 0944429 136.20
t
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
PrB&ribed 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
�4, ge c Purchase Order No.
lLE— Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i7 6
Total St
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
r
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�p 7 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
6� f 20
(gnat e
Cost distribution ledger classification if T itle
claim paid motor vehicle highway fund