177024 09/09/2009 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
CHECK AMOUNT: $345.80
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241
CHECK NUMBER: 177024
CHECK DATE: 9/9/2009
DEPARTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRIPTION
1207 4239040 345.80 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
r 1 3737 WALOEMERE ROAD
l INDIANAPOLIS, IN 46241-0000
(317)612-1310
Account 89924 License R2903542 Time: 12:21
AZ GOLF MANAGEMENT CORP. Invoice#: 0148931 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 09-10-2009
12120 BROOKSHIRE PKWY Terms B.CODlW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846 -7431 Salesman: 16 T. WEBSTER 16
ITEM QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 6 COORS LIGHT 07199031600 16.05 0.00 0.00 96.30
24 LSE CAN
30975 1 HEINEKEN 07289000020 27.00 0.00 0.00 27.00
12 CAN
10110 6 LITE 03410057306 16.00 0.00 0.00 96.00
24 LSE CAN
Cases: 13 Beer$: 219.30 Content$: 219.30
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0,00
Misc: 0 Misc$: 0.00
Gals: 29.2
Total Sales 219.30
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 219.30
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0148931 Cash and Check 219.30
0148932 Cash and Check 126.50
Total Charge 0.00
Total Cash and Check 345.80
Total 345.80
PAYMENT TYPE AMOUNT
Cash 0.00
Check# 3 345.80
Total Checks 345.80
Total Collected 345.80
Inv#: 0148931 219.30
InN: 0138932 126.50
6 1
Customer's Signature Driver's Signature
"Your signature is acceptance that alllhe product listed above was received
and delivered in good condition"
"Driver's cannot pickup product unless proper pickup form has been completed...
Not Responsible for shorlaye or breakage after merchandise is delivered and
accepted`
VALID
MONARCH BEVERAGE CO'`. INC.
PERMIT #W4908938-INP1983
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241 -0000
(317)612 -1310
Account B9924 License R2903542 Time: 12:21
AZ GOLF MANAGEMENT CORP. Invoice 0148932 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 09- 10-2009
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 45032 -0000 Driver VB PHILLIPPO,C
(317)846 -7431 Salesman: 16 T. WEBSTER 16
ITEM# CITY DESCRIPTION U,P.C, PRICE DISC DEP AMOUNT
10180 1 LITE KEG 03410057154 41.00 0.00 30.00 71.00
LITE 114 BBL
24569 1 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 85.50
LAGER 116 BBL
31164 -1 MiSC DEP, 01003116400 0.00 0.00 30.00 -30.00
$30 EMPTY KEG
Cases: 0 Beer$: 156.50 Content$: 96.50
Btls: 0 Wine$: 0.00 Deposit$: 30.00
Kegs: 2 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-1) Misc$: 0.00
Gals: 12.9
Total Sales 156.50
Total Credits -30.00
Total Tax 0.00
INVOICE TOTAL 126.50
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0148931 Cash and Check 219.30
0148932 Cash and Check 126.50
Total Charge 0.00
Total Cash and Check 345.80
Total 345.80
PAYMENT TYPE AMOUNT
Cash 0.00
Check# 3 345.80
Total Checks 345.80
Total Collected 345.80
Inv 0148931 219.30
In61A,1 v i 0146932 126.50
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
ty� State BCAd of Accounts City Form No. 201 (Rev. 1995)
1 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.
n Payee
/22 l Sf f)CS F`it% Purchase Order No.
3 �73 �1). Terms
aqlJ IlGU U Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total .J 6
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
1 0 2 0'7 6149_f 3 90 -VO /7S,'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
Signat
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund