174437 07/08/2009 0 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
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ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $196.40
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
9 oN �o, INDIANAPOLIS IN 46241 CHECK NUMBER: 174437
CHECK DATE: 7/8/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUNT DESCRIPTION
1207 4239040 196.40 FOOD BEVERAGES
s 10,NARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
T 3737 WALOEMERE ROAD
INDIANAPOLIS, IN 46241-0000
(317)612 -1310
Account 89924 License R2903542 Time: 11:58
AZ GOLF MANAGEMENT CORP. Invoice 0579451 PD#
BROOKSHIRE GOLF CLUB Load 4040 Date: 07-09 -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 8 COORS LT 07199031600 16.05 0.00 0.00 128.40
24 LSE CAN
10110 8 LITE 03410057306 16.00 0.00 0.00 128.00
24 LSE CAN
31164 -2 MISC DEP. 01003116400 0.00 0.00 30.00 -60.00
$30 EMPTY KEG
Cases: 16 Beer$: 256.40 Content$: 256.40
Btls: 0 Wine$: 0.00 Deposit$: 60.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 (-2) Misc$: 0.00
Gals: 36.0 0
Total Sales 256.40
Total Credits -60.00
Total Tax 0.00
INVOICE TOTAL 196.40
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0579451 Cash/Check 196.40
Total Cash/Check 196.40
PAYMENT TYPE AMOUNT
Check# 4 1%.40
Inv0: 0579451 19c.40
Customer's Signature Driver's Signature
"Yuur signature is acceptance that alllhe pruduct listed above was received
and delivered in good condition"
"Drivers cannot pickup pruduct unless proper pickup funs has been completed.
Nut Responsible fur shurlage or breakage after merchandise is delivered and
accepted
VALID
Prescrib State,Board 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.
Payee
0YQ_6? V•- Purchase Order No.
3 151 Z° l� Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
G d q �J5'1 qaS it ►ti e l q Cc
Total A b
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
0 t
ON ACCOUNT OF AP FOR
(3 �y UJO
Board Members
PO# or 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
materials or services itemized thereon for
which charge is made were ordered and
received except
20 Q
gnature
title
Cost distribution ledger classification if
claim paid motor vehicle highway fund