174600 07/15/2009 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
CHECK AMOUNT: $392.45
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 174600
CHECK DATE: 7/15/2009
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AM OUNT DESCRIPTION
1207 4239040 392.45 FOOD BEVERAGES
r MONARCH BEVERAGE CO. INC.
j PERMIT a yW4906938-INP1983
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241 -0000
(317)612 -1310
Account 89924 License R2903542 Time: 10:12
AZ GOLF MANAGEMENT CORP. Invoice#: 0587026 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 07 16-2009
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032.0000 Driver VB PHILLIPPO,C
(317)846 Salesman: 16 T. WEBSTER 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 9 COORS LT 07199031600 16.05 0.00 0.00 144.45
24 LSE CAN
10110 6 LITE 03410057306 16.00 0.00 0.00 96.00
24 LSE CAN
Cases: 15 Beer$: 240.45 Content$: 240.45
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 33.7
Total Sales 240.45
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 240.45
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0587026 Charge 240.45
Total Charge 240.45
Inv GSB702c 2ii1. 45
f
Customer's Signature Driver's Signature
"Your signature is acceptance that all the product listed above was received
and delivered in good condition"
"`Drivers cannot pickup product unless proper pickup form has been completed.`"
Nut Responsible fur shortage or breakage after merchandise is delivered and
accepted
VALID
5563 Mbnarch'Beverage Co., Inc.
3737 Waldemere Road Permit Nos:
Indianapolis, IN 46241 W49-08938
(317) 612-1310 W49-87358
BROOKSHIRE GOLF CLUB IN-P-1983
AZ GOLF MANAGEMENT CORP. DUNS NO 000034 go
-54-5
12120 BROOKSHIRE PKWY DUE DATE 0/00/00
CARMEL IN 46032 LOAD SALESMAN �ACCOUNT NO.� INVOICE DATE I INVOICE NO.
R2903542 317 846-7431 �400 16 B9924 86318
SPECIAL INSTRUCTIONS TERMS
.2 B. COD /W. CHARGE
KEGS
'DESCRIPTION _OC /BTLS CODE AMOUNT
LITE KEG LITE 1/4 BBL F-OOR 1 10180 71.00 71.00
SAM ADAMS KEG LAGER 1/6 BBL 7 002_ 2 X4569 85. 17 1. 00 I L
A&
0 CASE 3 KEGS 0 BOTT 0 MISC
242.00 BEER$ .00 WINE$ .00 SODA$ .00 MISC$ 242.00
90.00 DEP$ 152.00 CONT$ 18.08 GALL
DESCRIPTION ICODEJ OTY. PRICE AMOU NT1_ DESCRIPTION7.
LESS
TOTAL
HORSE TROUGH 311 2 100.00 C is io
,MPTY BARREL 31162 10.00 DRFT TUB 700 2 10. 00 PAYMENT
4 r GUNINESS GAS 311
1 1 50. 00 CASH/CHECK
C po
'.MTY KEG NEW 31164 3 30. HAND PUMP 70027 60.00
GUINESS PUMP 700',33 120.00
NOVELTY BOX, 311 9 200.00
-'MPTY CASES Z1146 1.20 "7
F--TOTAL CREDIT _0 IO
7! NO (A)
X CUSTOMER'S x SIGNATURE "I I n y
DRIVER' S&S1G?fAT%AE_ YOUR SIGNATURE IS ACCEPTANCE OF ALL
OUR DRIVERS CANNOT PICK UP PRODUCT UNLESS PICK up IS PRINTED ONINVOICE. ABOVE ITEMS. PLEASE CHECK CAREFULLY.
NOTE: NOT RESPONSIBLE FOR SHORTAGES OR BREAKAGE AFTER MERCHANDISE
IS.PELIVERED;, CUSTOMER COPY
Pres)fribed br 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
Purchase Order No.
3/ �D�/I�E, Terms
'J dy Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
o9 6s� a
Total ,3 yS
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
r
VOUCHER NO. WARRANT NO.
p 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
USA oaf x396- bill(s) is (are) true and correct and that the
cp materials or services itemized thereon for
which charge is made were ordered and
received except
j 20
gn
title
Cost distribution ledger classification if
claim paid motor vehicle highway fund