174147 03/05/2009 a CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 CHECK AMOUNT:
CHECK NUMBER: 174147
CHECK DATE:
D EPAR T MENT ACCOUNT PO NUMBER IN VOICE N UMBER AMOUNT DESCRIPTION
MONARCH BEVERAGE CO. INC.
PERMIT #W4906938-INP1983
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241 -0000
(317)612-1310
Account B9924 License R2903542 Time: 12:33
AZ GOLF MANAGEMENT CORP. Invoice 0572148 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 07 -02 -2009
12120 BROOKSHIRE PKWY Terms B.000 /W.CHARGE
CARMEL, I,N 46032 -0000 Driver VB PHILLIPPO,C
(317)846;7431 Salesman: 16 T. WEBSTER 16
ITEM 0Y DESCRIP]ION U.P.C. PRICE DISC DEP AMOUNT
24569 2 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 171.00
LAGER 1/6 BBL
Cases: 0 Beer$: 171.00 Content$: 111.00
Btls: 0 Wine$: 0.00 Deposit$: 60.00
Kegs: 2 Soda$: 0.00 Discount$: 0,00
Misc: 0 Misc$: 0.00
Gals: 10.3
Total Sales 171.00
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 171.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0572147 Cash /Check 466.55
0572148 Cash /Check 171.00
Total Cash /Check 637.55
PAYMENT TYPE AMOUNT
Check# 414 637.55
mvr os�21 a aca.ss
RM
Customer's Signature Driver's Signature
"Your signature is acceptance that AI(lie product listed abuve was received
and delivered in good condition"
"Drivers cannot pickup pruduct unless pruper pickup furm has been completed.''"
Nut Responsible fur shurtage ur breakage after merchandise is delivered and
accepted`
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241-0000
(317)612-1310
Account B9924 License R2903642 Time: 12:33
AZ GOLF MANAGEMENT CORP. Invoice#: 0572147 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 07- 02-2009
12120 BROOKSHIRE PKWY Terms B.CODlW.CHARGE
CARMEL, IN 46032 -0000 Driver VB PHILLIPPO,C
(317)846;7431 Salesman: 16 T. WEBSTER 16
ITEM# Q?Y DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 11 COORS LT 07199031600 16.05 0.00 0.00 176.55
24 LSE CAN
30975 6 HEINEKEN 07289000020 27.00 0.00 0.00 162.00
12 CAN
10110 8 LITE 03410057306 16.00 0.00 0.00 128.00
24 LSE CAN
Cases: 25 Beer$: 466.55 ConturA 466.55
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 56.2
Total Sales 466.55
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 466.55
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0572147 Cash/Check 465.55
0572148 Cash/Check 171.00
Total Cash/Check 637.55
PAYMENT TYPE AMOUNT
Check# 4147 637.55
059214/ 466.5:
Inv/: 0592140 191. �6
Rjl� b
Customer's Signature Driver's Signature
"Your signature is acceptance that all the pruducl listed above was received
and delivered in good condition"
Drivers cannot pickup product unless pruper pickup form has been cumpleted.
Not Responsible fur shortaye ur breakage after merchandise is delivered and
accepted
VALID
Prescribed by Ste Board,of Accounts City Form No. 201 (Rev. 1995)
r 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
1 v oaz'V` C D Purchase Order No.
3 l3 1 a rte Terms
��'j L A Le?, L�i Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n 2 0 05'12 1 r �.l (¢3"?
Total S�
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.
Q 12 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
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
200
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund