173644 06/16/2009 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $637.50
CARMEL, INDIANA 46032 3737 WALDEMERE AVE
INDIANAPOLIS IN 46241 CHECK NUMBER: 173644
r CHECK DATE: 6/16/2009
DEPARTMENT ACCOUNT PO NUM INVO NUM BER AMOUNT DESCRIPTION
1207 T 4239040 i 637.50 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938- INP1983
e -F 3737 WALOEMERE ROAD
INDIANAPOLIS, IN 46241 -0000
(317)612-1310
Account 89924 License R2903542 Time: 11:14
AZ GOLF MANAGEMENT CORP. Invoice#: 0554993 PO#
BROOKSHIRE GOLF CLUB Load 4001 Date: 06-18-2009
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032 -0000 Driver XX BOYLES,S
(317)846-7431 Salesman: 16 T. WEBSTER 16
ITEM OTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
10180 2 LITE KEG 03410057154 41.00 0.00 30.00 142.00
LITE 114 BBL
24569 2 SAM ADAMS KEG 00000000000 55.50 0.00 30.00 171.00
LAGER 116 BBL
31164 -2 MISC DEP. 01003116400 0.00 0.00 30.00 -60.00
$30 EMPTY KEG
Cases: 0 Beer$: 313.00 Content$: 193.00
Btls: 0 Wine$: 0.00 Deposit$: 60.00
Kegs: 4 Soda$: 0.00 Discount$: 0.00
Misc: 0 -2) Misc$: 0.00
Gals: 25.8
Total Sales 313.00
Total Credits -60.00
Total Tax 0.00
INVOICE TOTAL 253.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0554993 Charge 253.00
Total Charge 253.00
Total Cash and Check 0.00
Total 253.00
PAYMENT TYPE AMOUNT
Cash 0.00
Total Checks 0.00
Total Collected 0.00
1-6: 0554993 253.00
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...
Nut Responsible fur shortage ur breakage after merchandise is delivered and
accepted
VALID
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
3737 WALOEMERE ROAD
INDIANAPOLIS, IN 46241-0000
(317)612-1310
Account 89924 License R2903542 Time: 11:53
AZ GOLF MANAGEMENT CORP. Invoice#: 0555666 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 06 -18 -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# OTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
20610 10 COORS LT 07199031600 16.05 0.00 0.00 160.50
24 LSE CAN
10110 14 LITE 03410057306 16.00 0.00 0.00 224.00
24 LSE CAN
Cases: 24 Beer$: 384.50 Content$: 384.50
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 54.0
Total Sales 384.50
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 384.50
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0555666 Cash/Check 384.50
Total Cash/Check 384.50
PAYMENT TYPE AMOUNT
Check# 4 384.50
Customer's Signature Driver's Signature
"Your signature is acceptance that allthe product listed above was received
and delivered in good condition"
01ivers cannot pickup product unless proper pickup form has been completed.
Not Responsible for shurtaye or breakage after merchandise is delivered and
accepted
VALID
Prescrib -by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
r 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
/9 12eW -2a Purchase Order No.
lc Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
N SUM OF
ON ACCOUNT OF APPROPRIATION FOR
/mod 644
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�Q C7SSS"lo 3 3 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