172661 05/20/2009 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
I NDIANAPOLIS IN 46241 ONE CIVIC SQUARE MONARCH BEVERAGE CO INC CHECK AMOUNT: $640.00
CARMEL, INDIANA 46032 3737 WALDEMEREAVE
CHECK NUMBER: 172661
CHECK DATE: 5/20/2009
DEPARTMEN ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT D ESCRIPTION
1207 4239040 640.00 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
w PER41T #W4908938
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241 -0000
(317)612-1310
Account B9924 License R2903542 Time: 12:05
AZ GOLF MANAGEMENT CORP. Invoice#: 0525108 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 05- 21-2009
12120 BROOKSHIRE PKWY Terms B.0001W.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317)846 -7431 Salesman: 16 T. WEBSTER 16
ITEM# OTY DESCRIPTION U.P.C. PRICE DISC OEP AMOUNT
20610 20 COORS LT 0719903160b 16.05 0.00 0.00 321.00
24 LSE CAN
10110 20 LITE 03410057306 16.00 0.00 0.00 320.00
24 LSE CAN
Cases: 40 Beer$: 641.00 Content$: 641.00
Otis: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 90.0
TRACYINAT 5119
-To to I Sales 641.00
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 641.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0525108 CashlCheck 641.00
Total Cash /Check 641.00
PAYlfENT TYPE AMOUNT
Check# 7 641.00'.
Inv#: 052510B 641.00
P��11 Va
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
Pr, r ibed by Male 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.
i_ Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total CQ
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.
V�MCtQ ALLOWED 20
G� IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
auj-0
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�qQ �Dl• 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
zZ 20
Siaptat
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund