171225 04/28/2009 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
CARMEL, INDIANA 46032 3737 WALDEMERE AVE CHECK AMOUNT: $164 -00
INDIANAPOLIS IN 46241 CHECK NUMBER: 171225
CHECK DATE: 412812009
D EPARTMENT AC COUNT PO NU MBER INVOICE NUMBER AMOU DE SCRIPTION
1207 4239040 164.00 FOOD BEVERAGES
MONARCH BEVERAGE CO. INC.
PERMIT #W4908938-INP1983
3737 WALDEMERE ROAD
INDIANAPOLIS, IN 46241-0000
(317)612-1310
Account 89924 License R2903542 Time: 14:55
AZ GOLF MANAGEMENT CORP. Invoice#: 0501642 PO#
BROOKSHIRE GOLF CLUB Load i 4040 Date: 04-30 -2009
12120 BROOKSHIRE PKWY Terms B.COD /W.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
10180 1 LITE KEG 03410057154 41.00 0.00 30.00 71.00
LITE 114 BBL
91021 -1 MISC 00000000000 60.00 0.00 0.00 -60.00
OVER PAY BEER
'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
$30 EMPTY KEG
Cases: 0 Beer$: 242.00 Content$: 92.00
Btls: 0 Wine$: 0.00 Deposit$: 30.00
Kegs: 3 Soda$: 0.00 Discount$: 0.00
Misc: 0 -3) Misc$: -60.00
Gals: 18.0
INV# 486055
Total Sales 242.00
Total Credits 1200(
Total Tax 0.0
INVOICE TOTAL 122.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0501641 Cash /Check 42.00
0501642 Cash /Check 122.00
Total Cash /Check 164.00
PAYMENT TYPE AMOUNT
Check# 1225 164.00
11,11: 0511141 11. N
lnvl: 0501142 122.00
IA
pr
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 pruper pickup form has been completed.
Not Responsible for shurtage or brealaye 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 R2903542 Time: 14:54
AZ GOLF MANAGEMENT CORP. hwoice#: 0501641 PO#
BROOKSHIRE GOLF CLUB Load 4040 Date: 04- 30-2009
12120 BROOKSHIRE PKWY Terms B.CODIW.CHARGE
CARMEL, IN 46032-0000 Driver VB PHILLIPPO,C
(317).946 -7431 Salesman: 16 T. WEBSTER 16
ITEM# QTY DESCRIPTION U.P.C. PRICE DISC DEP AMOUNT
3071 1 CORONA LIGHT 08066095621 26.00 0.00 0.00 26.00
2112 CANS
10110 1 LITE 03410057306 16.00 0.00 0.00 16.00
24 LSE CAN
Cases: 2 Beer$: 42.00 Content$: 42.00
Btls: 0 Wine$: 0.00 Deposit$: 0.00
Kegs: 0 Soda$: 0.00 Discount$: 0.00
Misc: 0 Misc$: 0.00
Gals: 4.5
Total Sales 42.00
Total Credits 0.00
Total Tax 0.00
INVOICE TOTAL 42.00
PAYMENT
INVOICE# PAYMENT TYPE AMOUNT
0501641 Cash/Check 42.00
0501642 Cash/Check 122.00
Total Cash/Check 164.00
PAYMENT TYPE AMOUNT
CheckN 1225 164.00
1111: 1111641 4[. uU
Inv OSOtc42 122.OU
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 for shortage or breakage after merchandise is delivered and
accepted`
VALID
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
S
0-o 7
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
kt
0
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
yY� n n
i �p�t)A2djf T) aaet Purchase Order No.
�.f_L Terms
,yo/i�3r� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
VOUCHER NO. WARRANT NO.
mm ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
6,
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
j� a/� j yU 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
,f�j� CJ� r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund