207832 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 361189 Page 1 of 1
1f f ONE CIVIC SQUARE COCA COLA REFRESHMENTS INDPLS V&K AMOUNT: $871,76
s CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE
CHICAGO IL 60674 CHECK NUMBER: 207832
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 3356315407 871.76 FOOD BEVERAGES
COCA-COLA REFRESHMENTS
INVOICE PAGE 1 OF 2
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB COCA -COLA REFRESHMENTS
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317-243-3771
OUTLET 1866466 INVOICE# 3356315407
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL18 SEQ- 00007 DATE 04 04 1 2
DOC# 33563154070 PL- 101 TIME: 08:41:48 CHARGE NET 15 PROX
SHELL BALANCE 389- 4/02/12
PALLET BALAK 0 4/02/12
DEBBIE
SALES
DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED
DASANI -24 BOTTLE CASE
20PET24L DASANI WATER 5063 10 34.00 3661 -21.52 12.48 124.80
SUBTOTAL 10 124.80
20OZ 24L PET CSD +MM+-NT
20LSPETS CNTR CLASSIC 5788 3 34.00 3675 -11.20 22.80 68.40
20LSPETS CNTR DIET COKE 5789 3 34.00 3675 -11.20 22.80 68.40
SUBTOTAL 6 136.80
20OZ POWERADE
20PTLWM POWERADE LL 5994 7 34.00 3675 -10.96 21.04 147.28
1330 -2.00
20PTLWM POWERADE FPUNCH 5995 5 34.00 3675 -10.96 21.04 105.20
1330 2.00
20PTLWN,PADE ORANGE 6938 6 34.00 3675 -10.96 21.04 126.24
1330 -2.00
20PTLWM POW MOUNTAIN BLA 4035 5 34.00 3675 -10.96 21.04 105.20
1330 -2.00
20PET8P PA ZERO FRT PNCH 1285 3 34.00 3675 -10.96 21.04 63.12
1330 -2.00
20PET8PK PA ZERO MXD BRY 7634 3 34.00 3675 -10.96 21.04 63.12
1330 -2.00
SUBTOTAL 29 610.16
DEPOSITS ON SALES
DESCRIPTION ART# QTY PRICE ADJ# RATE NET EXTENDED
SHELLS 16/20 OZ 0605 6 0.00 «IMPLIED» 0.00
SUBTOTAL 6 0.00 s
CONTINUED
COCA-COLA REFRESHMENTS
I
INVOICE PAGE 2 OF 2
SHIP TO: REMIT TO:
BROOKSHIRE GOLF CLUB COCA-COLA REFRESHMENTS
CITY OF CARMEL INDIANAPOLIS SALES CENTER
12120 BROOKSHIRE PKWY 2329 PAYSPHERE CIRCLE
CARMEL IN 460333314 CHICAGO, IL 60674-2329
317-243 -3771
OUTLET 1866466 INVOICE* 3356315407
AR# 1866466
RTE- 375 DRIVER- 3707 LOAD- ISL18 SEQ 00007 DATE 04 04 1 2
DOC# 33563154070 PL- 101 TIME: 08:41:48 CHARGE NET 15 PROX
SHELL RAKE 389 4/02
PALLET BALAHC B 4/02/12
DEBBIE
NET PRODUCT QTY 45 TOTAL PRODUCT 1,530.00
TOTAL ADJUSTMENTS -658.24
SUB-TOTAL'. 871.76
0031201550
AMOUNT DUE 871.76
THE UNDERSIGNED CONFIRMS AGREEMENT
TO THE TERMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.
ROUTEPERSON CUSTOMER
LAST PAGE
Prescribed by State 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/04/12 3356315407 Pop $871.76
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.
ALLOWED 20
Coca -Cola Refreshments
Indianapolis Sales Center IN SUM OF
2329 Paysphere Circle
Chicago, IL 60674 -2329
$871.76
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 3356315407 I 42- 390.40 I $871.76 1 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
Thursday, April 05, 2012
Director, Brooksh re Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund