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207673 03/27/2012 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: $755.50 INDIANAPOLIS IN 46241 CHECK NUMBER: 207673 CHECK DATE: 3/27/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 755.50 FOOD BEVERAGES .r" o Monarch Beverage Company, Inc. World Class Beer, Inc. 9347 East Pendleton Pike Indianapolis, IN 46236 (317) 612 -1310 www.monarcii- beverage.com www.worldclassbeer.com Permit Numbers W49- 08938 W49 -87358 IN -P -1983 INVOICE 2462686 CUSTOMER 89924 03/30/12 11:37AM PAYMENT TERMS: COD Sold By Mike Knotts Deliver To Delivered By Justin Dickason Brookshire Golf Club 12120 Brookshire Pkwy Carmel, IN, 46032 License RR2903542 Permit Info: Beer #RR2903542 Expires on 0113112 Wine #RR2903542 Expires on 07/1:3/12 Liquor #RR2903542 Expires on ,;1113112 Delivered Goods [MBC] Item Pack UNet Qty Amount Coors Light 2 /9pk 16oz 20627 CB 16.00 5 80.00 Alum CAN Coors Light 24 Lse Can 20610 CB 17.30 15 259.50 Lite 2/9/16oz Alum 10117 CB 16.00 5 80.00 Lite 24 Lse Can 10110 CB 17.30 10 173.00 Lite Lite 1/4 Bbl 10180 QK 45.00 1 45.00 30.00DPST 30.00 Samuel Adams Lager 1/6 Bbl 24569 QK 58.00 1 58.00 30.00DPST 30.00 Total [MBC] 728.00 37 755.50 Total Delivered 728.00 37 755.50 Received by: Total Less Deposits 695.50 Total Deposits CUIICCted 60.00 $755.5 Total Deposits Redeemed 0.00 Total Tax 0.00 Invoice Total 755.50 Payment 755.50 Due 0.00 Your Total Line -Item Discount Savings 32.50 Payment breakdown Check #207673 $755.50 I AFFIRM THAT, BY LAW, 1 AM AUTHORIZED TO PURCHASE AND RECEIVE THE ALCOHOLIC ITEMS ON THIS INVOICE. VOUCHER NO. WARRANT NO. ALLOWED 20 Monarch Beverage Inc. IN SUM OF 9347 E. Penleton Pike Indianapolis, IN 46236 -0000 $755.50 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1207 I 2462686 I 42- 390.40 I $755.50 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 Monday, April 02, 2012 Director, B ookshire Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 03/30/12 I 2462686 I Beer I $755.50 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