208551 05/02/2012 CITY OF CARMEL, INDIANA VENDOR: 359290 Page 1 of 1
0 ONE CIVIC SQUARE MONARCH BEVERAGE CO INC
INDIANA 46032 3737 WALDEMERE AVE CHECK AMOUNT: $173.00
CARMEL
INDIANAPOLIS IN 46241
CHECK NUMBER: 208551
CHECK DATE: 5/212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 173.00 FOOD BEVERAGES
Monarch Beverage Company, Inc.
World Class Beer, Inc.
9347 East Pendleton Pike
Indianapolis, IN 46236
(317) 612 -1310
www.monorch- beverage.com
www.worldclassbeer.com
Permit Numbers
W49 -08938 W49 -87358 IN -P -1983
INVOICE 2483769 CUSTOMER 89924 05/04/12 O7:27AM
PAYMENT TERMS: COD
Sold By Mike Knotts
Deliver To Delivered By Tim Schlegel
Brookshire Golf Club
12120 Brookshire Pkwy
Carmel, IN, 46032 License RR2903542
Permit Info: Beer #RR29O3542 Expires on 07/13/12
Wine #RR2903542 Expires on 07/13/12
Liquor #RR29O3542 Expires on 07/13/12
Delivered Goods [MBC] Item Pack UNet Qty Amount
Lite 24 Lse Can 10110 CB 17.30 10 173.00
Total [MBC] 173.00 10 173.00
Total Delivered 173.00 10 173.00
Received by: Total Less Deposits 173.00
Total Deposits Collected 0.00
Total Deposits Redeemed 0.00
$173.00 Total Tax 0.00
Invoice Total 173.00
Payment 173.00
Due 0.00
Payment breakdown
Check #208551 $173.00
Delivery discrepancies on this order Item Pack Ordered Shipped
New Belg Fat Tire 2/12pk 12oz CAN 40215 CB 5 0
I AFFIRM THAT, BY LAW, I AM AUTHORIZED TO PURCHASE
AND RECEIVE THE ALCOHOLIC ITEMS ON THIS INVOICE.
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))
05/04/12 2483769 Beer $173.00
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
Monarch Beverage Inc.
IN SUM OF
9347 E. Penleton Pike
Indianapolis, IN 46236 -0000
$173.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 2483769 I 42- 390.40 I $173.00 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
Friday, May 04, 2012
Director, Brook ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund