210551 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 364765 Page 1 of 1
Q� ONE CIVIC SQUARE SOUTHERN WINE SPIRITS INDIANA CHECK AMOUNT: $204.57
CARMEL, INDIANA 46032 PO BOX 278350
MIRAMAR FL 33027 -8350 CHECK NUMBER: 210551
CHECK DATE: 715/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1330215 204.57 FOOD BEVERAGES
SOUTHERN WINE SPIRITS REMIT TO: E
OF INDIANA SOUTHERN WINE SPIRITS INDIANA IIIIIIIIIIIIIIIII Hill VIII IIIIIIIIIIN 11 111111111111 Hill 1111 IN NUMB 1330215
800 o
Cmmerce Parkway West Dr. PO BOX 278350
Suite D MIRAMAR FL. 33027 -8350 I I I IIII I IIII VIII (IIII VIII IIIIrIIII UMBER 1653
Greenwood, IN. 46143 -6100 I II III IIII VIII (IIII IIII III III
Permits: W W41 -27134 99 1 800 276 5148
w ROUTE STOP
SCITY OF CARMEL S BROOKSHIRE GOLF CLUB -'•'7G kr 112 23
2120 BROOKSHIR3 46033
CARMEL IN PKWY l 12120 BROOKSHI PKWY IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII I
I
LCARMEL IN 46033 w
T T n f
O I O PAGE' 1 OF 1
2500 754
1 3 Exp: 7/113 {•,2 Night Bill
SALES PERSON PERMIT�NUMBER DELIVERY INSTRUCTIONS P.O.# PHONE NUMBER INVOICE DATE
y995 2�9 -03542 y 317` 846 -7431 6/20/2012.
PRODUCT NET CASE NET BTL. UNIT DIV UNIT
LOC CASES BTLS SIZE DESCRIPTION PACK W -LOC. B -LOC. CODE PRICE PRICE PRICE CUE 5 DISCOUNT d NET AMOUNT
1 1.OL CROWN ROYAL CANADIAN 80 YRC 12 7601 360.12 31.51 31.51 001 31.51
1 1.OL ABSOLUT VODKA 80 12 15402 315.00 27.75 27.75 X02 27.75
3 1.OL ABSOLUT VODKA 80 12 15402 315.00 27.75 27.75 002 83.25
PROMO# 1241
2 1.OL MALIBU RUM COCONUT 42 12 33451 190.08 17.34 17.34 002 34.68
1 1.OL BAILEYS IRISH CREAM 34 12 193505 310.56 27.38 27.38 001 W; 27.38
1 1.OL SOLUT VODKA CHERRYKRAN 80 12 310910 27.75`-.•002 h �27:7 5
PROMO# 1241•
;.i
UNIT DELIVERY CHARGE 1 126161 0 Ell '4
$200 INIMUM O DER IS R QUIRED
W O W T�- O A
SU HERNW NEONLINE COM
CA ES BOTTLES WINE GALLON CUSTOMER PAGE GROSS TOTAL TOTAL DISCOUNT PAY THIS AMOUNT
PAGE TOTAL ORDER TOTAL PAGE TOTAL ORDER TOTAL
LIQUOR GALLON 2 3 8 F i
t t
:�iis ia3iiliiiiiiil` :i�`'i
9 9 BEER GALLON BROOKSHIRE GOLF CLUB 1 32.32 27'75 »:1:2:(3:4 >5:7:
T ER AND CONDITIONS: THIS SALE SHALL BE MADE IN ACCORDANCE W INVOICE NO. CUSTOMER NO. NET AMOUNT DUE DATE sery ce'charge of 925.00 charged an the occurrence of a bouncetl check.
CARTON DRIVER LOADED TH ALL APPLICABLE LAWS AND REGULATIONS. CUSTOMER SHALL BE R nose l exemine goads befoie signing. All claims, including breakage pr shortage, must
SIBLE FOR ALL SALES TAX DUE ON SALES OF GOODS. IN THE EVENT 0 made immediately upon roc eipt of shipment. OUR RESPONSIBILITY FOR SAFE
ACTION TO COLLECT INDEBTEDNESS CREATED BY THE SALES OF GOODS, S IELIVERY OF GOODS CEASES'WHEN GOODS ARE IN BUYER'S POSSESSION OR
UTHERN WINE SPIRITS OF INDIANA SHALL BE ENTITLED TO RECOVER F UYER'S will AGENT SIGNS DELIVERY RECEIPT. S-b epb,- of goods conlirms
OM THE CUSTOMER HEREIN THE PRINCIPAL AMOUNT OF THE greemen, that this invoice ispnyable at the address above end the, the total invoice
DEBTEDNESS, ALL ACCRUED AND ACCRUING SERVICE CHARGES AS OFT 133021 5. 1653 204 7 04 2 012 s due end payable within tit14 days of the invoice date at invoice included.
PUT UP CHECK BY SPUTE BE EN THE COMPANY AND O THE LICENSEE S
E MAY BE ILEDGIN NV D of then cherges f dota 1 pu p rch r a- t lg5 antl b will esul i lass of
DELIVERY RECEIPT:NO CLAIMS FOR SHORTAGES ILL BE ALLOWED UNLESS INSPECTED AND NOTED AT TIME OF DELIVERY i s
ON OR MARION COUNTY AT SOUTHERN WINE &SPIRITS' OPTION.
\�..1, ny tl scou antl may result in loss of credit privileges. Reasonable cos,s and
X 6� 1 n V
Customer CO Signature fees he etldetl.�
Print Name \J) l l/
ININV012 Py J
VOUCHER NO. WARRANT NO.
ALLOWED 20
Southern Wine Spirits Indiana
IN SUM OF
P.O. Box 278350
Miramar, FL 33027 -8350
$204.57
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 1330215 42- 390.40 I $204.57 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, June 21, 2012
Director, BrookshirE 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))
06/20/12 1330215 Wine and Spirits $204.57
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