210627 07/11/2012 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
q ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO Box 2856 CHECK AMOUNT: $339.70
w o� KOKOMO IN 46904-2856 CHECK NUMBER: 210627
CHECK DATE: 7/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 339 . 70 FOOD & BEVERAGES
M' ERICA 1 INVOICE
� ��� CITY OF CARt�EL
dba BROOKSHIRE GOLF CLUB
' INC. 12120 BROOKSHIRE PARKWAY
CARMEL IN 46032
2755 Commerce Dr.
P.O. Box 2856
Kokomo, IN 46904-2856 r<R L 7 V 5-+2 EXP. i i 3 i
765-459-3117
80Q-382-0675
Fax: 765-457-7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
07/12/12 488666 Dustin Smith 13 800 13
7;M�UNAT�
DOC
s°
BASE March 5, 2012
PROMO #0712
PUMP $40/$33 REFUNDABLE
109 3 Budweiser 24 Lse Can 17 .30 51 .90
209 9 Bud Lt 24 Lse Can 17.30 155.70
8308 2 --- Shock Top 2/12 can 23.30 46.60
1537 2 Stella 2/10 Pack 14.9 oz 23.00 46.00
7025 2 312 2/12 Can 24.75 49.50
70
Cases 18
--o° •° • ° - - • ° TOTAL. SALE 349.70
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
9230 PUMP DEPOSIT 33.00 N
9270 IMPORT PUMP DEPOSIT 33.00. K
349.70
® CREDITS
❑ Cash ❑ EFT ❑ Escrow Check Number
70
Driver Z// Received By ) g--�
1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF $
P.O. Box 2856
Kokomo, IN 46904-2856
$836.45
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 487157 42-390.40 $46.50 1 hereby certify that the attached invoice(s), or
1207 488158 42-390.40 $440.25 bill(s) is (are)true and correct and that the
1207 I 488666 ( 42-390.401 $349.70
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, July 12, 2012
Director, BrooVAire 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))
06/26/12 487157 Beer $46.50
07/05/12 488158 Beer $440.25
07/12/12 I 488666 I Beer I $349.70
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