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210228 07/02/2012 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1 ONE CIVIC SQUARE MID AMERICA BEVERAGE INC CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $381.25 KOKOMOIN 46904-2856 ,oy� CHECK NUMBER: 210228 CHECK DATE: 7/2/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 381 . 25 FOOD & BEVERAGES MINIERICA CITY OF CARMEL INVOICE BEVERAGE d ha BROOKSH,I-RE- GOL•F , CLUB - INC■ 12120 BROOKSHIRE PARKWAY CARMEL IN 46032 2755 Commerce Dr. P.O. Box 2856 Kokomo, IN 46904-2856 nrn�nn-rcn•-� cvo n- i+ Z i + Kokomo, IN 4. 800-382-0675 Fax: 765-457-7967 BEER W3409212 INVOICE DATE INVOICE NUMBER SALESMAN NUMBER; CUSTOMER NUMBER ROUTE 06/26/12 487157 Dustin Smith 13 800 13 PRICE DEPOSIT, AMOUNT ANTITY DESCRIPTION •. BASE March 5, 2012 PROMO # 0612 PUMP $ 40/$33 REFUNDABLE CLOSED 7-9-12 225 1 ' Bud L.t 1/4 BBL 46. 50 30.00 76. 50 1/4 Barrels 1 • • • TOTAL SALE 76. 50 10303 EMPTY AB 1/6 30.00 T 10304 EMPTY AB 1/2. 30.00 H 10405 ® EMPTY AB 1/4 30.00 A 10310 EMPTY IMPORT 1/2 30.00 N 9230 PUMP DEPOSIT 33.00 9270 IMPORT PUMP DEPOSIT 33.00 K 76. 50 RETURNS TOTALCREDIT§ 7 ® CREDITS �1 ❑ Cash El EFT ❑ Escrow ❑ Check Number U Driver A Received B r ® is v Y MIWAMERICA INVOICE BEVERAGE CITY OF CARMEL dba BROOKSHIRE GOLF CLUB INC. _12120• BROOKSH I RE' PARKWAY 2755 Commerce Dr. CARMEL IN 46032 P.O. Box 2856 Kokomo, IN 46904-2856 r3R2905542 EXP. 765-459-3117 800-382-0675 Fax: 765-457-7967 BEER.W3409212 INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE 07/05/12 488158 Dustin Smith 13 800 13 BASE March 5, 2012 PROMO #0712 PUMP $40/$33 REFUNDABLE 109 3 - - Budweiser 24 Lse Can 17.30 51 .90 210 2 --- Bud Lt 16 oz 4/6 Can 21 . 15 42..30 225 1 -- Bud Lt 1/4 BBL .45. 50 30.00 75. 50 408 3 --` Bud Lt Lime 2/12 Can 20.60 61 .80 470 2 Shock Tap Ale 1/6 BBL 37 .25 30.00 134. 50 7025 3 — Goose Wheat 312 2/12 Can 24,75 74.25 L Case 1/4 Barrels 3 AMOUNT • TOTAL SALE PRICE 440.25 10303 f/�/� EMPTY AB 1/6 30.00 1 r T 10304 ��9 EMPTY AB 1/2 30.00 X0 10405 EMPTY AB 1/4 30.00 A 10310 EMPTY IMPORT 1/2 30.00 N 9230 PUMP DEPOSIT 33.00 9270 IMPORT PUMP DEPOSIT 33.00 K 440.25 TOTAL r CREDITS � G%�1 ❑ Cash ❑ EFT ❑ Escrow ©Check Number Driver ��/AJ"1/4 Received By � ��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 I 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, Brook ire 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 I $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