212886 09/25/2012 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: $334.80
INDIANAPOLIS IN 46241 CHECK NUMBER: 212886
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 334 . 80 FOOD & BEVERAGES
Monarch Beverage Company, Inc.
World Class Beer, Inc.
9347 East Pendleton Pike
Indianapolis, IN 46236
(317) 612-1310
www.monarch-beverage.com
www.worldclossbeer.com
Permit Numbers
W49-08938 * W49-87358 * 1N-P-1983
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INVOICE 2622623 CUSTOMER 89924 09/28/12 07:25
PAYMENT TERMS: COD
Sold By Marcella Moren
Deliver To Delivered By Chuck Phillip
Brookshire Golf Club
12120 Brookshire Pkwy
Cannel, IN, 46032 License RR29O35
Permit Info: Beer #RR29O3542 Expires on 10/13/
Wine #RR29O3542 Expires on 10/13/
Liquor #RR29O3542 Expires on 10/13/
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Delivered Goods [MBC] Item Pack UNet Qty AmOL
Coors Light 24 Lse Can 20610 CB 17.30 10 173.
Lite 24 Lse Can 10110 CB 17.30 6 103.
Samuel Adonis Octoberfest 24593 QK 58.00 1 58.
1/6 KEG
3O.00DPST 30.
Total [MBC] 334.80 17 364.
Total Delivered 334.80 17 364.
--eizkrd-Ua-1MQQ--------------------------- ----------------------
Misc $30 Empty Keg Return 31164 RE 0.00 -1 0.
3O.O0DPST -30.
Total Picked Up [MBC] 0.00 -1 -30.
Total Picked Up 0.00 -1 -30.
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Received by: Tot,,l Less Deposits 334.
Total Deposits Collected 30.
Total Deposits Redeemed -30.
$334.80 Total Tax 0.
Invoice Total 334.
Payment -334.
Due 0.
Payment breakdown
Check #1 $334.80
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Return discrepancies on this order Item Pack Ordered Shipp
Misc $30 Empty Keg Return 31164 RE 0
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I
I AFFIRM THAT, BY LAW, I AM AUTHORIZED Tj 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
$334.80
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 2622623 I 42-390.40 I $334.80 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, September 28, 2012
Director, Brookshire &If 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))
09/28/12 I 2622623 I Beer I $334.80
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