218712 04/02/2013 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
0 ` ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856 CHECK AMOUNT: $55.60
� + KOKOMOIN 46904-2856 CHECK NUMBER: 218712
IruM co
CHECK DATE: 4/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 55 . 60 FOOD & BEVERAGES
MIWAMMICA INVOICE
BEVERAGE CITY OF CARMEL
IN dba BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL. M 46032
P.O. Box 2856
Kokomo, IN 46904-2856! 3 J 41 EXH. U//115/ 13
765-459-3117 3 ;
800-382-0675
- Fax: 765-457-7967.
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
• 04/02/13 515656 Dustin Smith 13 BOO 13
o•
BASE October 7, 2012
PROMO ##0413
WINE: W3428870
Mid America Beverage Inc :
209 2 ✓ Bud Lt 24 Lse Can 17.80 35.60
1537 1 —" Stella 2/10 Pack 14.9 oz 24 .00 24.00
760, . 1 Goose 312 1/6 BBL 56.00 30.00 86.00
r '
• � �� "fie �' --
4 W�
i
Cases 3 1/4 Barrels 1
•• •• • TOTAL SALE 145.60
10303 f EMPTY AB 1/6 30.00 101- T
10304. t 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
145.60
.,;: rr
❑ � � CREDITS
Cash EFT Escrow C h ec k Numb er ® d-
6�
Driver ' Received By ��
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF $
P.O. Box 2856
Kokomo, IN 46904-2856
$55.60
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 515656 I 42-390.40 I $55.60 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
Wednesday, April 03, 2013
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))
04/02/13 515656 Beer $55.60
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