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HomeMy WebLinkAbout220260 05/21/2013 VENDOR: 359294 Page 1 of 1 CITY OF CARMEL, INDIANA g ONE CIVIC SQUARE MID AMERICA BEVERAGE INC ? CHECK AMOUNT: $188.20 CARMEL, INDIANA 46032 Po sox lass KOKOMOIN 46904-2856 CHECK NUMBER: 220260 CHECK DATE: 5/21/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 188 . 20 FOOD & BEVERAGES INVOICE MIM,,- NORICA TY BEVERAGE 2755 Commerce Dr. (;:;032 ' P.O. Box 2856 Kokomo, IN 46904-2856 765-459-3117 R 5 2 X 800-382-0675 Fax: 765-457-7967 BEER W3409212 INVOICE DATE INVOICE NUMBER SALESMAN: NUMBER CUSTOMER NUMBER ROUTE' 3 S 0 0 1 06 D,u cf w F.? s-7, r 20 j %­4 Jv ' 'TOTAL SALE zi,� xc 10303 EMPTY AB 1/6 30.00 10304 EMPTY AB 1/2 30:00 10405 EMPTY AB 1/4 30.00 9230 PUMP DEPOSIT 33.0 0 , 9270 IMPORT PUMP DEPOSIT 33.00 T :aj:F%, y CREDITS ❑ 0 Cash ❑ EFT ❑ Escrow U Check Number Y Driver— Received By jjlll I -W /��222/� \\ ^ �� � \ �\\^\/? ��\\i:��\://���J© G� - - _ , + �. fir. , ��» » - #2 \ « - � - a/�« \��\z\ �{�J�:���§d:����; 2 � � ` » _ .v . : v +� . .a, . . . �zy >, � © - . - y�. -cz�� 9 � �}��� _, , \ � \� \{2 @�x � 2 �I� + z - . +\�� � � - - - »` - 1 » \ \�_ _S /_ \_\� �~ � < � Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) 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 L� rJ Av-,in,__ Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total I 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 WARRANT NO. ?0 ON ACCOUNT OF APPROPRIATION FOR "�IAD Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the x » : materials or services itemized thereon for which charge is made were ordered and received except 49M � '' L'f.�r'i' 1.' 1F 20 «• :. 120-& Signature Title Cost distribution ledger classification if . claim paid motor vehicle highway fund