223653 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 364765 Page 1 of 1
ONE CIVIC SQUARE SOUTHERN WINE&SPIRITS-INDIANA CHECK AMOUNT: $227.36
PO BOX 864860 CARMEL, INDIANA 46032
ORLANDO FL 32886-4860 CHECK NUMBER: 223653
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1528419 227 . 36 FOOD & BEVERAGES
SOUTHERN WINE &SPIRITS REMIT TO:
OF INDIANA SOUTHERN WINE&SPIRITS -INDIANA IIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIN IIIIIIIII III IIIIIVIII NUM ER 1528419
800 Commerce Parkway West Dr. PO BOX 864860
Suite D ACCOUNT
Greenwood, IN. 46143-6100 ORLANDO, FL.32886-4860 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII Jill IIII NUMBER 1653
Permits:W41-27133&W41-27134 99 1-800-276-5148
S CITY OF CARMEL S BROOKSHIRE GOLF CLUB ROUTE 112 STOP 22
O 12120 BROOKSHI PKWY H 12120 BROOKSHI PKWY IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
L CARMEL IN 46033 R3 I CARMEL IN 46033 R3
D P
DUPLICATE
T T PAGE 1 OF 1
O O 2500 754
1 3 Exp: 7/13/2014 Night Bill
SALES PERSON PERMIT NUMBER DELIVERY INSTRUCTIONS P.O.# PHONE NUMBER INVOICE DATE
...................................................................................................................................................
...................................................................................................................................................................
- - -74 1
5 035 7 846 3 8/14/2013 99
29 42 31
LOC CASES BTLS SIZE DESCRIPTION PACK W-LOC. B-LOC. PRODUCT NET CASE NET BTL. UNIT DIV UNIT NET AMOUNT
CODE PRICE PRICE PRICE COE DISCOUNT
2 1.OL SEAGRAMS 7 CROWN 80 12 3001 193.56 17.63 17.63 001 35.26
3 1.01, ABSOLUT VODKA 80 12 15402 324.00 28.50 28.50 002 85.50
2 1.OL SEAGRAMS VO CANADIAN 80 12 151600 229.56 20.63 20.63 001 41.26
3 1.01, CAPT MORGAN RUM SPICED 70 12 317436 243.36 21.78 21.78 001 65.34
UNIT DELIVERY CHARGE 1 126161 001
FF CTI E JUN 1, 2013 SWSI WI L NO
ON ER C CEPT CASH AS FORM OF PAYMENT.
TOT BTL 10 YTD OTAL DISC UNT:
PAGE TOTAL CA ORDER TOTAL PAGE TOTALS I ORLDER TOTAL WINE GALLON CUSTOMER PAGE GROSS TOTAL TOTAL DISCOUNT PAY THIS AMOUNT
LIQUOR GALLON 2.64
10 BR
0 O
1 BEER ALL N BROOK
SHIRE o SHIRE GOLF CLUB 1 227.36
2 36
CARTON DRIVER LOADED EITH ALL APPLLIICABLE THIS SALE SHALL BE MADE IN ACCORDANCE
REGULATIONS.CUSTOMER SHALL BE INVOICE NO. CUSTOMER NO. NET AMOUNT DUE DATE sery ca chmgn.1930.00willbechrayed on lhaaccurrancnofabau nc.d check.
leas.enemlnn goods before signing.All clam I. including ONSIB LI or shortage,must
F ESPONSIB
ACTION T FOR ALL SALES TE DUE ON SALES OF GOODS.IN THE EVENT made immediately upon receipt of sGOOD I.OUR RESPONSIBILITY FOR SAFE
F ACTION WI COLLECT INDEBTEDNESS CREATED BY THE SALES OF GOODS. ELIVERY Of G0005 CEASES WHEN GOODS ARE IN BUYER'S POSSESSION OR
ROM THE WINE&SPIRITS OF INDIANA SHALL M ENTITLED HE RECOVER n t� UYER'$AGENT SIGNS DELIVERY RECEIPT.Such eccnpumca of goods con lirms
ROM THE CUSTOMER HEREIN THE PRINCIPAL AMOUNT OF THE 15 2 8 419 16 5 3 2 2 7 3 6 /2 8 2 13 graemonl tM1al thiv invoice iv pnyablo.t the sJdrave above and that the wtol invoice
NOEBTEDNESS,ALL ACCRUED AND ACCRUING SERVICE CHARGES AS OF l a duo and payoblo w17'I ft-1115)bn of Iha invoice d.ln of Yrv.ica included.
HE DATE OF THE SALE OF THESE GOODS.ANY LAWSUIT INVOLVING ANY 1 nol then lolly poiJ,this and ell prior it—ice,will,as P.Illt—by I. ,bear inlarnst
PUT UP CHECK BY ISPUTE BETWEEN THE COMPANY AND THE LICENSEE MAY BE FILED IN DELIVERY RECEIPT:NO CLAIMS FOR SHORTAGES WILL BE ALLOWED UNLESS INSPECTED AND NOTED AT TIME OF DELIVERY arvice eM1orgas from dote of purchn 5%per mooch enJ will iasuh in love of
OHNSON OR MARION COUNTY AT SOUTHERN WINE&SPIRITS'OPTION v ny Jiscorm[end may resuh in loss of credit privilege.,gaesunabla costs antl
/� /� neys'feen will ba aJdad.
ININVOIC SWS Copy Print Name Sign.[—
VOUCHER NO. WARRANT NO.
ALLOWED 20
Southern Wine & Spirits -Indiana
IN SUM OF $
P.O. Box 864860
Orlando, FL 32886-4860
$227.36
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 1528419 I 42-390.40 I $227.36 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
Thursday, August 15, 2013
Director, Broo V hire 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))
08/14/13 I 1528419 I Alcohol I $227.36
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