223573 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO sox 2856
CHECK AMOUNT: $356.00
KOKOMO IN 46904-2856
>o„� CHECK NUMBER: 223573
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 356 . 00 FOOD & BEVERAGES
MIWAMERICA INVOICE
, B� I,GE . CITY OF, CARMEL
'NC■ dba BROOKSH,IRif 'GDLF CLUB'
12120 BROOKSHIRE PARKWAY
2755 Com`'merce Dr. CARMEL IN 46032
- P.O. Boz;2856;%
Kokomo,'IN,46904-2856 R 5 • t XH. 0//1,5/1
765-459-311,7
800-382-0675
Fax: 765-457-7967
BEER W3409212
.INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
l $ Qf13 533804 Dustin Smith 13 804 13
R0156-CT ANTIT
•.
BASE October 7, 2012 5
PROMO #0813
WINE: W3428870
Mid America Beverage Inc
109 10 f Budweiser 24 Lse Can 17.80 178.00
209 10 Bud Lt .24 Lse Can 17.80 178.00
Cases 20
TOTAL SALE 356.00
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00
9230 PUMP DEPOSIT 33.00.
9270 IMPORT PUMP DEPOSIT 33.00
356.00
® CREDITS
❑ Cash ❑ EFT ❑ Escrow Check Number
�r
Driver .l� Received By
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF $
P.O. Box 2856
Kokomo, IN 46904-2856
$356.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 533804 I 42-390.40 I $356.00 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 29, 2013
Director, Brook 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))
08/29/13 533804 Beer $356.00
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