224724 10/01/2013 CITY OF CARMEL, INDIANA VENDOR: 359294 Page 1 of 1
ONE CIVIC SQUARE MID AMERICA BEVERAGE INC
CARMEL, INDIANA 46032 PO BOX 2856
CHECK AMOUNT: $263.95
? KOKOMO IN 46904-2856
CHECK NUMBER: 224724
CHECK DATE: 10/1/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 263 . 95 FOOD & BEVERAGES
------ -- - --- - - - - - - - - ---- - -
MWAMERICA INVOICE
BMIMGE . CITY OF: ,CARMEL ':
INC. / dba, BROOKSHIRE GOLF CLUB
'----.12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. ; CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904-28561
7654593117 RR2903542 EXP. 07/13/14
800-382-06751 h4
Faz: 765-457- 7967 .
III
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBERF ROUTE
10/03/13 538033 Dustin Smith 13 800 13
—.DESCRIPTION" PRI
D AMOUNT
•D
BASE Sepember 30, 2013
PROMO #0913
Wine: W342887 .
Pump $52/$47 Refundable
109 2 /� Budweiser 24 Lse Can 13.60 37.20
209 6 -- Bud Lt 24 Lse Can 1,9.60 111 .60
408 3 B Lt Lime 2/12 Can _ 21 .85 65. 55
1537 2 Stella.- 2/10 Pack 14.9 oz 24.80 r 49.60
Rt x
Cases 13
TOTAL SALE 263.95
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 114 30.00 A
9230 PUMP DEPOSIT 33.00 N
9270 IMPORT PUMP DEPOSIT 33.00 K
263,95
All
ft
CREDITS
❑ Cash El EFT ❑ Escrow /d ®Check Number �
Driver �5jl� Received By
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid America Beverage Inc.
IN SUM OF $
P.O. Box 2856
Kokomo, IN 46904-2856
$263.95
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 538033 I 42-390.40 I $263.95 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
Tuesday, October 15, 2013
Director, Brooks 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))
10/03/13 I 538033 I Beer I $263.95
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