241865 02/03/15 CITY OF CARMEL, INDIANA VENDOR: 353824
ONE CIVIC SQUARE U S FOODS CHECK AMOUNT: $*******574.13*
CARMEL, INDIANA 46032 PO BOX 78000 CHECK NUMBER: 241865
FM,�roN. DEPT#78792 CHECK DATE: 02/03/15
DETROIT MI 48278-0792
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 1455230 574.13 FOOD & BEVERAGES
U . INVOICE
RXW Page 1 of 2
ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED
90569922 1455230 01/20/2015 90569575 3798.9 1054 62 01/19/2015
FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
517201 NET 30 DAYS 2191 ENTER OFF OF 111TH STREETM
BILL TO SHIP TO REMIT TO
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods,Inc.
1411 E.116TH ST 1235 CENTRAL PARK DRIVE E PO BOX 78000 DEPT#78792
CARMEL, IN 46032 CARMEL,IN 46032 IL EGG INSPECTION FEE PD .IAN 3..0 2015
ATTN:MICHELLE COMPTON Dept.:0 DETROIT,MI 48278-0792
(000)000-0000 (317)843-3873 (800)428-2118
SHIPPED FROM: 12301 CUMBERLAND RD,FISHERS, IN DRIVER NAME: Thomas Bova ROUTE NUMBER: 2191 --
SHIPPED DATE: 01/20/2015 DRIVER ID: 3221171 STOP NUMBER: 10
INVOICE LINE DETAILS
QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
ORD I SHP ADJ UNIT NUMBER UNT PRICE PRICE
DRY
3 3 0 CS 4260238 SAUCE,CHS NACHO SHLF STABL ORTEGA 4/107 OZ CS $51.4000 $154.20
1 1 0 EA 8036576 CANDY,M&M PNT 1.74 OZ M&M 48 EA EA $34.1400 $34.14
3 3 0 CS 9089079 POPCORN,RAW KIT W/OIL&SALT FANCY FARM 36/8 OZ CS $26.4000 $79.20
3 3 0 CS 9463688 CHIP,TORTLA CORN YLW RND EL PASADO 6/2 LB CS $19.9000 $59.70
FROZEN
5 5 0 CS 2011278 PRETZEL,KING SOFT BKD FZN SUPR PRTZL 50/5 OZ CS $34.8800 $174.40
1 1 0 CS 5403548 ITALIAN ICE,LMN DBL CUP FZN CHILL 12/16 OZ CS $21.5500 $21.55
1 1 0 CS 7175128 ICE CREAM CONE,VNL TFF BB CHAMP 2/12/4.6 OZ CS $21.4500 $21.45
1 1 0 CS 8187999 ICE CREAM BAR,CHOC TACO&VNL KLONDIKE 24/4 OZ CS $24.2400 $24.24
PRODUCT CLASS RECAP
PRODUCT CLASS TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL ITEMS TOTAL WEIGHT TOTAL EXTENDED
ORDERED SHIPPED ADJUSTED DELIVERED SHIPPED SHIPPED PRICE
DRY 10 10 0 10 4 167.22 $327.24
FROZEN 8 8 0 8 4 99.74 $241.64
DELIVERY SUMMARY TOTALS 181 181 01 181 8 266.961 $568.88
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Usa INVOICE
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ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED
90569922 1455230 01/20/2015 90569575 37989 1054 62 01/19/2015
FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
517201 NET 30 DAYS 2191 ENTER OFF OF 111TH STREETM
DELIVERY SUMMARY
AS SHIPPED DELIVERY AMOUNT $574.13
Product Total Adjustments $0.00
Total Charges Adjustment $0.00
Total Allowance Adjustment $0.00
Sales Tax Adj: Rate:VAR $0.00
TOTAL ADJUSTMENT 0.00
DELIVERED AMOUNT $574.13
INVOICE SUMMARY
Product Total $568.88
FUEL SURCHARGE $5.25
Sales Tax Rate: 0.00 $0.00
PLEASE REMIT THIS AMOUNT BY 02/19/2015 $574.13
CUSTOMER ACCEPTANCE
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a)1-1/2%per month or(b)the maximum rate that the customer may lawfully contract to pay,and in
all events calculated in accordance with applicable law.
CUSTOMER SIGNATURE: .MICHELLE COMPTON
SIGNED AT: 01/20/2015 04:21 PM(UTC)
We appreciate your business.Please visit our website www.usfood.com for a fast and easy way to order. Or contact customer service at: (800)253-0277
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
353824 U S FoodService, Inc. Terms
Dept 78792
P.O. Box 78000
Detroit, MI 48278-0792
Invoice Invoice. Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/20/15 1455230 Concessions _ 37989 $ 574.13
Total $ 574.13
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
I
Voucher No. Warrant No.
353824 U S Food&&Pice.,�' Allowed 20
Dept 78792
P.O. Box 78000
Detroit, MI 48278-0792 In Sum of$
$ 574.13 }
. i
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center i
PO#or Board Members
Dept# INVOICE NO. A.CCT#lTITL AMOUNT
1095-1 1455230 4239040 $ 574.13 1, 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
i
January 30, 2015
$ 574.13 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund