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244995 05/05/2015 CITY OF CARMEL, INDIANA VENDOR: 359366 CHECK AMOUNT: $*******686.36* (9, ONE CIVIC SQUARE SYSCO FOOD SERVICESCARMEL, INDIANA 46032 PO BOX 7137 CHECK NUMBER: 244995 INDIANAPOLIS IN 46206.7137 CHECK DATE: 05/05/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 504301591 686.36 FOOD & BEVERAGES GoodtNngs CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO come from • :>Ii':: ��'��;�::3:::�iC13SF�Ad %�:�:� :�::�::5::�::;5:.:'..:..::.:.:.:.::::.:....:...:.:'�::::::::::::::�::'��:':>'.�:;:::::':;;;f;::::5;::�;;:5::;::;::cS;;S:�':::5: BROOKSHI RE GOLF CLUB... �l/ScO® ;;::T:fi,,EK;S:,DP:;:;:; 12120 BROOKSHIRE PKWY ;::.;.:.::.::;;:.:;:;:::. 412940 504301591 5 1 SYSCO INDIANAPOLIS, LLC CARMEL IN 46033 4000 W 62ND ST :><«.�<:sF?.fl�?>�:06i::: :.. .. ... 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MA s RAT ETOM C� I ADIAL SI v INTO I I Sy,E �A CT,oF# RU�sT R PAYABLE ON OR BEFORE TOTAL 7 •23 r i M I A "fir � G s o "�sQ FtS'o $ 87Hfbvc� 5�29�15 LAST PAGE 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL p FULL PAYMENT IS RECEIVED. VOUCHER NO. WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF $ PO Box 7137 Indianapolis, IN 46206-7137 $686.36 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1207 I 504301591 I 42-390.40 I $686.36 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, April 30, 2015 Director, Brookshir olf 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)) 04/30/15 504301591 Food $686.36 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