245622 05/20/15 u ��A
"f CITY OF CARMEL, INDIANA VENDOR: 359366
® ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****1,442.1 5*
4 CARMEL, INDIANA 46032 PO Box 7137 CHECK NUMBER: 245622
INDIANAPOLIS IN 46206-7137 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 505141455 1,360.23 FOOD & BEVERAGES
1207 4239040 505141456 81.92 FOOD & BEVERAGES
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
oft comefrom :015t I V..1.OAl I
BROOKSHIRE GOLF CLUB... 5I/14/th
12120 BROOKSHIRE PKWY ®SC®� 412940 505141455 4 1
SYSCO INDIANAPOLIS, LLC /007
CARMEL IN 46033 4000 W 62ND ST �14 11
INDIANAPOLIS, IN 46268 4446 :�:�:TE0i!Vl:- ::—:::P4qT�btfF 9Af:ANC.FZ::AR
317-846-7431 UE FRIDAY 4 WEEKS AFTER ORDER
EST� b3903/ �UKMAL L)MMY
CITY OF CARMEL SN1 3-9�ARY T.FVERENZ
1 civic SQUARE DRIVER: THOMAS, DWAYNE
-CARMPT. IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4, 60 250.4 AND 60-7414 ARE INCORPORATED HEREIN BY REFERENCE.
EXTENDED 11 llrTm;:r%]Tcz
Nf
CITY DESPRIPTIPN
PR I.CE
11:: P: :Xy
W; DAIRY .. .... rnnp clTy,
I S: jNLY5 LB BBRLCLS CHEESE AMER 120 SLI YEL 8131 669..7:114 .189
GROUP ::::TOTAL**** .::;,,19.;•,8.9.,. '19,
MEATS
1 S. 605.,.3 CIZFIREIMP BEE. F:, G.RND PTY. -HMSTYLE TJ 8 62231 81601103... 79.26 79.2.6 . .....
CS 25 LB JHNSV.LE BRAT PRCKULTIMATE 5XI. 101558;;.2116860 39.98 79:96
2 S 25 LB BBRLCLS FRANK ALL-MEAT 5XI. 6 IN 74865067:9? 113.773.6,,_ 27;99:..* 83 97
GROUP TOTAL* 43 iq�
2
FROZEN
LS, C.S. ......1. 212 C.NTSYS.CLS BUN HOT DOG WHITE 6" HINGD 54607120 2496624 35.49. .... 70,98 ...... .... .
..... . .......
........ ....
...... I C:S: 903,.7502FRNANDO BURRITO BRKFST EGG. SAUS CHS 9161 8019671 5.,8.83 58.83
.... . .....
CS 196 CT VITO ROLL KAISER HNY BUTR 4.25" 91010 7975362 32 60 65.20
GROUP TOTAL**** 195::01
CANNED DRY
3 11.99 17.99
-e IS NL 24 CT 4ERSHEY CANDY BAR PAY DAY 80723 703„0414
NICKER CANDY BAR SNICKER 1.86 OZ .....
LG IS
NL CT 3256479,;,1793:837; 32.59 32.59
Is
NL 36 CT ARS CANDY BAR 3 MUSKETEER 42208 1760531 29.98 29.98
.. ........
NL 36 CT REESES CANDY PEANUT BUTTER CUP 44000 5197769 24.97 24�.97:
X.
C.S.: 16.0... CT ",.A.,Y.S CHIP VARIETY SYSCO/FRITO LAY 31831 6586721 25.62 25.62 .... .... ....
0 ......
cs :: 12 *23 OZ kRIZONA DRINK TEA ARN LD PALMER LITE 0,5,549;68..: : 14,,,,94.' , 69.76 ......
2 C. 4i 59.76 .. ..... ...
S 135 LB SYS REL SHORTENING FRY LIQ CLR ZTF 104052 IE 4518403 25. 8
..........
..... .......--------
2 CS 121 LB BBRLCLS SNACK MIX SYZZLIN 4;0593`137:25,5:6.: 4 8:4 38
..........
O� X,
1-15 CS 24500 MLPU9LlFE WATER PURIFIED .......11476557
,47..6 1.S.5.7 8108847 .........4.65.:'..,:.
108847 ..... 4.65- 2 7 0:
.. ........... ......
T X ....... .......
2:
...... ....
0
N r A r P q �l PPr rPQCC NA/T OPEN. CLOSE: 2:uu PM
P.O. BOX 7137
2 21E 5 31 25.0 559 INDIANAPOLIS IN SUB
D
--E=
D T
IMPORTANT: PERISHABLE PRODU&TS ARE NOT 46206-7137 TOTAL
F3ELIVERY. ELIGIBLE FOR R RETURN AFTEP
Co PLEA�,E AFTER NVOICE, WE WILL NOT BEE�E E ON
T ” A VE
�,AFER Y U�H
A T, VJP
P , M�RLE
v- R ANY SHOR AD R Y U HAVE 8IGNED. PIECES I T TAX
DRIVER'S NO. PCS CUST. NO. PCs TOTAL
SIGN OELVD. S I G!N REC. INVOICE
I 'N AIM T L�ji UB� TOTAL
C T� RA 'co" �Ap.g Cy Yp�'�'�STI�URC
-Y� OM ODITIES, PSI
T
0 To 5 A R HES INV NTo I PAYABLE ON 0 BEFORE -
7 NNP�%O- SIES 1LOFMOT M IV AL
DERIVED FROM THESE COMMODITIES, RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL
o FULL PAYMENT IS RECEIVED.__ kNT. ON PAGE 2
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
come from , ; .,;.... ......:.,Dav
BROOKSHIRE GOLF CLUB... ;i .......,
.;:. .
12120 BROOKSHIRE PKWY ys SYSCO INDIANAPOLIS, LLC 412940 505141455 4 2
:...::::... ::. :..:.::...
CARMEL IN 46033 4000 W 62ND ST .ftoLFE.::..
INDIANAPOLIS, IN 46268 11' , .
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
I MXNT NORMAL DELIVERY
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: THOMAS, DWAYNE
CARMFL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
.: ":: '::;: :::.; 'iFTEM .EXT.ENDED...:o ?
QTY': PAC ..SIZE
T ITEM DESCRIPTION CODE. :::. PRI135: :> PRICE ^;
**
PAPER ,& DISPOSABLE **
.1141 1 S 1280 CT SYS REL CUP. PLAS TRANS ,1602 ;SOFT Y'E1.60,SYS:.735.8:30:4;,..:7;6.9;8:. _... 76.98
S . 12500 CT ORKAD.V NA'00PKIN DI$P XPRESSNAP WXX
HT „DX9Q0„133Q6,$7. 59.26 59.26
S, ., 4125CT SYS IMP PLATE PLAS BLK IMPACT 10.,25” PI1+OESY5...2$1811Q 121.$1 121.81
145 S 181500C=ORG P TISSUE TOILET CORELESS 2PLY WH 19378 6092.605 5776 57.76
GROUP TOTAL*.***
3.15.81
** PRODUCE..*** . .
S 112 CT SYS IMP APPLE RED DEL FCY FRSH „ 7410608 11 87 11.87
S 25, LB SYS NAT LETTUCE ROMAINE GOURM SNGLS 5063599 28,64 28,64
S 15 LB SYS IMP, ONION RED FRESH JUMBO 1039494„ 9.98 „5.98
weISC.S 212 LB SYS CLS SALAD POTATO MUST 20100,1 6733166 38.87 38.87
.� -.2 SO- 25 .'LB SYS CLS, SALAD POTATO RED SKIN 201004 641,8784 23.82 47.64
C 15X6 SYS IMP TOMATO 1 LAYER FRESH 1008630 15.78 15.78
GROUP TOTAL****.
** DISPENSER ***
S 15 GAL OCACOL SYRUP COKE CLASSIC 5X1 BIB 04250010 90593 7O 60 70.60
:GROUP TOTAL**** 40 70.60
ORDEF SUMMARY 66948
xx
Nrpn . . . . .. i i;iR:EN(. '.;TQ;_"ii:'i:i::i iii::
77
P.O. BOX 7137
= 12 12 12.4 225 INDIANAPOLIS IN SUB
q IMPORTANT: PERISHABLE PRODgUCTS ARE NOT ELIGIBLE FOR REggTURN$$��ggAFTE 4206-7137 TOTAL 1360.23
E 3 5 43 37.4 704 FOR VANY SHORTAGE AFTER YIOU HVAVE E$IGNEO IPIECEST RE CEIVEDOMUSTE TAX
v
DRIVER'S No. PCS CLIST. NO, PCS TOTAL
SIGN C OELVD. H SIGN REC. INVOICE
I THhEH IRZ�oAgg�yE gq�GC�I€jUN LT5 C OF OMH OD TIIF�SSLE7EL�GG�ooRtICU 7lugRgINLVOO EMry1AppfiETl gL�CC UB�I T170Ull T E $7gAgEE77�C OF2YHETRgUEgLT�ER p TOTAL 1360.23
THESE COMMODITIES RETAI��A TRU T LRAM VER THESEL COMMOCD 1011ES,D IAL INVENTO I S OFF O OR THTER PRODUCT PAYABLE ON OR BEFORE
I DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FRDM THE SALE OF THESE COMMODITIES UNTIL 6/12/15 LAST PAGE
o FULL PAYMENT IS RECEIVED.
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
come from
04V;t7A7i ! < COSFOhtERii<;t s 1'l> »>
. _.
BROOKSHIRE GOLF CLUB... 51 15
12120 BROOKSHIRE PKWY ysco- 7 TES cK::,s:.:or::::; 412940 505141456 2 1
..:::.:.::::.:
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST .............
INDIANAPOLIS, IN 46268 444A P
.:
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: MAS, DWAYNE
CARMFL TN 46032...... ..... .... EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE,
QTs PA $IZE »»,. r �P: AD It IRTIVIFNTA
Y...:..:. .::....C.....:.
ITEM:D.ESGR,IP..,TION.......»:>.....:.
.:.. ..�.......: ..... ........................... .:: ...::..:::. ::::.: ....... ............. .. :::�:::rrrs::::::::iss:»v..a:.0 i�E�+:<�iis PR LC ::;'.;?i:: .;:::..
* FROZEN
...
S12CT RCTYBK..000KIE CHOC CHN:.::.K
DWNHM, ,30Z ,I,W,;;;;; 83.4,9439 „..,7.6:9276:9.92
„ . .,OUPTOT Zb. . ..
MIS . :H..RG S >HG$...FOR::.FUEL..SURCHARGE5,:QQ,
0 S A RY 67.027
...
... ..........
xx
.............................. .............
:......::. ....
...... . .:.:.
. ............ ...........
::.>... ....
.. ... ..... .. ..
X XX
P.O. BOX 7137
2 1 .7 18 INDIANAPOLIS IN SUB p
p IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN SS ggAFTE 4 206-7137 TOTAL 81.92
E 1 .7 18 FDOR ANY SHORTAGE AFTER V16UI HVAVIE E$IGNEO IPIEC ST BE
MUSTS TAX
v
DRIVER'S NO. PCS CUST. NO. PCS TOTAL
SIGN NO.
SIGN RSC. TOTA1lE $1.92
I TTH7E�{pPRZIgE�{pAggLyE ggEGCFICIUlNryLT55uu,,R L FC p7��MEO DEI77IEESS LgI gL E7E GROIN�7TLHI IgNLV ICME Ap SE LDCgTUB Eg C37p Ou g7�{CE qg gAE77(U7)�0 R7YHETRSUEgLIE p
THESE COMMODITIES ROEtAINCS�A TRUST PRAIM AOVER�TMESE TOMMODITIES��ALL�IIJvEN70RIE$I OF'FO'OD�ORCOYHER PRODUCT PAYABLE ON OR BEFORE
1 DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 6/12/15 LAST PAGE
o FULL PAYMENT IS RECEIVED.
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))
05/14/15 505141455 Food $1,360.23
05/14/15 505141456 Food $81.92
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF $
PO Box 7137
Indianapolis, IN 46206-7137
$1,442.15
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
T
1207 505141455 42-390.40 $1,360.23 I hereby certify that the attached invoice(s), or
1207 505141456 42-390.40 $81.92 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, May 14, 2015
r
Director, Brooksh fe Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund