249433 09/09/15 1
+ r CAA*R!
��. CITY OF CARMEL, INDIANA VENDOR: 359366
d 2 ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****2,154.43*
CARMEL, INDIANA 46032 PO BOX 7137 CHECK NUMBER: 249433
'�:�)�,(IN��,r INDIANAPOLIS IN 46206-7137 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 508271561 1,222.43 FOOD & BEVERAGES
1207 4239040 509031453 932.00 FOOD & BEVERAGES
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C �T<]K�ER[� ORIGINAL INVOICE Comp/osmr/AL pnOpcnTv OF ovoCo
BROOKS CLUB...
12120 ----BROOKSHIRE PKWY sij�
SYSCOINDIANAPOLIS, LLC
CARMEL IN 460I3 4000 W62ND ST
INDIANAPOLIS, IN 46268
' 317-846-743I ,
MANIFE.M 1)4/UI6 NORMAL DELIVERY
CITY OF CARMEL MA* SN139 GARY LEVERENZ
1 CIVIC SQUARE DRIVER: THOMAS, DWAYNEA MFL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4. 80-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
UN ENDED.
:IFFECTIVE 7/01 .1:5 SYSCO INDIANAPOLIS..WI,LL NO LONGER ACCEPT CASH AS A FORM..OF...RAYMENT.
/F ---;i: 1�11:C:S :::�%:O PTY HMSTYLE: ....62-2 1. 8: :6G. 03 73�.I:& 58.:52 ...... .............
^-
GROUP TOTAL 1:10.A6
P.O. BOX 7137
2 2� 1 23 21.8_ 392 INDIANAPOLIS SUB
R IMPORTANT: PER ISHABCLCEI�PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTEF 4210N6-7137 TOTAL
PIELRIVERY. PLEA
CUST
DR I VER'S N 0.=PC S CUST.Xf NO. PCs TOTAL
CIL
T LA CT B
I DER I VIED FROM THESE COMMODITIES, AND ANY RE(EIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL CONT. ON PAGE 2
o FULL PAYMENT IS RECEIVED.
_
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
comefrom Div, DA7� C1 sroalEn
BROOKSHI RE GOLF CLUB+++ ��®� ®
12120 BROOKSHIRE PKWY -TRUCK STOP412940 509031453 4 2
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST
INDIANAPOLIS, IN 46268
317-846-7431 D E FRIDAY 4 WEEKS AFTER ORDER
IMANTFRSTE— F)471)'/b NORMAL DELIVERY
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: THOMAS, DWAYNE
ARMEL EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
77
..TY....: >:.a PAC 512E :' tI.EM:.;E�ESGR1PT10N;'::i::.
T spot:;:'. PREc PR„SCE
CHEMICAL
.:.:. ..
S 12802 YS: REL BLEACH CHLORINE LIQ 5,25.. % 1100339504.4: 1934.0.27 14:.55.. 1.4.55 ..
D I CS, 602 OZ..,. EYSTON CLEANER FLOOR ALKALINE RTU,. , 610:0681 198373.7 47..$7 47...$7
HAZARD *.
::GROUP.._TOTAL****
2.426
>F .. . .
PROD E. .... .. -::: :;::...::.. .._. .
C S : 5 LB..'' BRLIMP:'>:SALiAD CHICKEN:.: :.:;:.:. -:' ::::.: -
✓ ;5107 : 251,0717 . 41,0$. 41.os
S .. 1 LB > PROD TOMATO
.
_ ..... 0 9.50.8 ...2 (7:. .. . 6.1
7 ;.:::
GROUP TOTAL " 67.25
,MIS CHARGES HG5FORF L;SUCHAR
:
;
»'
ORDEP SJMMARY 59820
X.
...::: .:. . ....::.
....::.:...
J
v
P.O. BOX 7137
2 4 3.0 92 INDIANAPOLIS IN SUB
R IMPORTANT: PERISHABLE PRODgUCTS ARE NOT ELIGIBLE FOR REE$TppURNg�gAFTE 4 206-7137 TOTAL 932.00
2 1 27 24.8 484 EOR ANY SHOR AGE�PIECEAFTER YIOU HAVIE E$IGNEO(PIECES RECEIVED MUSTS TAX
DRIVER'S NO. PCS CUST. No. PCs TOTAL
SIGN oELVD. SIGN REC.
INVOICE
I gTH7E pPE gEf{pA LT�RPL �O�MEO EI7IEs LgISE7EpGOR UTL INVOICE'A Lp gUBJEC37 TOu 7HCE qg AET �)ORYHETRgUESLT�E p TOTAL 932.00
THESE RCOMMODITIESTROETAItVCS AFTf2UST�C LAIMAOVER THSE RAL CONr1 r+�S DEIAL TIES ACTtOgIE0S170F�SF O�OD90R�COl�HER PRODUCTS
1 DERIVED FROM THESE COMMODITIES, ANO ANV RECEIVABLES RM PROCEEDS PROMVTHE R PAYABLE ON OR BEFORE
o FULL PAYMENT IS RECEIVED. SALE OF THESE COMMODITIES UNTIL 1p/02/15 LAST PAGE
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))
09/03/15 I 509031453 I Food I $932.00
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
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF $
PO Box 7137
Indianapolis, IN 46206-7137
$932.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 509031453 I 42-390.40 I $932.00 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, September 03, 2015
Director, Brookshire Yif Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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Good things CUSTOMER'S'ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
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BROOKSHIRE GOLF CLUB...
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12120 BROOKSHIRE PKWY �®s ...LI 412940 508271561 5 2
SY5C 0 INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST !???::E:<:::
DI N
ANAPOLIS, I 46268
IN -:'
317-846-7431 DUE FRIDAY 4 WEEK AFTER ORDER
CITY OF CARMEL MA* SNI FRPN7.
1 CIVIC SQUARE DRIVER: THOMA , DWAYNE
CARMPT. IN 46012 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
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2 10 57 157 P.O. BOX 7137
.
z INDIANAPOLIS IN SUB
•I 3 7 37 28.6 bas O R ANVNT: PERISHABLE PRODUCTS ARE NOT SHOR�GE AFTERTVI6U HAVEESIGNED PIIEC STRECE VEO MUSTEGIBLE FOR RETURN E 4206-7137 TOTAL 1272.43
TAX
DRIVER'S DOL PCs CuST. NO. PCs TOTAL
i SIGN 7 g D SIGN REC. INVOICE
o gTU7EH OP R�7�ggEEHHppAgggg��yyEE SSgqEEGGCcRIICUUryryLT55UUC LppCO MMEEO�EI RIIEgHALg�gL E7EAGRp�NC NV IC MMAppti F�TIggEE?L pqVCSU6�1 EgEg CC33T(TOuu gT�{cE gg�gAETU OF�YHE7RgUESL�ER p TOTAL 1272.43
THESE COMMODITIES RETAI�S�q TRUST CLAIM OVER THES ��j,�pp, ,Eg, ALL ItJVENTORIES 0F'FOOD ORIC 'HER PRODUCTS PAYABLE ON OR BEFORE/25/15 LAST PAGE
1 DERIVED FROM THESE COMMODITIES, AND ANV RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 7
u FULL PAYMENT IS RECEIVED.
CUSTOMER'S ORIGINAL INVOICE
� Good things CONFIDENTIAL PROPERTY OF SYSCO
n come from
BROOKSHIRE GOLF CLUB...
12120 BROOKSHIRE PKWY ®s :..TRe sa-- 412940 508271561 5 1
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST
INDIANAPOLIS, IN 46268
317-846-7431 DUE FRIDAY 4 WEEK AFTER ORDER
RMA
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: THOMA , DWAYNE
A MET, IN 4�032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1 4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
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FFECTIVE 7/06l:5 SYSCO INDIANAPOLIS WILL„NO.„LONGE ACCEPT, CASH,..AS.,AFORM...OF.,,. AYMENT.....................
SKXOUR .MA F `D 'I'AIS,S. ...;..
6.
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C S .CHEESE R... .2.0....$LI 2.8131...66.9.7.119.8.9...............39...78...... .
:::::::::GR U- TOTAL****. ........... ............ .7
3.9..:...8........
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U 73.6.....2.8...95.... . 86..85.. ............. .....
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1.E SEA ..BSN........... .......... . 8138 06.7.7.. 62865.2 ... 6.....9.4.........:.::.6.2•..9:4.. ...:
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P•0. BOX 7137
] 2 5 27 22.9 451 INDIANAPOLIS IN SUB
n IMPORTANT: PERgISHABLE PRODggUCT$ ARE yNyOT ELIGIBLE FOR RggT�URNg�gAFTE 4206-7137 TOTAL
E FOR ANY SHORS GE AFTER VIOUHAVE E$IGV E O(PIECES RECEIVED MUSTE
v TAX
DRIVER'S No. PCS CUST. N0. PCS TOTAL
DELVD.
� SIGN SIGN REC. INVOICE
q 7EHOERZ��}{p gg�yEgq�GCR1C�7N r�U1 p�O-�MNME 7RESg 7E GpR�ryruL RIp MEMp E SEo ppC EgC37p UST��{C� qg gET7`u R7H gEgL�E p '
7HEgE RCOI.dMODITIESTROETAINCgF7pIJSTO�L�IM A��ER�THESEp♦rI'MOD TIES�IALL SItJVEORIES,OF FOOD�ORC7HE♦ PRODUCTS PAYABLE ON OR BEFORE TOTAL
I DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEED$ FROM THE SALE OF THESE COMMODITIES UNTIL ONT• ON PAGE 2
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))
08/27/15 508271561 Food $1,272.43
08/28/15 Food ($50.00)
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF $
PO Box 7137
Indianapolis, IN 46206-7137
$1,222.43
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 508271561 42-390.40 $1,272.43 1 hereby certify that the attached invoice(s), or
1207 42-390.40 ($50.00) 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
Friday, August 28, 2015
d
Director, Brookshire olf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund