249914 09/23/15 Coq_
CITY OF CARMEL, INDIANA VENDOR: 359366
d '• ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****1,156.00*
i, =4 CARMEL, INDIANA 46032 PO BOX 7137 CHECK NUMBER: 249914
INDIANAPOLIS IN 46206-7137 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 509160829 1,156.00 FOOD & BEVERAGES
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
pft !
come from tA.W:iOA7E cusTaMeR',: :BROOK . WAPR 10:44-
12120 B )
RE GOLF CLUB... ! ysc ®
12120 ROOKSHIRE PKWY Ta cls.s'off. : 412940 •509160829 8" 1
SYSCO INDIANAPOLIS, LLC /014
CARMEL IN 46033 4000 W 62ND ST �r�Lt.E,;::;<''::
INDIANAPOLIS, IN 46268 : ST::.. . .::..;::.. .
317-846-7431 DUE FRIDAY 4 WEEKS FTER QRDER
MANI !11949 NORMAL DELIVERY
CITY OF CARMEL '
1 CIVIC SQUARE DRIVER: AYERS, AARON
EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
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F RM F AYMENT
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EFFECTIVE 7. 01 15 SYSCO.INDIANAPOLIS W1 LL NO LO...G CC , „CASH„_AS .
:S:K:::::YOUR :MA FOR:::DETAILS
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�C ;: NL:_5LB ,.ASASOL: CHEESE':>CHEDDAR..:i.ACK::::;FAN.CY SHRD:. :' 287 971$ ..::;1$:.2:3'' 8 3
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GROUP16.69
ME ...TOTAL*
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F:::. S >.6. 5:3.:..OZ I991MP;:.:BEEF GRND.PTY:::HMSTi' ,E:.;:T:J.;,;.$;:.::........:.: >. . .......:622.3.x::. 6 k. 03 ..::7.3..,. . 58. , ....
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5:::.;>>:> 5:::LB:::::;: :HNSVLE BRATWU'RST:::>::PRCK ::UhTI:MATE 5X1.._._.:..................101558 2.1.1.6.8.60. .39.3 ..
;.; ": : ::>: :::..'.:.. :28.95:+J+++++` 57.90 <=
S.::LB.. BRLCLS:::FRANK ALL--MEAT;:;:::5X1";S:::IN:;:;;:;:;::;:<;;::::. .. .:...:T48.6�0:67:92.. .:1,:37.7;3.6 ..::.
GROUP TOTAL**** 256.40 .. .... _._._....... : ,..
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:. :. ::.::: >:; - ::;: 24948;;;89:5::.: 66627.4 . 55..9.8: :: 55..98.'
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GROUP TOTAL*
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VF '': '- :: S >::"1 12..CN..T YS.:CLS BUN:HOT:`DOG..;hiHITD: 6. HINGB:::::<: <: ' ;; :;::.>:;,�460712:0 24955 35-.. �....8... ....... ........... ....:. ::.:::::...,::... .
;, IN ASST BL :BAN CHOC :CH "I W 673473:02:18.2.5. 781311:4 25;,5$.
F : s z ,250 xRsIMP MUS�' l 1 / I ,>:25;68:. „.: . .,
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GROUP TOTAL**4* 129.16
. "DRY.. _:..:....... .. :::... .:..::..:.:..:... ... ...
.:.CANNED .& . ::: >" ::;
V
J.,: NI 4$.CT NLCK:ER .CANDY :BAR: SNICKER 1.$6 QZ:.: 255479 1733$3. 3..;... 3 ....59
D 60 CT 'JAYS CHI:P :VARI HTY.>:SYSCOJFRIM I,AY:... ::::.:—<31831,658.672 2562 25.6:2
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�D.. :::..:.. 5,:..1. 2.3:.;'a?Z.;:. RIZONA::.DRINK.IEA.. AR 0 . ,.PALMER.LITE. : ... . . 96.. ...::. ;-.,-:,:: :<.;;:;.:.-:.;:
6.36:::`-
4. 46:36 `
S ;>l 1..L'I*R; �R PTR MTX :COCKTAIL.:BLDY MARY. ;:.: : .::- ;; <.'4.77:00 08.7.470 . > "
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42.::1:.
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' siT<;ra;
L P.O. BOX 7137
2 1 3 18 17.1 273 INDIANAPOLIS IN SUB
a IMPORTANT: PERISHABLE
PRODSSUCTS ARE NOT ELIGIBLE FOR RETURN SS ggAFTE 4206-7137 TOTAL
6 EOR AENY SHORTAGE AFTER YI6U HAVE ESIGNEO ILL
RECEIV�O MUSTS TAX
TOTAL
DRIVER'S NO. PCS CUST. iJo. PCs
SIGN DEL.VD. SIGN p [IEC. INVOICE
It qU HOPIRZIHpAggLyE gq�GCRIIC SX TC 1pEO7MHMEOpEITRIIEgS�ALgI S�ETE[�G�N�1TLF�I RgINLVOIOCME MAp DF�T IgEgLDgCSUB! Ti TO E dSTgAFTTI(IC OIYIy,_TRgUEgLT�E R O TOTAL
THESE CJMMODIT IES Rp AINSA TRUST CLAIM OVER TH�SEOMMOCDITIE S, ALL INVETNTp1 fIOS 70Ubd9 pit7HEF� PRODUCTS]PAYABLE ON OR BEFORE
I DERIVEDFROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OFF THESE COMMODITIES UNTIL ONT. ON PAGE 2
o FULL PAYMENT IS RECEIVED.
i
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
„
come from Mv,.DATA cusTOMEx: .:
BROOKSHI RE GOLF CLUB...
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12120 BROOKSHIRE PKWY TR cK<--s °� .: 412940 509160829 8 2
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND SIN 46268 RouE
INDIANAPOLIS,
317-846-7431 DUE FRIDAY 4 WEEK AFTER ORDER
CITY OF CARMEL '
1 CIVIC SQUARE DRIVER: AYERS, AARON
CARM 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.
E
{vi :EXTENDED ler A ill-gThfigluts
QT ;:::«.: . >.. LTEM:':DE S,.CRIR::T::,I,.ON.;.;:. N1..:. .:. PRICE
D: S 2 SLTR URLI:I<E:: WA:m 'R:' PURI) I:FI>;.<. ;.::-.;. 65:: 4...b5:_.
3.
GRbUP ,'TOTAL****: 18.5.94
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PA PER:: � I?LSPOSABLE... >:> ;:::>::;::>::>;; :>::::>::;:.
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39,:96:
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4 ':74
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D:.r>>:' S::;.1 100.::;CT YS...CLS:>:;GLfJVE::;:::RfJLY :.CAS.T:..DI S ..M 3 X36$ 3..$...... 9.. ::»
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H?2 HBS O 467; ;.;:4 12:< ; 49;`12 -
D ::.:.:: >:... : S .Za 55.;.GAL YS ;CLS::.:TiZN..ER-4RASH 36X58. .7:::ML BLK ; _ 5$ 8...........:::: 9..... .... -. ;: .;:,.::.:.-: :._:::.:::::.:::.
D S ::..;-. 540..CT RKADV<;;3�AP.KIN 1JI:.SP.;:.:XPRESSN.AP::.WHT;': ,' DX900, 3346.$... ..._59.. 6.. 59..26 .
7:?SS1;R24 0191516 ::::3.99:>: :::>::>::.. ... ;;::;. ::
D ONLY 5-0 OCT::,:: YSTRNZ: STRAW:.::PLAS..WRPD:::::JM80 STRP 7.7:5YSTWJ . .... . .
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14 2
4::. 47 217 3: :
7B . 5 9
D :.: NO 14flOCT ..R..OWN:; :`;.::WRAP .I3RY: WAX:>;5NDi�I<I:;CH .. ...... :. _.. ... ... _........ ....: ,
----------
GROUP,,*,TOTAL**** 220.29
CHEMICAL:. .:.::.. ...' -. _..
98
.2': 0658011:: 3.9 " :9.8<::
CS. 3. 3.:bOZ.>:.: EYS:TON 'C'LEANER I)EGRSR;::HGH::.TM�::>C�RL RTU._ 6i00b.3. 3
*
GROUP TOTAL* * 39,.,98..... ._
ACKER :.LETTUCE. E�F.iAF'.:.BE'tmTER':,::BRG.R
NIC I >:: :;
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SSYS ::CLS:.:SALAD* COLESLAW ORTG: III XTE::::.... _.201x.34 5452975:::::.3
_.. .. 38.80::: `::::: :::._:<>::..::;::':: ==_:=:-_ .>:_=>�:;:;: :;>-_-:_->:=_
...
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4. 4 2 „. <:
LMP:::T MATO. _ LI:.CED..1 4.. «::-::::..44 :51.: 61.376 3:.:....:3 . ... 3. . .
GROUP.:...TOTAL......................:.. T,S :. 4.::.:..; .......
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E:T:. ,:.;:::,:0:4.24. 1.0 27 . 46 .7 :12.> :: 7:1» 12::::.:;:::: .: _ -
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GROUP TOTAL*****.......... .. .1..�.a 2
GE::;:.;:; 4.0;;
MIS RG S :.. HG5::FOR FUEL..SURCHAR
..::.::..:
P.O. BOX 7137
z 1 316 10.5 235 INDIANAPOLIS IN SUB
R IMPORTANT: PERISHABLE PRODggUCTS ARE NOT ELIGIBLE FOR RETURN g gAFTE H206-7137 TOTAL
e FOOR ANY SHORI'SAGE AFTER YIOU INVOICE ESIGNED IPIEC ST RECEIVE OO MUS TE
TAX
DRIVER'S NO. PCS OUST. NO. PCS TOTAL
SIGN DELVD SIGN REC.
INVOICE
I TTH7FH OP RZZII ggEEHHppAgggg��yyEE ggqq��GGCCRRIIII LT�rruuR L ��OTTMMHHMMEEO DEI7IIESS LgIg7EEDGo THI INVOICMEMAOF�F�T IgEOLQ UB Eg C37p OU g7�{CE gg7gAE77`U7)''ORY E7RgUEg`T�E p TOTAL
THESE �OMMODITIESTf1� AIC AFTRUSTP LLAIMAOVE RATH�ryCSULT IqqLL COT ESQ LSN ET �R ESID90RC0 TER PRODRT PAYABLE ON OR BEFORE
E E �MMODI AL I V IT
O O 7H UC S
DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PRCCEEOS FROM THE SALE OF THESE COMMODITIES UNTIL ONT• ON PAGE 3
o FULL PAYMENT IS RECEIVED.
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
,pm come from OAT�
CUSTOMER::;, -INVOICE NUMBER 'il"O
BROOKSHIRE GOLF CLUB... l®C�®®
12120 BROOKSHIRE PKWY o7 TR CK St" 412940 509160829 8 3
SYSCO INDIANAPOLIS, LLC /014
CARMEL IN 46033 4000 W 62ND ST f3OuJE:::
R
ST.:fnfF aaA x
INDIANAPOLIS, IN 46268 NCES: ARE SUBJF�+��:�To R�A+�i��Eli4�Rnff'
317-846-7431 D�E FRIDAY 4 WEEK AFTER RDER
MANIFESTt RMAT. QFJJ WRY
CITY OF CARMEL IMA* SN13-9- GARY LEVERENZ
1 CIVIC SQUARE DRIVER: AYERS, AARON
CARMEL N 46Q32 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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N' r • CLOSM 2 fJO PM T T.
AqF qpI IT JLJR rimp rpnqq w OP N: 7:UU AM I .. ;
v P.0• BOX 7137
A
2 INDIANAPOLIS IN SUB
IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTEF 4206-7137 TOTAL 1156.00
D E F
MA
5o8 DELIVERY. PLEA INVOICE,,WE WILL NOT RECEIVED 34 27.6 AGE
TH V , M
2E 6 FOR ANY SHOR AGE AFTER U HAVE GNED. PIECES RECE T TAX
v— '�CllIGN TOTAL
PCS No. PCs
DRIVER'S us,. NO.
INVOICE
SIGN
I TH 10� .AA�4SLTXJLC�o
E
� RrN JIS R-JNV?'OC0� T1gLD dJfi;
pTE g3e, 'Fy� R?j
TOTAL 1156.00
THESE
�gj �XAlA T UT LAM RH SkCOODI IES, IllS ois-o g�IN%&' SPAYABLE ON OR BEFORE
,
COM-ODITIESAND ANY RECEIVABLES OR PROCEEDS I DERIVED FROM THESE IDS FR M THE SALE OF THESE COMMODITIES UNTIL 10/16/15 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))
09/16/15 509160829 Food $1,156.00
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
$1,156.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1207 I 509160829 I 42-390.40 I $1,156.00 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
Friday, September 18, 2015
Director, Brookshi Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund