251087 11/04/15 1y p,Ggq�f
CITY OF CARMEL, INDIANA VENDOR: 365677
® ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CHECK AMOUNT: $*'******21.47*
CARMEL, INDIANA 46032 PO BOX 88029 CHECK NUMBER: 251087
vM�ruri � CHICAGO IL 60680-1029 CHECK DATE: 11/04115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 926071745 21.47 FOOD & BEVERAGES
(,',81ordory
FOOD SERVICE STORE
Fishers
9540 Masters Rd
Indianapolis, IN 46250
(317) 845-0712
Invoice
A/R Inquiries 1-800-968-6490
Customer Service 1-800-968-4164
www.gfs.com _
BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PKWY
CARMEL,IN
100133245
Invoice Number 926071745
Invoice Date 10/20/15
Terms: Net 30 Days
Bag Rclsble Sandwc 7.99
4154401
Onion Ring Beer Bt 7.49
1436411
Fries RC 3/8" Slth 5.99
4372401
TAX 0.00
*K-*m BALANCE 21 .47
GFS Charge 21 .47
CHANGE 0.00
TOTAL NUMBER OF ITEMS SOLD = 3
10/20/15 02:31pm 1905 4 195 65122
IIII illlill I IIIII III 11111111 IIIII
80190500401951510201431
Total Due: 21 ,47
Customer acknowledges receipt of -the
goods referenced above and promises to
pay to the order of GFS the total due
pursuant to the Customer's Account
Application Agreement
Customer agrees that if a check draft
and/or order of payment
(Trans 8rfion) issued for payment of
this invoice is dishonored, GFS may
re-present the Transaction and issue a
draft against the account upon which
the Transaction is drawn for a fee up
to the maximum permitted by law.
The perishable agricultural
commodities shown on this invoice are
sold subject to the statutory trust
authorized by section 5(c) of the
Perishable Agricultural Commodities
AP--1930 (7 U. SSC. 499e(c)). The
ase' 1�=_r of_these commodities retains a
trust over these commodities, all
inventories of food or other products
derived from these commodities and any
receivable or proceeds from the sale
of these commodities until full
payment is received.
Store 1905 Lane 4
Transaction 195 Operator 65122
VOUCHER NO. WARRANT NO.
ALLOWED 20
Gordon Food Service, Inc.
IN SUM OF$
P.O. Box 88029
Chicago, IL 60680-1029
$21.47
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 926071745 I 42-390.40 I $21.47 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
Wednesday, October 21, 2015
/4"/-
Director, BrookWe Golf 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))
10/20/15 926071745 Food $21.47
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