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251356 11/04/15 ti u�'"q'�1,. u, CITY OF CARMEL, INDIANA VENDOR: 365677 *�;*;;** k �� CHECK AMOUNT: $ 29.55 .�; ei•, ,ONE CIVIC SQUARE GORDON FOOD SERVICE, INC ice: CARMEL, INDIANA 46032 Po Box 88029 CHECK NUMBER: 251356 9q,�`TON�� CHICAGO IL 60680-1029 CHECK DATE: 11/04/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 926072172 16.07 FOOD & BEVERAGES 1207 4239040 926072173 22.26 FOOD & BEVERAGES 1207 4239040 926072268 26.77 FOOD & BEVERAGES 1207 423904.0 CK249269 —35.55 FOOD & BEVERAGES i I/d Gordon 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 926072173 Invoice Date 10/30/15 Terms: Net 30 Days Onion Ring Beer Bt 7.49 1436411 Fries RC 3/8" Slth 5.99 4372401 24Z WHITE RND TOP 1 .79 2160970 Jumbo Spanish Onio 6.99 5473361 TAX 0.00 **** BALANCE 22.26 GFS Charge 22.26 CHANGE 0.00 TOTAL NUMBER OF ITEMS SOLD = 4 10/30/15 01 :08pm 1905 4 47 66090 IT 111111111111111111111111111111111111111111 80190500400471510301308 Total Due: 22.26 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 �L'�� ,-'V _� Customer agrees that if a check draft and/or order of payment (Transaction) issued for Payment of this-invoice is-dishonored, GFS mdu- 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 6(c) of the Perishable Agricultural Commodities Act, 1930 (7 U,S,C. 499e(c)). The seller 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 47 Operator 66090 Gordon" FOOD SERVICE STOKE 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.efs.com BROOKSHIRE GOLF CLUB 12120 BROOKSHIRE PKWY CARMEL,IN 100133245 Invoice Number 926072268 Invoice Date 11/02/15 Terms; Net 30 Days Roma Tomatoes 1-51 9.99 1848101 Fine Shred Mex Che 12.49 3261351 Romaine Hearts Let 4.29 2117821 TAX 0.00 *** BALANCE 26.77 GFS Charge 26.77 CHANGE 0.00 TOTAL NUMBER OF ITEMS SOLD = 3 11/02/15 02;07pm 1905 2 81 65122 III11111111111111 IIII IIIIIIIIIIII 80190500200811511021407 Total Due; 26.77 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 (Transaction) 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 Act, 1930 (7 U.S.C. 499e(c)), The seller 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 1906 Lane 2 Transaction 81 Operator 65122 ' 1 Go, rdon, FOOD SERVICE SWORE Fishers 9590 Masters Rd Indianapolis, IN 96250 (317) 895-0712 Invoice A/R Inquiries 1-800-968-6990 Customer Service 1-800-968-9169 www.gfs.com BROOKSHIRE GOLF CLUB 12120 BROOKSHIRE PKWY CARMEL,IN 100133295 Invoice Number 926072172-- Invoice Date 10/30/15 Terms; Net 30 Da9s 2 @ 5.29 . Juice Orange 1-1Ga 10.58 6936711 Cran Juice 100% 1- 5.99 5792301 TAX 0.00 * ** BALANCE 16.07 GFS Charge 16.07 CHANGE 0.00 TOTAL NUMBER OF ITEMS SOLD = 3 10/30/15 12:90pm 1905 3 191 69856 VIII IIII�IIII IIIIIIIIIIIIIIIIIIIII IIIIIII 801905010301911510301290 Total Due: 16.07 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 (Transaction) 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 1trust " authorized by section 5(c) of the Perishable Agricultural Commodities Act, 1930 (7 U.S.C. 999e(c)). The seller 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 3 Transaction 141 Operator 61856 Gordon Food Service Q.0 PO Box 1787 FOOD SERVLCE Grand Rapids, MI 49501-1787 Credit Memo CK249269 Phone: 1-800-968-6490 Fax: 616-717-9047 Date 9/28/15 Email: cheri.zokoe@gfs.com Customer Accounts Receivable Representative 100133245 BROOKSHIRE GOLF CLUB Cheri Zokoe L 1906/90 BROOKSHIRE GOLF CLUB 1 CIVIC SQUARE CARMEL IN 46033 In applying your check#249269, received on 9/28/15, we noticed the following discrepancy: ® Invoice 4926069688 for $35.55 was paid a second time. On 9/15/15 check#1301034 included invoice 826069688. It wasp aid a second time on the above mentioned check. We have left a credit memo of $35.55 on your account as reference number CK249269. Please indicate that number when deducting. Thank you. VOUCHER NO. WARRANT NO. ALLOWED 20 Gordon Food Service, Inc. IN SUM OF $ P.O. Box 88029 Chicago, IL 60680-1029 $29.55 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 CK249269 42-390.40 ($35.55) 1 hereby certify that the attached invoice(s), or 1207 926072173 42-390.40 $22.26 bill(s) is (are)true and correct and that the 1207 926072172 42-390.40 $16.07 materials or services itemized thereon for 1207 926072268 42-390.40 $26.77 which charge is made were ordered and received except Tuesday, November 03, 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)) 09/28/15 CK249269 Food ($35.55) 10/30/15 926072173 Food $22.26 10/30/15 926072172 Food $16.07 11/02/15 926072268 Food $26.77 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