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Home My WebLink About303773 09/30/16 ♦�w'Cggf CITY OF CARMEL, INDIANA VENDOR: 359366 ® ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****"'822.63` r_. Q CARMEL, INDIANA 46032 PO BOX 7137 CHECK NUMBER: 303773 INDIANAPOLIS IN 46206-7137 CHECK DATE: 09/30/16 t�ON DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 609220738 822.63 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) SYSCO FOOD SERVICES ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 7137 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service INDIANAPOLIS, IN 46206-7137 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $822.63 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Brookshire Golf Course Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 609220738 42-390.40 $822.63 I hereby certify that the attached invoice(s),or 9/22/16 609220738 Food $822.63 1207 101 1207 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday,September 23, 2016 1A I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and 1 have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer GoodtHngs CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO me from BROOKSHIRE GOLF CLUB... IS 12120 BROOKSHIRE PKWY /SCO : `T�::e >`S' "' 412940 609220738 7 2 SYSCO INDIANAPOLIS LLC CARMEL IN 46033 4000 W 62ND 5T .... LIS IN 4 INDIANAPOLIS, 626 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER SHELLFISH SHIPPER ID: IN007RS MANI hl 010 CITY OF CARMEL 1 CIVIC SQUARE DRIVER: KIMBLE IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE i:........::::::;:::;:..::::5::i:::c:i:::::::::i:::;::::<:;2:::::.'::::i::>:;;:i:::::i::;::i:::;i:::i:::::is::::i:::<::i<:i:: i5::i::i::i::i:-: ::i::i::i::i::i::i:::i:::i:::5:: : ::i::i::i::i:::i:::;?:::i::::i::i::i::;::i::i:;:: :: :::::i::i:::::S::i :.�::::::::.::::::::::: .........:.......::::::::::.::::::.....:...:.:.....:::.,:..::..:.:......:......:......:::::::. ::::.... :..::..: : .. ...... ... :::.::::::::... ::::::::::::::::.:...:::::::::::::::::..:::::::::::::.::::.E fE1t4.:::.::.::::.:UNtT.::::::::::::::E3;iNESED......::.: S.......... T.:: .YS.::. .M ...PA :::.FAS.:::BLK:..:1.MPAC. .:.:.l.t#...: .S::.P1.. # YS::::::.2.81$. . 0:::. .37...:4 .::::.::.....:::.::::::..::::::::.1 ... . ..... .........:..._:::::::::::::::::::::..:.::::..:::::.::::::::::........ :::::::::::.. .......................................................................................... . . :..:BS:............................1................ :7:.:47.::.:::..:::::... 254.44 GROi7P::TOTAL... * .......... .................................................. . .............................................................................. ................................................................................................................................................. ROME 111110 INNER�t�I�i�i�,RRODUC- ...... �... SAN:::GREEN...I<`€SVG...TR1I��;D.;::FR�...3..$.1�91##.......�.$10� 0.......�4...9 ..................................��...95................-,...._.-..........-----��---,.........----------...... 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I P.O. BOX 7137 1 7 3.7 66 INDIANAPOLIS IN AB R IMPORTANT: PERgISHABLE PRODSUCTS ARE yN�OT ELIGIBLE FOR REggTURNg�ggFTE 46206-7137 TOTAL 822.63 E 2 3 23 12.5 326 �ORIVANY SHOR SAGE AFTER YIOU HAVE E$IW EO(PIECES RECEI DD MUSTS TAX v NO. PCS OUST. NO. PCS TOTAL DRIVER'S DELVD. SIGN RSC. r,gTSHI7EG�.�NppE g��pAgg�yEgp�GCgICuryLTSu�RPLp�07MHM�OpEI7RIIES gLTEEpGORIrycU7LH�gRIgNLVpIC Lac UB O �•E A O UTC TOTALINVOICS 822.63 THESE RCOMMODITIESTROETAINCS AFTRUS7PCLAIMA VER THESETCOMMODI I� �5AL gINVE OF I I�V.� ogj� c 7 t ��5Uc1° PAYABLE ON OR BEFORE I DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 10/21/16 LAST PAGE o FULL PAYMENT IS RE CEIVEO. Good things CUSTOMER'S ORIGINAL INVOICE BROOKSHIRE GOLF CLUB... �come from ® 12120 BROOKSHIRE PKWY l/SCOSYSC 400W 0 ND62NDPSTIS, LLC CARMEL IN 46033 0 317-846-7431 INDIANAPOLIS, IN 46268 CITY OF CARMEL SHELLFISH SHIPPER ID: IN007RS 1_CIVIC SQUARE _-_ ***.F F F IOPEN: 7:00 AM ------------CLOSE: 2 UU ] 2 1 2 16 8.8 260 N DELIVERY. ° AN PLEARg'E CHECKPTHIgU NVOICREE yNyETWILG NOT BERFIEESPONNgI gp v FOR ANY SHORTAGE AFTER YOU HAVE SIGNED. PIECES RECEIVED MUS DRIVER'S NO. PCS CUST. NO. PCS gDRIVOER'S gg�yEgp� RC �uJ o� DELVD.UIH RISSLIGN MppRE gE� gCg7 gEcgTp 7 US7�{C' ggTgE77(IT7� �7yHER7EgCI�EgL�E THESERN I COMMODITIET�oEA�nCAF70Jy1.OD�IgA tj �GQ�SETLOMMO�IESDATLLSINVENTORIESI OF'FOOD90FCO7HERRPRODI 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UN' 0 FULL PAYMENT IS RECEIVED. 412940 609220738 -1.4. sD- I [. ...... P.O. BOX 7137 INDIANAPOLIS IN 4206-7137 CONFIDENTIAL PROPERTY OF SYSCO AL' 7 1 . ON PAGE 2