316635 9/29/2017 CITY OF CARMEL, INDIANA VENDOR: 365677
ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CHECK AMOUNT: $*****1,000.33*
:? r° CARMEL, INDIANA 46032 PO Box 88029 CHECK NUMBER: 316635
v CHICAGO IL 60680-1029 CHECK DATE: 09/29/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 926098932 1,000.33 OTHER EXPENSES
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Gordons P.O.Box1787 INVOICE
GrandRapids,MI 49501-1787
FOOD SERVICE STORE www.gfs.com C:E#=:=DATE
1-800-968-7500 926098932 09/14/2017
TAIL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE MP# MP LOCATION TERMS
N 100060884 1906 INDY-FISHERS IN MP153 OUT# 1905 Fishers 30 Days Terms-Prox
10th
SHIP TO: Carmel Fire Department
2 Civic Square
Carmel,IN 46032
ITEM CODE CITY DESCRIPTION CAT COST GUIDE SPECS UNIT PRICE TAX AMOUNT
4173500 17 CASE FRANKS BEEF 8/#2-5#GFS 3 15.49 30.98 526.66
1526810 1 CASE MILK CHOC FF 40-8FLZ TRUMOO 6 14.99 14.99 14.99
6058910 89 CASE 1-16CT HOT DOG BUNS MARKETPLACE 1 2.59 2.59 230.51
5252351 3 EACH TBLCVR PLAS WHT 40'X100'4CT GFS 7 12.99 38.97
5426601 6 EACH COOKIE CHOC CHIP 8-54.6Z CHPAHOY 1 10.99 65.94
4988831 3 EACH NAPKIN LNCH 1PLY 1/4 FLD 12-50OCT GFS 7 4.29 12.87
6965440 1 CASE KETCHUP BOTTLE PLAS SQZ 9-64Z GFS 1 2.89 25.99 25.99
1142781 3 EACH PLATE PPR 9"ECON WHT 12-100CT KE 7 3.29 9.87
8550100 1 CASE MUSTARD YELLOW PREP 6-40Z GFS 1 3.13 18.79 18.79
8371050 1 CASE COOKIE OREO SUPERCRTN 6-52.5Z NAB 1 9.29 55.74 55.74
PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 1000.33
1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD
396.97 526.66FRTAX
EE2FR COOLER WAREHOUSE MISC. TOTAL
5-POULTRY 6-DAIRY 7-DISPOSABLE SSANITATION Customers signature evidences receipt of all items listed and its promise to pay
the amount due to GFS.Customer agrees that if a check,draft and/or order of INVOICE TOTAL 1000.33
14.99 61.71 payment("Transaction")issued for payment of this invoice is dishonored,GFS
9-DISP.BEVG 10-PRODUCE 11-TABLETOP 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 pemlitted by law. PAID 0.00
TOTALS BY TAX CATEGORY Received By: SALE NBR 53
%RATE TAX %RATE TAX / } � LANE NBR 02
The perishable agricultural commodities shown on this invoice are sold subject to the / USER ID
statutory trust aulhonzed by section 5(c)of the Perishable Agricultural Commodities
Act,19301 U.S.0 499e(c)).The seller of these commodities retains a trust claim over DATE 09/14/2017
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 GARY TIME(GMT) 11:11:00
full payment is received.Eggs delivered in the stale of Illinois include an Illinois Egg Signature:
Inspection Fee in the price.Maryland MDA Inspection Fees at a rate of$.08 Par dozen
*A....e.,.---fa,H..I _ .. ..-- .. . .. .-, ---__...r...---"-;A f-lo-after the due date