317599 10/19/2017 CITY OF CARMEL, INDIANA VENDOR: 365677
u„ CHECK AMOUNT: $""`""'27z 47`
ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CHECK NUMBER: 317599
CARMEL, INDIANA 46032 ao sox aaozs
' CHICAGO IL sosao-iozs CHECK DATE: 10/19/17
9
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 -53.98 OTHER EXPENSES
851 5023990 926098971 220.81 OFOODR&EXPENSES
BEVERAGES
1207 4239040 926099577 83.64 PROMOTIONAL FUNDS
1120 4355100 926100109 22.00
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i'
Gor onf P.O.Box1787 INVOICE
FOOD SERVICE STORE www gfsapcom MI 49501-1787 INVOICE# DATE
1-800-968-7500 926098971 09/15/2017
TAL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE ll 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
6755401 1 EACH CANDY VAR PK FS 6-30CT HERSH 1
19.99 19.99
5426601 3 EACH COOKIE CHOC CHIP 8-54.62 CHPAHOY 1
10.99 32.97
4173501 1 EACH GFS FRANKS 8/#ALL BEEF 2-5# 3
15.49 15.49
3573201 1 EACH HERSHEY FUND RAISING ASST MAX 1
33.99 33.99
4173500 2 CASE FRANKS BEEF 8/#2-5#GFS 3 15.49 30.98 61.96
6058910 13 CASE 1-16CT HOT DOG BUNS MARKETPLACE 1 2.59 2.59 33.67
1051821 6 EACH COOKIE OREO 12-14.3Z NAB 1 3.79 22.74
PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 220.81
1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD
143.36 77.45 F::: cooLea I Wu Ifouse I MUSIC. Toru TAX
5-POULTRY 6-DAIRY -DISPOSABLE 8-SANITATION
Customers signature evidences receipt of all items listed and its promise pay
the amount due to GES.Customer agrees that if a check,draft and/or orderer of INVOICE TOTAL 220.$1
9-DISP.BEVG 10-PRODUCE 11-TABLETOP payment(Transaction')issued for payment of this invoice is dishonored,GFS
may represent the Transaction and issue a draft against the account upon
which the Transaction is drawn for a fee up to the maximum permitted by law. PAID 0.00
TOTALS BY TAX CATEGORY Received By: SALE NBR 41
%RATE TAX %RATE TAX
�V/ LANE NBR 04
The perishable agricultural commodities shown on this invoice are sold subject to the USER ID
statutory bust authorized by section 5(c)of the Perishable Agricultural Commodities
Act,1930(7 U.S.0 499e(c)).The seller of these commodities retains a trust claim over DATE 09/1512017
these commodities,all inventories of food or other products derived from these
commodities and any receivable or proceeds from the sale of these commodities until ANN TIME(GMT) 09:08:00
full payment is received.Eggs delivered in the state of Illinois include an Illinois Egg Signature:
Inspection Fee in the price.Maryland MDA Inspection Fees at a rate of$.08 per dozen
nHur fhc H.-HAtp.
09/15/1709:1 Credit Detail Report Page: 1
i Store #:1905 Fishers rpt/cred rpt.p
Create Last Sent Cred Corp
Customer Invoice Credit ID Date Date Verif # Type Origin Memo # Edits
-------------------------------------------
100060884 Carmel Fire Depa 926098971 154286 09/15/2017 09/15/2017 0 CUST ST 0
Unit $ Ext $ P Actual Emp
Type # Item Description Qty Weight Value Value Reas U Item ID Edits
----------------------------------------------------------------------------------- ------------------------------..--11----------
M 1 6755401 CANDY VAR PK FS 6-30CT H 1.00 0.00 19.99 19.99 89 0 0 55136 Q 4 Vt1`Q
M 2 3573201 HERSHEY FUND RAISING ASS 1.00 0.00 33.99 33.99 89 0 0 55136
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Page:1 of 1
Gordon P'O.Box 1787 INVOICE
GrandRapids,MI 49501-1787
FOOD SERVICE STORE ww.gfs.com INVOICE# DATE
1-800-968-7500 926100109 10/13/2017
TAIL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVEMP# 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
2415711 4 EACH CUP FM 16Z 40-25CT DART 7
2.29 9.16
4593991 1 EACH SIP LID/14Z,16Z,20Z FM CUP WHT 7
2.99 2.99
7489001 1 EACH STIRRER 8"UNWRPD RED 10-50OCT KE 7
2.29 2.29
4733591 4 EACH GFS CREAMER CANISTERS 9
1.89 7.56
PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 22.00
1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD
FREEZER COOLER WAREHOUSE .-C.MC. TOTAL TAX
5-POULTRY 6-DAIRY -DISPOSABLE S-SANITATION 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 22.00
14.44 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 permitted by law. PAID O.D
0
0rRA7.56
TOTALS BY TAX CATEGORY Received By: SALE NBR 158
TE TAX %RATE TAX LANE NBR 04
The perishable agnoultural commodities shown on this invoice are sold subject to the USER ID 71600
statutory trust authorized by section 5(c)of the Perishable Agricultural Commodities
Aa,1930(7 U.S.0 499e(c)).The seller of these commodities retains a trust claim over DATE 10/13/2017
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 MARK TIME(GMT) 13:53:00
full payment is received.Eggs delivered in the state of Illinois include an Illinois Egg Signature:
Inspection Fee in the price.Maryland MDA Inspection Fees at a rate of$.08 per dozen
_____'Acceptance constitutes agreement to_a time price differential of 1 1/2%per month on the uQpaid balance a--------------------------
G
er the due date _____________
PLEASE CUT ALONG THE DOTTED LINE PLEASE CUT ALONG THE DOTTED LINE
THEN RETURN BOTTOM PORTION. THANK YOU FOR YOUR ORDER. THEN RETURN BOTTOM PORTION.
VV PLEASE ENCLOSE THIS STUB WITH PAYMENT.
Gordon Food Service,Inc.
P.O.BOX 88029
Chicago,IL 60680-1029
PAY THIS AMOUNT
CUSTOMER# INVOICE# DATE
22.00
100060884 926100109 10/13/2017
111111111111U 1111111 100060884210926100109000002200400000220044
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