HomeMy WebLinkAbout325745 05/30/18 CITY OF CARMEL, INDIANA VENDOR: 365677
i. ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CHECK AMOUNT: $********27.43*
CARMEL, INDIANA 46032 PO Box 66029 CHECK NUMBER: 325745
v "oN CHICAGO IL 60680-1029 CHECK DATE: 05/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 926108429 27.43 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 365677 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
GORDON FOOD SERVICE, INC IN SUM OF$ CITY OF CARMEL
PO BOX 88029 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.
CHICAGO, IL 60680-1029
Payee
$27.43
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
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
926108429 42-390.40 $27.43 1 hereby certify that the attached invoice(s),or 5/22/18 926108429 Food $27.43
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
Tuesday, May 22,2018
Et
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
120—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Page:1 of 1
Gordon P.O.Box1787 INVOICE
GrandRapids,MI 49501-1787
FOOD SERVICE STORE www.gfs.com INVOICE III DATE
1-800-968-7500 926108429 05/22/2018
TAL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE MP# MP LOCATION TERMS
N 100133245 4040 73406 1905 Fishers Net 30 Days
KRIS MILLER#73406
SHIP TO: Brookshire Golf Club
12120 Brookshire Pkwy
Carmel,IN 46033
ITEM CODE QTY DESCRIPTION CAT COST GUIDE SPECS UNIT PRICE TAX AMOUNT
7133401 1 EACH TORTILLA FLOUR 10"SFST 12-12CT GRSZ 1 2.69 2,69
7133701 1 EACH TORTILLA FLOUR 12"SFST 12-12CT GRSZ 1 3.29 3,29
7628611 2 EACH EGG SCRMBD LIQ MIX W/MILK 15-2#GFS 6 2.99 5.98
2484101 1 EACH NUTRI-GRAIN BAR APPLE-CINNAMON 1 6.99 6.99
6945801 1 EACH APTZR MOZZ STIX BRD BKABLE 6-2#GCHC 2 5.99
5.99
7801701 1 EACH GRILL BRICK IW 12CTACS 7 2.49
2.49
PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 27.43
1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD
12.97 5.99 FREEZER COOLER WAREHOUSE MISC. TOTAL TAX
5-POULTRY 6-DAIRY 7-DISPOSABLES 8-SANITATION
Customers signature evidences receipt of all items listed and its promise to pay
5.98 2.49 the amount due to GFS.Customer agrees that if a check,draft and/or order of INVOICE TOTAL 27.43
9-DISP.BEVG 10-PRODUCE 11-TABLETOP 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. PAID 0.00
TOTALS BY TAX CATEGORY Received By:
SALE NBR 195
%RATE TAX %RATE TAX LANE NBR 03
The perishable agricultural commodities shown on this Invoice are sold subject to the USER ID 73448
statutory(rust authorized by section 5(c)of the Perishable Agricullural Commodities \
Act,1930 V U.S.0 499e(c)).The seller of these commodities retains a trust claim over DATE 05/22/2018
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 TIME(GMT) 11:31:00
full payment Is received.Eggs delivered in the slate of Illinois include an Illinois Egg Signature:
Inspection Fee in the price.Maryland MDA Inspection Fees at a rate of$.08 per dozen