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Home My WebLink About326403 06/15/18 .'4�� ,p'yf CITY OF CARMEL, INDIANA VENDOR: 359366 ® ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****1,406.30* f9� ?�; CARMEL, INDIANA 46032 PO BOX 7137 CHECK NUMBER: 326403 .y��oN,.�. INDIANAPOLIS IN 46206-7137 CHECK DATE: 06/15/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 138549358 1,406.30 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 359366 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER SYSCO FOOD SERVICES IN SUM OF$ CITY OF CARMEL PO BOX 7137 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. INDIANAPOLIS, IN 46206-7137 Payee $1,406.30 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 138549358 42-390.40 $1,406.30 1 hereby certify that the attached invoice(s),or 6/7/18 138549358 Food $1,406.30 1207 101 1207 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday,June 11,2018 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer IIIIIIII IIIIIIIIIIiIIIIIIIIIIIIIII IIIIIII CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO IIIIIIIIIIIIIII IVIIIVIIIIIIIIIIIVIIIII s II VIII VIIIVIIIII IVIIIIIII' DEL6/Q /18 I.CUSTOMER INVOICE NUMBER :Y PAGE t > BROOKSHIRE GOLF CLUB+++ Apo ef TRUCK saoP S come 412940 138549358 8 1 12120 BROOKSHIRE PKWY \1 /008 CARMEL IN 46033 , SYSCO INDIANAPOLIS, LLC ROUTE PURCHASE ORDER 4000 W 62ND ST b 317-846-7431 INDIANAPOLIS, IN 46268 7742 TERMS -PAST DUE BALANCES ARE suBSECT xo SERVICE CHARGE a DUE FRIDAY 4 WEEKS AFTER ORDER �. BROOKSHIRE GOLF SHELLFISH SHIPPER ID: IN007RS JMANIFEST# 619978 NORMAL DELIVERY 10row 12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ 0 CARMEL IN 46033 SSZE [ ITEM DFiSCRIPTZON ITEM; UNIT" TUNIT EXTENDED A .P INVOICE•AD,TUSTMENTS' T`5CODE Z?RICE AMOONT' PRICE X ? CODE QTY *** GET SIZZLING SOLUTIONS FOR YOUR SUMMER NU AT SY COFOOD E COM ** . SK..,,YOUR MA.ABOUT S SCSCOACCOU�ITCENTER COM;, & H 'W YOU,,,; EARN CRE17,I ON; YOUR;: OUNT! .....; pAIRY C 3S NL LB; BRLCLS CHEESE.;AMER !12fl ,S;LZ YEL 28131" 6697114 • 7 26 51.?8 F 4$ OZ LU'BNY ICE CREAM BAR _gRANGE .....:0007,0640304693, :'1666148 19 28 19.28' 0 • z I 'S 2.4 4..5 .OZ B,LV BNY ICE CREAM SNDWCH,CHIPNF!:00070640310821, 1595487 25 27 50 54In' a F1 S 24 OZ ZCLS. ICE ITALIAN ;CHERRY TUBE 22430 ;2560324 ' 22 29 22,29 y 0 F S 24 OZ ZCLS ICE ITALIAN. LENlOI..TUBE 22410 560316 21.58 21,58; GROUP TOTAL**** 165.47 *** MEATS *** ... .... F S 6::0 .3 OZ T BEEF PATTY GRD SEA HS FRZi 7?Q3003 6964597 : 73.86 147.721: ......... SULE BRATWURST CKD ULTIMATE! 5X1 ii 101558 .2116860 43.32 86.64' 0 0 BRLCLS FRANK ALL—MEAT 5X1' 6 ZN : 7486506792 1137736 ..:29:30..? 117..20: GROUP TOTAL**** 351.56 *** FROZEN *** F �1. 'S 1 00 G YS Imp'...APTZR SPANAKOPITA 6986178 6986178 60.45 60:45! °- F ." 1 160 77 OZ _CIiOR.. APTZR SPINACH CHIP DIPPER 1000Q04534 ,:4435`782 62 4Q ': 62:40: A .. ..... P F 1 611 LB SYS SMP POTATO FRY SKON .3/8 P :1073473040:9594 1998:907 37.21 GROUP TOTAL**** 160 06 ***.....CANDIED & DRY '*** z D 1' 2 0 CT< YS': CHIP VARIETY, BKD .. 92268 4$30455 27.51 : 27.51' 0 2160 CT YS''. CHxP VARIETY SYSCO/FRITO LAY 3;1831 6586721 .27.51 S5.02 d l S 12 5 202 ROPCNA' JUICE .CRNBRX CKTAIL PET 00864 4760062 22:75.. 22.75 "x D6 S 24'.SLTRPURLIFE WATER PURIFIED 12273782 : 810$847 5.99 :'. , 35.94' K CASES SPLIT rOT.PCS CUBE GROSS WT. OPEN.11:00 AM CLOSE• 2:00 PM REMIT TO:- ' n P.O. BOX 7137 26 3 29 19.5 412 INDIANAPOLIS, IN SUB 46206-7137 TOTAL TAX DRIVER'S NO. PCS CUST.sxos®xervox�evxaexcss oe naa xxsns N0. PCS TOTAL SIGN DELVD. SIGN v REC. INVOICE A TOTAL IMPORTANT PAC&PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE UTHORIZED BY SECTION 5 (C) OF THE PERISHABLE AGRICULTURAL CO[MIODITIES ACT 1930 V.S.C. 499EN,. THE SELLER OF THIS COMMODI TAINS A TRUST CLAIM OVER THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES,WD CONT. ON PAGE 2 SPECT TOCANY DISPUTE ARISZNGIVABLES OR SFROM OUTIOFTHE YOUR RRECEIPT OFETHESEODITIES PRODUCTS%SEAVTIL ICES AOA ARELL PAYMENT ZGIVING UPDYOUR RIGATYOU AGREE TO SERVE INTANY PRESENTATIVE CAPACITY,OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS, ANY LAWSUIT INVOLVING ANY SUCH DISPUTE. IIIIIIIII IIIIIIIIIIIIIIIIIIIillllllllllllhl1111111111111111111111111111111llll IIIIIIIIII IIIIIIIIIIIIIIIIII CUSTOMER'S DATE ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF sYSCO I N 4 1 2 9 4 0. 1 3 8 5 4 9,3 5 ood41ngS 2 V 6/07/18 BROOKSHIRE GOLF CLUB+++ e from TRUCK STOP 412940 138549358 8 2 /008 12120 BROOKSHIRE PKWY fScom�/SCO SYSCO INDIANAPOLIS CARMEL IN 46033 LLC ROUTE PURCHASE ORDER 4000 W 62ND ST b 317-846-7431 INDIANAPOLIS, IN 46268 7742 TERMS -PAST DUE:,BALANCES JE ARE SUBCT To SERVICE CHARGE DUE FRIDAY 4 WEEKS AFTER ORDER h BROOKSHIRE GOLF SHELLFISH SHIPPER ID: IN007RS MANIFEST# 619978 NORMAL DELIVERY a 12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ °z CARMEL IN 46033 °e ITEM: UNIT �'IT EXTENDED T p INVOICE:ADJUSTMENTS y o ,4r7t a PACK SIZE ITEM'DESCRIPTION xAx r CODE i :PRICE ANODNx PRICE z I CODE• QTY GROUP TOTAL**** 141.22 DISPOSABLE *** S 12 0 CT',. SYS REL• CUP PLAS TRANS 1602 SOFT YE160SYS .': 7358304 99.48' l�1 S 1 8IN YS ;CLS FILM P`7C ROLL 2000FT SLI CUTR ;9060 0496034 33 10; 33 10 D S:V .1 � 51000.T SYS CLS FORK PLAS BLK MEDHVY MDLNGT YMWFESYS ( 8003370 62 4AJ S 4 ,25CT SYS IMP"'PLATE PLAS BLK IMPACTIIO 25 PIlOESYS ! 2818110 158.47 158.47': . . GROUP TOTAL**** 353.33 *** ;CHEMICAL ,t** N 0 1 • .S ,3Q .60Z YSTON„CLEANER•DEGRSR HGH TMP GRL• R 6100632 0658:011 39.98• GROUP TOTAL.* 39.98 *** PRODUCE *** _BRLIMP SALAD CHICKEN 5',1071 ';.2510717 47.77 j• ;;47 77 a C 1 CS:::,: ;2 LB:: ,BRLIMP SALAD, TUNA ALBACORE 51194 ;; 2511'947 49 60, • ,• 49.60 GROUP TOTAL**** 97.37 *** 'DISPENSER *** N ..............._ u, 0 .S 1 .5 INMAID ,SYAU-P LEMONADE BIB 16760298 89.08.832 48.63 ;48.63! S 12.5GALGLDPEAR SYRUP TEA CON UNSWT BLK PR 0225:0298 .:; 7065776 .93.98;` GROUP TOTAL**** 92.61 MIS. CH ARGE S CHGSIFOR FUEL .SURCHARGE ' 4,.70 :I * a a ORDER S UMMA RY 74029 ' d �n ... .... ,. H CASES SPLIT OT.PCS CUBE GROSS WT. OPEN:11:00 AM CLOSE: 2:00 PM REMIT To P.O. BOX 7137 9 9 7.1 143 INDIANAPOLIS, IN SUB 46206-7137 TOTAL 1406.30 35 3 38 26.6 555 TAX DRIVER'S NO. PCS CUST.sxeeav I-saxov 9 or.••-xmu NO. PCS TOTAL SIGN DELVD. SIGN X REC. INVOICE TOTAL 1406.30 [TAXNS TANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE RIZED BY SECTION 5 (C) OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (U.S.C. 499E(C)I. THE SELLER OF THIS COMMODI A TRUST CLAIM OVER THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER BPRODUCTS DERIVED FROM THESE COMMODITIES ')/06/18 LAST PAGE NY RECEIVABLES OR PROCEEDS FROM THE SALT OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.FURTHER YOU AGREE WITCT TO ANY DISPUTE ARISING OUT OF YOUR RECEIPT OF THESE PRODUCTS/SERVICES: YOU AAE GIVING UP YOUR RIG(iT TO SERVE IN ANY SENTATIVE CA TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.