HomeMy WebLinkAbout327258 07/10/18 a�r_t�AM
CITY OF CARMEL, INDIANA VENDOR: 359366
4.,
ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $*****2,769.65*
CARMEL, INDIANA 46032 PO sox 7137 CHECK NUMBER: 327258
?y�TON INDIANAPOLIS IN 46206-7137 CHECK DATE: 07/10/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 138563004 1,002.90 FOOD & BEVERAGES
1207 4239040 138570060 1,537.47 FOOD & BEVERAGES
1207 4239040 138571543 229.28 FOOD & BEVERAGES
Prescribed by state Board of Accounts City Form No.201(Rev.1995)
VOUCHER NO. WARRANT NO.
Vendor# 359366 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
SYSCO FOOD SERVICES IN SUM OF$ - 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
$1,002.90
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
138563004 42-390.40 $1,002.90 1 hereby certify that the attached invoice(s),or 6/21/18 138563004 Food $1,002.90
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
Thursday,June 21,2018
1 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CUSTOMER 6/21/18INAL uN VrACE CONFIDENTIAL mirmPROPERTG OF SYSCO
Goothings
BROOKSHIRE GOLF CLUB+++ comefrom TAucE sxoP 412940 138563004 9 1
CARMEL
BROOKSHIRE PKWY S��sco� /009
CARMEL IN 96033 SYSCO INDIANAPOLIS, LLC RouTE PURCHASE ORDER
4000 W 62ND ST b
INDIANAPOLIS, IN 46268 7742 TERMS, PAST DUE;sALANCEs ARE sUBJECT so SERt/ZCE CHARGE
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
BROOKSHIRE GOLF
SHELLFISH SHIPPER ID: IN007RS IMANIFEST# 621173 NORMAL DELIVERY
ro
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ
CARMEL IN 46033
L �oa ITEM '?UNIT SIT`: EXTENDED'- T p INVQICE ADJUSTMENTS y
o TY d PACK SIZE;_ ITEM!DESCRZPTIdN - :.CODE . „PRSCE AKo - PRICE X. I Coni;. 4TY,. .,
-
HICKEN SANDWICHES ON MENUS UP 8% IN 5YRS ASK YOUR MA FOR S SCO CLFLSSIC CHICKEN
SK YOUR MA ABOUT SYSGOAGGOUNTCENTER COM & H W YOU, EARN GREAT 011 YOU2
***
4, CT LU,;♦BNY ICE CREAM CANE VAN SN10070640014122.•! 4147466 15 97; 15 97
F 1 $ 48 5 <7Z LtT BNX...ICE C?EAM _SANDWICH. A QQ070640310104 ( 1666155 _24 75 24 75 y
O
x
5............... LU HNY ICE CREAM SNDWCH;CHIP',0007064QS0621 X595',4$7 25 27, 50 54
. .29 ZCY,S.. I.CE ITAT, ANI_LEMON xUBE ..._ 22410 2560316 ................15;8tn
GROUP TOTAL**** 112.84 O
*** MEATS ***
.. a
60 3.,QZ Tis, BEEF"..;PATTY GRD SEA HS FRS.. 7.703003„ 6964',:59? "73 $6! ?3.9
GROUP TOTAL**** 73 86�
.., •, o
*** SEAFObD ir,xt
a
F S 1 OLB f.,'.ICELNDC: .COD kBTRD BREWER S- CH.4 OZ, 1QQ01654 6673::776 72 36 .:.. 72:36
GROUP TOTAL**** 72 36
0
n
6 LB' SYS :,IMP POTATO: FRY :SKON ,3/,8, �?' 10,73'47304Q95,9,4 `; 19.98.907. ..:37.21 37:21
GROUP TOTAL**** 37.21
DRY ***
i
v
C..•: 1S: NL". ._8 CT. .NICKER.CANDY ;BAR ST3ICKEFZ,1 ,86 OZ " 256979 1?9383? <...S6,50i , 36 50
a
. .: .., .
C 1 „GAL'„SCHWRTZ PICKLF:.,CRS CUT `ICQ „296582...7.,,0756 1028919. 40.20:; 40.20 ..
24,..5LTR .PURIIFE-_WATER :PURIFIED 1147655?-,': 81Q8$47 .'; 6. .37';.. :',63 ?0 x
GROUP TOTAL**** 140.40
*rr* ;PAPER, "`DISPOSABLE ***
0
2
ONLY OCT,OSYSCO FOIL SHEET 93010. T51N ,SILVER =.W6R3 6938500 .,7 8:99' 36.98 °
.. ...
S.. .4 OQ..C. SYS .;CLS. GLO,VE.. LATEX;I FDSUC .PWDRFREE 304750022.!; 8347;841 4$ 9,2 ...., 48 92.....
D. 250 3 5Ys” 'cLs'.LINER TRASH 33313:9. .5-ML,SLK• H6639MB5, 4075958 45.65:' 45.55
CASES SPLIT T.PCS CUBE GROSS WT. OPEN:11:00 AM CLOSE: 2:00 PM , , REMIT TO
P.O. BOX 7137
21 3 24 12.4 459 INDIANAPOLIS, IN SUB
46206-7137 TOTAL
TAX
DRIVER'S NO. PCS COST.sxcsso mrvoxoe—rt—or N0. PCS TOTAL
SIGN 7 DELVD. SIGN X REC. INVOICE i
TOTAL
MPORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE
UTHORIZED BY SECTION 5 (CI OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (O.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 CONT; ON PAGE 2
ANY RECEIVABLES OR PROCEEDS FROM THE SAL OF THESE COMMODITIES(R�TIL FULL PAYMENT IS RECEIVED.FURTHER YOU AGREE WITk
SPECT TO ANY DISPUTE ARISING OUT OF YOUR RECEIPT OF THESE PRODUCTS/SERVICES: YOU ARE GIVING UP YOUR RIGHT TO SERVE IN ANY 1
PRESENTATIVE CAPACITY,OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.
IIIII IIIIIIIIIIIIIIIIIII IIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
IIIIIIII IIIIIIIII4 ' Z DELV. DATE CUSTOMER 'INVOICE.NUMBER PAGE
Goo thin 6/21/18
BROOKSHIRE GOLF CLUB... comefgsrom TRUCK STOP 412940 138563004 9 2
12120 BROOKSHIRE PKWY �I,SC® � /009
CARMEL IN 46033 SYSCO INDIANAPOLIS, LLC Rotrr PURCHASE ORDER
4000 W 62ND ST 7742 TERMS —PAST DVEBAI.ANCES ARE SUBJECT To SERVICE CHARGE i' 10
317-846-7431 INDIANAPOLIS, IN 46268 DUE FRIDAY 4 WEEKS AFTER ORDER F
SHELLFISH SHIPPER ID: IN007RS MANIFEST# 621173 NORMAL DELIVERY O
BROOKSHIRE GOLF V
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ I
y
CARMEL IN 46033
o QTY N ITEM UNIT UNIT EXTENDED T p :' INVOICE ADJUSTMENTS y
PACK' SIZE: ITEM?DESCRIPTION TAx
c CODE PRICE AMouRT _ PRICE R i CODE gTY: K
1 S, 20U 5
SYS,;:CLS ,LINER_-TRASH' 36X58, 7..ML. BLK H7;258HBS_,.;: 4084:679 54 :6Z .;54 6
i
. . _ .
1 S 8 75 C, SYS CLS NAPKINDINNER. 15X16.75, 2P 1/SW2187 4467779 31.97 31.97
H
S '12 00 C, ORKADV NAPKIN,;:;DISP',XPRESSNAP, WHT ? DX900 [ 1330,687 68.831
7
1 .,.S 10 X51N COLAB PAD GRIDDLE POLISHING >: 60225-07 00 0065324 16.84 16.84'
......
a
`�1 S 4.50CT SYSTRNZ •TRAY ,FOOD: PAPR 11B DYTTDZ, ;! 2003380 48.35, 48.35 0
_. ..... ...
N
S 4 .50CT', SYSTRNZ TRAY FOOD PAPR 2LB D2TTDZ 2004,236 54 76; 54.•76 , . N
... .
1 S 2 50CT! SYSTRNZ ,TRAY FOOD PAPR 3LB D3TTDZ 2004242 40 93 40.93 "
GROUP TOTAL**** 447.85
*** PRODUCE ***
..
0
C 1 ,...5
W. LB IMPE'RSH_ ONION RED FRESH JUMBO 1039494 . .', 9:,77 9 77.
C �1 15X.6:' IMPFRSH TOMAT6: 1 LAYER FRESH 1008:630 24.02:
24.02 -
GROUP TOTAL**** 33 79 0
*** IDISPENSER.***
,.... _...... .. N
C)
a
D 1 !CS 1 GAL COCACOL -SYRUP, COKE' CLASSIC ,5X1 BIB 04250010 4090593 79:89 79.8.9 ;
GROUP TOTAL**** 79.89
MI SC CB ARGE HGS.. FOR FUEL SURCHARGE 4.70
o
ORDE, S UMMA RY 86059 85800 a
. z
0
0
K
CASES SPLIT rOT.PCS CUBE GROSS WT. OPEN:11:00 AM CLOSE: 2:00 PM REMIT To
P.O. BOX 7137
10 10 10.5 192 INDIANAPOLIS, IN SUB
46206-7137 TOTAL 1002.90
31 3 34 22.9 651 TAX
DRIVER'S NO. PCS CUST,sxcseo INVOICE EVIDENCES OF ALL IiEHE N0. PCS TOTAL
SIGN DELVD. SIGN v REC.
X
INVOICE
in
A PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST TOTAL 1002.90
SECTION 5 (C) OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (U.S.C. 499E 1 THE SELLER OF THIS COMMODI PAYABLE ON OR BEFOREST CLAIM OVER-THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES,IVABLES OR PROCEEDS FROM THE SAL OF THESE COMMODITIES UNTIL FULL PAYMENT IS AECEIVED.FURTHER YOU AGREE WITH7/20/18 LAST PAGE
NY DISPUTEARISING OUT OF YOUR RECEIPT OF TAESE PRODUCTS/SERVICES: YOU AAE GIVING UP YOUR RIGRkTTO SERVE IN ANY
E CAPACITY,OR TO PARTICIPATE AS A MEMBER OFA CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
VOUCHER NO. WARRANT NO.
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
$229.28
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
138571543 42-390.40 $229.28 1 hereby certify that the attached invoice(s),or 6/30/18 138571543 Food $229.28
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,July 02,2018
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIII�IIIIIIIIIIIIIIII�IIIIIIIIII CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL ICEENUMBE PRIPAGE
OPERTY OF SYSCO
_ DELV. DATE. .,
0/18
BROOKSHIRE GOLF CLUB+++ Gotdthing.s 6K STOP
come from TaocR STOP 412940 138571543 6 1
12120 BROOKSHIRE PKWY S)/SCCY /962
CARMEL IN 46033 SYSCO INDIANAPOLIS, LLC ROUTE �-, PUR E ORDER 1
4000 W 62ND ST b
INDIANAPOLIS, IN 46268 O1F °TERMS_—PAST�DOE BALANCES ARE-SUBJECT To,SERVICE,CHARGE` °
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER 0
SHELLFISH SHIPPER ID: IN007RS MANIFEST# 621870 CUSTOMER WILL CALL °
BROOKSHIRE GOLF m
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ H
CARMEL IN 46033 DRIVER: z
L o UNI EXTENDED T p INVOICE ADJUSTMENTS' ~
o °.QTY r.,PACK SIZE, ITEM.DESCRIPTION, ; ��-., RICE" X.? : 'QTY
ITEM UNIT "
e S. A K YOUR FOR SYSCOSCO C SSIC CHI CODE
w.
HICKEN SANDWICHES ON MENUS UP 8% IN 5YR
SK ,YOUR MA ABOUT SYSCOACCOUNTCENTER COM- & HOW YOU: EARN CREDIr ON YOUR` y OUpiT
_
-THE ,
BELOW AGREES.;TO TRANSPORT THE, PRO UCTS ,ON ITIS 2 . DICE° ( PRODUCT ) AN
NVIRONMENT AND IN A MANNER THAT PROVIDES ADEQUATE S ETY CO ITION AND TEM E TURE
PROTECTION EOR PRA6b CT_AND- TO COMPLY WITFI AN ,APPLIC _LE LAW, OR REG CATION D G;
1. .. - - _
RANSPORTATION. THE SIGNER RELEASES SYSCO FROM ALL C IMS RE TED T ' THE IRAN TATION O v
PRODUCT:'TO PRODUCT'S DESTINATION; -AND_ aIN. DOI G 50,. T SIGNS ACCEP ,S "AND .AS $-,FULL H
SPONSIBILITY FOR THE INTEGRITY OF PRODUCT. PRODUCT BTAINE FROM ILL—CAL NOT z
ELIGIBLE' FOR RETURN, n
L FIRMANTE SE COMPROMETE A TRANSPORTAR LOS RODUCTOS DE EST _ 'FACT (EL "P O CTO")., EN a
AMBIENTS Y,"DE`'.UNA MANERA QUE PROP.ORCIONE ONDICIO S.,"ADEC„ADAS_,D SEGURID_ N
PROTECCI4N DE LA TEMPERATURA PARA EL PRODUCT , Y CUMP IR CON CUALQU ER. LEY 0_ ULAC14N 0
qy�
PLICABLErDURANTE.':EL TRA$PORTlk EL FIRMANTE IBERA,sA YSCO E TOIJA RECLAM2 I S .Y,-DE
_.
ODAS DEMANDAS RELACIONADAS CON EL TRANSPORT DEL PRO UCTO DEST NO DEL P O CTO, Y AL
CERLO;.,,EL, FIRMANTE` ACEPTA Y ASUME TODA" LA SPONSAB LIDAD- OR_LA NTEGRID L'.;
PRODUCTO. EL PRODUCTO OBTENIDO DE LA AREA DE ENTREGA (WILL— L) NO ES ELEGI L PARA
EVOLVER:
CUSTOMER SIGNATURE:.
a
ATE-,
_
CUSTOMER PRINTED NAME: _
*** DAIRY ***
S II 2 244 5 OZ LU BNY ICE CREAM SNDWCH CHIP00070640310821 } 1595487 _25 27 50.54
GROUP TOTAL*:*.**. . .. 50 54° o
*** MEATS ***
a
BEEF PATTY GRD SEA HS FRZ 7703003 6964597 73.86 73.86
GROUP ,TOTAL****..... .,. -:_. W 73. 86,
F 1 60 3 OZ NT
4
*** CANNED & DRY
0
1 S 2 5 EINZ KETCHUP FANCY POUCH D _10013000515501 744,9051 35.73 35.73
CS2 .5 GEINp
0
Z MUSTARD YELLOW POUCH ,10013000652008 7938939 . 2.9 17 429 17 V
***
.,• _,_. . ._ `_GROUP.TOTAL_...: _- .___ � = � .. ,r. _ __ . _ .. ,•:�6.4 '90��.
0
***CHEMICAL ***
,. Cn
1S 303.60Z YSTON CLEANER DEGRSR,HGH TMP, GRL R 6100632 0658_011 , 39,98 39 ,98 z
' GR
. - _•.. .. .:.".. ... OUP TOTAL
CASES SPLIT OT.PCS CUBE GROSS WT. OPEN,11:00 AM� CLOSE• 2:00 PM REMIT',TO -
n
P.O. BOX 7137
6 6 2.9 106 INDIANAPOLIS, IN SUB
46206-7137 TOTAL
TAX
DRIVER'S NO. PCS CUST.sxcs®xmroxce evxnsneEs oe xcc xrrns NO. PCS TOTAL
SIGN DELVD. SIGN v REC. INVOICE
X
TOTAL
IMPORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE
UTHORIZED BY SECTION I (C) OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (U.S.C. 499E(C)). THE SELLER OF THIS COMMODI
TAINS A TRUST CLAIM OVER THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES CONT. ON PAGE 2
AND SPECT TOCEIVABLES OR ANY DISPUTE ARISINGSOUT OFTHE S OF YO RECEIPT OFETHESEODITIES PRODUCTS%SERVIC S:TIL FULL PYOUARENT IGIVI GIUPDYOUR RIGkTYOU
TO SERVE INTANY
PRESENTATIVE CAPACITY,OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII DELIVERY COPY CONFIDENTIAL PROPERTY OF SYSCO
DELV. DATE CUSTOMER INVOICE NUMBER IPAGE
- I N 4 1 2 9 4 0 1 3 8 5 7 1 5 4 3 0 0 2 1 - 6/30/18
Good ings
BROOKSHIRE GOLF CLUB... S'e come from TRUCK STOP 412940 138571543 6 2
12120 BROOKSHIRE PKWY `lo /962
CARMEL IN 46033" SYSCO INDIANAPOLIS, LLC ROUTE PURCHASE E 1 0
4000 W 62ND ST. 01F TERMS —PAST DUE BALANCES ARE SUBJECT TO SERVICE CHARGE
317-846-7431 INDIANAPOLIS, IN 46268 DUE FRIDAY 4 WEEKS AFTER ORDER
SHELLFISH SHIPPER ID: IN007RS MANIFEST# 621870 CUSTOMER WILL CALL °
BROOKSHIRE GOLF
_ ro
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ y
CARMEL IN 46033 DRIVER:
L o ITEM UNIT SIT EXTENDED T p INVOICE ADJUSTMENTS y
o
QTY PACK " SIZE ITEM,DESCRIPTION CODE' PRICE AMOUNT PRICEg;I CODE QTY K
ORDER SUMMARY 4962
H
°z
- - N
N
., °
a
t+
' m
0
i
0
i
), N
O
1�
J
a
M
x
y
- _....._ ,._...... H
z
. K
CASES SPLIT OT.PCS CUBE GROSS WT. OPEN:11:00 AM CLOSE: 2:00 PM REMIT TO
0
P.O. BOX 7137
INDIANAPOLIS, IN SUB
46206-7137 TOTAL 229.28
6 6 2.9 106 TAX
DRIVER'S NO. PCS CUST. encEvcrs oe ncc xrxxs NO- PCS TOTAL
SIGN DELVD. SIGN v REC. INVOICE
X
TOTAL 229.28
NRESENTATIVE
ORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST pAYABLE ON OR BEFORE
HORIZED BY SECTION 5 (C) OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (O.S.C. 499E fC11. THE SELLER OF THIS COMMODI
AINS A TRUST CLAIM OVER THESE COP4fN IS ALL INVENTORIES OF FOOD OR OTHER ADDUCTS DERIVED FROM THESE COMMODITIES, -]/2-]/18 LAST PAGE
ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.FURTHER YOU AGREE WITH
PECT TO ANY DISPUTE ARISING OUT OF YOUR RECEIPT OF THESE PRODUCTS/SERVICES: YOU ARE GIVING UP YOUR RIG{IT TO SERVE IN ANY
CAPACITY,OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.ZU1 (Rev.Ivua)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 359366
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
$1,537.47
- 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
138570060 42-390.40 $1,537.47 1 hereby certify that the attached invoice(s),or 6/28/18 138570060 Food $1,537.47
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,June 29,2018
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
IIIIIIIIII IIIIIIIIIIIIIIIIIIII IIIIIIIIIII IIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CUSTOMER'S OATE
RIGINAL INVOICE CONFINIEPROPERT OF SYSCO
Good things 6/28/18
BROOKSHIRE GOLF CLUB... comefrom TROCR STOP : 412940 1385,70060 2 1
12120 BROOKSHIRE PKWY S��sto� /010
CARMEL IN 46033 SYSCO INDIANAPOLIS, LLC ROUTE PURCHASE ORDER
4000 W 62ND ST o
317-846-7431 INDIANAPOLIS, IN 46268 7742 TERMS —PAST DUE;',BALANCES ARE SUBJECT ,T0 SERVICE CHARGE ': [
DUE FRIDAY 4 WEEKS AFTER ORDER
SHELLFISH SHIPPER ID: IN007RS MANIFEST# 621726 NORMAL DELIVERY O
BROOKSHIRE GOLF ro
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ 0
CARMEL IN 46033
O 'QTY PACK SIZE ITEM DESCRIPTION ITEM t)NIT TNCIT EXTENDED T p INVOICE ADJUSTMENTS y
C CODE PRICE AMOUNT; PRICE s.I coDEr QTY:: ,.
HICKEN SANDWICHES ON MENUS UP 8% IN 5YRS. ASK YOUR FOR S SCO C SSIC CHI
SK :YOUR' MA.ABOUT SYSCOACCOUNTCENTER COM .&. H F1 YOU.'; C :EARN,?. CREDI ON YOURA,X OUNT
F 1 S• 12 4 CT',. LU ;BNY ICE CREAM CONE VAN SN 100706406141224147:466. 15 97 15.97
b
I 1 S 24 _ rJ_QZ. LU BNY ICE CREAM SNDWCH CHIP �OQ070,6403.1'0821 1595487 25 2T 25 27
GROUP TOTAL**** 41.24 z
o�o , t*,r MEAT
S
,t,t*
, i. •, :. n
F 160 .3.O;Z TNT BEEF .PATTY GRD SEA HS �'RZ , 770;3003 ;, 6964;597 73 .86; 73 86 N
F 2 $ 2 LB ': BRLCLS FRANK ALL-MEAT 5X1 6 IN . 748650;67.92 1137736 29.30 ;58.60
C "1/1 S 4 .5LB(, BRLCLS HAM,HONEY SMK SLI ,.67OZ 2:0660 'i 196.3..289 45
,.00 45.00:
F 1 _S24 OZ OLTEN PORK FRITTER BNLS HMSTY 2A00,9,.. 6583710 A7 27` 47 27.
. ...
GROUP TOTAL**** 224.73 0
*** ;POULTRY **'
m
c
.. .. . N
F 5 2 LB' SOULES . CHICKEN BREAST B..NLS WNG LT BRD 6:4126 7052497 .,_4.6.. 95 234.75
a
a
F 5 -S 2 5 LB SOULES CHICKEN BREAST FIL SOUTH STYLE 60426 ;! 7052,482 48.05 240.2,5
F 1 S 2 LB SYS CLS CHICKEN FACT;BRST .';STRIP PRCEG 5;0424 :' 1647353 ,46.94'' 46.94' o
C fl S 4. 5L8; BRLCLS TURKEY.;'BREAST SLI O/RSTD' ;2265594]13 ' 196.0..434 ..;58.95: 58 95
GROUP TOTAL**** 580.89
*** ;FROZEN.***
F 2S NL LB ! YS ,IMP. GHEESE. STICK MOZZ.BRDi3:25 4101',OlUB .1925767 25.17;', 50.34a
C 1 $ 1 0 LB: MARIA CHIP CORN TRTLLA WHT, 4CUT BULK 6206 :,0270:757 21.62= 21.62
F 1 6LB . SYS I=MP POTATO FRY..:SKON 3/8 P ';10734730409594 1998:907 :.37.21: 37..21
F 2 S 6 ... 5 L... SIMPRST, POTATOIREDSKIN HLV .A$..:10071179776772: :.39.0,99,00 34.75:: 69.50
"z
GROUP TOTAL**** 178.67
K
CASES SPLIT OT.PCS CUBE GROSS WT. OPEN:11:00 AM CLOSE: 2:00 PM REMIT TOS.
P.O ..BOX.7137 z
23 2 25 14.5 309 INDIANAPOLIS, IN SUB
46206-7137 TOTAL
TAX
DRIVER'S NO. PCS CUST.sx—O Z-OICE Evx ES OF
FNOPCS TOTAL
SIGN DELVD. SIGN v INVOICE
X
TOTAL
1PRESENTA
ORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE
HORIZED BY SECTION 5 (C) OF THE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 F.S.C. 499EN,. THE SELLER OF THIS COMMODITVAINS A TRUST CLAIM OVER THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES
ANY RECEIVABLES OR PROCEEDS FROM THE SAL OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.FURTHER YOU AGREE WITk CONT. ON PAGE 2
PECT TO ANY DISPUTE ARISING OUT OF YOUR RECEIPT OF THESE PRODUCTS/SERVICES: YOU ARE GIVING UP YOUR RIGAT TO SERVE IN ANY
TIVE CAPACITY,OR TO PARTICIPATE AS A MEMEEA OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.
IIIIIIIIIII 111111 9 1111111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllll IIII CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
IIIIIIIIIIIIIIIIIIII IIIIIII'II3I I 9 DEL6V%2AATE CUSTOMER INVOICE NUMBER PAGE
/18
Goodthings
BROOKSHIRE GOLF CLUB+++ come from TRUCK STOP 412940 138570060 2 2 SYSCO INDIANAPOLIS, LLC
12120 BROOKSHIRE PKWY ��iSC®�4000 W 62ND ST /010
CARMEL IN 46033 ROUTE. PURCHASE ORDER 317-846-7431 INDIANAPOLIS, IN 46268 7742 TERMS -PAST DUE BALANCES ARE SUBJECT TO SERVICE CHARGE b
C
DUE FRIDAY 4 WEEKS AFTER ORDER p
SHELLFISH SHIPPER ID: IN007RS MANIFEST# 621726 NORMAL DELIVERY o
BROOKSHIRE GOLF 0
12120 BROOKSHIRE PKWY MA: SN139 GARY LEVERENZ y
CARMEL IN 46033
Ll QTY d PACK SIZE ITEM DESCRIPTION ITEM UNIT TAXI EXTENDED . TA p INVOICE ADJUSTMENTS K
CODE PRICE AMOUNT PRICE X I 'I CODE QTY:: g
*** CANNED & DRY *** _. ....._.. 5
• ICS 160 CT YS CHIP VARIETY SYSCO/FRITO LAY 31831 6586721 27.51 27.51
• V,112 CS 1 5 LB SYS REL SHORTENING FRY LIQ CLR ZTF 5020553 4518403 24.93 49.86
`/1S 61 GAL HEINZ VINEGAR WHITE DSTD 5% 10013000007549 4040895 30.44 30.44 n
GROUP TOTAL**** 107.81 H
*** PAPER & DISPOSABLE *** z
D V/1 CS 25200 C SWHEART CUP PAPER WTR CONICAL 4 OZ 4R-2050 9289711 86.17 86.17 [
.GROUP TOTAL*,*** 86.17
*** PRODUCE *** o
C v- 2 CS 25 LB IMPFRSH BEAN GREEN FDSVC TRIMMED FRS 1810910 1810910 29.80 59.60
C 1 ICS 2 LB IMPFRSH LETTUCE LEAF BETTER BRGR 4966123 36.18 36.18
0
C 1 ICS 45 LB IMPFRSH LETTUCE SAL MIX SEPARATE FRE 1675602 1675602 27.50 27.50 ~
C C 2 LB BRLIMP SALAD CHICKEN 51071 2510717 47.77 47.77 0
C 1 C BBRLINP SALAD TUNA ALBACORE 51194 2511947 49.60 49.60
GROUP TOTAL**** 220.65
*** DISPENSER ***
o
D /1 �S 1 .5 INMAID SYRUP LEMONADE BIB 16760298 8908832 48.63 48.63
D Vf CS 12.5 LDPEAK SYRUP TEA CONC UNSWT BLK PR 02250298 7065776 43.98 43.98
GROUP TOTAL**** 92.61
.MISC 2BARGES CHGS FOR FUEL SURCHARGE 4.70
z
0
o
.ORDS SUMMARY 2943 88663 0
M
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w
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..,. ,.... ... .. .... . ... ,
CASES SPLIT rOT.PCS CUBE GROSS WT. 0PEN:11:00 AM CLOSE: 2:00 PM REMIT TO Z
P.O. BOX 7137
13 13 13.7 283 INDIANAPOLIS, IN SUB
46206-7137 TOTAL 1537.47
36 2 38 28.2 592 TAX
DRIVER'S NO. PCS COST,sxcseo xervoxee xsvxnexces or us x..p". NO. PCS TOTAL
SIGN DELVD. SIGN X REC. INVOICE
TOTAL 1537.47
IMPORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SUBJECT TO THE STATUTORY TRUST PAYABLE ON OR BEFORE
AUTHORIZED BY SECTION 5 (C) OF TAE PERISHABLE AGRICULTURAL COMMODITIES ACT 1930 (U.S.C. 499E(C1I. THE SELLER OF TdIS COMMODI
TAINS A TRUST CLAIM OVER THESE COMMODITIES ALL INVENTORIES OF FOOD OR OTHER RODUCTS DERIVED FROM THESE THIS 7/27/18 LAST PAGE
D ANY RECEIVABLES OR PROCEEDS FROM THE SAL OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.FURTHER YOU AC ;E WITH
SPECT TO ANY DISPUTE ARISING OUT OF YOUR RECEIPT OF THESE PRODUCTS/SERVICES: YOU ARE GIVING UP YOUR RIGHT TO HE IN ANY
PRESENTATIVE CAPACITY,OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS,IN ANY LAWSUIT INVOLVING ANY SUCH DISPUTE.