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Home My WebLink About328762 08/14/18 CITY OF CARMEL, INDIANA VENDOR: 365677 ® ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CHECK AMOUNT: $********25.29* CARMEL, INDIANA 46032 PO BOX 88029 CHECK NUMBER: 328762 CHICAGO IL 60680-1029 CHECK DATE: 08/14/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 926111239 15.29 FOOD & BEVERAGES 1207 4239040 926111242 10.00 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 365677 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GORDON FOOD SERVICE, INC IN SUM OF$ CITY OF CARMEL PO BOX 88029 An invoice or bill to be properly itemized must show:kind of service,when;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 $25.29 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 926111242 42-390.40 $10.00 1 hereby certify that the attached invoice(s),or 8/5/18 926111239 Food $15.29 1207 101 1207 101 926111239 42-390.40 $15.29 bill(s)is(are)true and correct and that the 8/5/18 926111242 Food $10.00 1207 101 materials or services itemized thereon for 1207 101 which charge is made were ordered and received except Monday,August 06, 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 Page:1 of 1 Gordon P.O.Box1787 INVOICE GrandRapids,MI 49501-1787 FOOD SERVICE STORE www.gfs.com INVOICE# DATE 1-800-968-7500 926111239 08/05/2018 TAL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE MP# MP LOCATION TERMS N 100133245 4040 73406 1905 Fishers Net 30 Days Kristoffer Miller#73406 SHIP TO: Brookshire Golf Club 12120 Brookshire Pkwy Carmel,IN 46033 ITEM CODE QTY DESCRIPTION CAT COSTGUIDE SPECS UNITPRICE TAX AMOUNT 4514280 2 CASE HAMBURGER BUN 4"12CT GFS 1 2.00 2.00 4.00 6058830 3 CASE 1-16CT HAMBURGER BUNS MARKETPLACE 1 2.50 2.50 7.50 2117821 1 EACH LETTUCE ROMAINE HRTS 7SCT MRKN 10 3.79 3.79 PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 15.29 1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD 11.5 FREEZER COOLER WAREHOUSE MIS.. TOTAL TAX 5-POULTRY 6-DAIRY 7-DISPOSABLES 8-SANITATION Customefs 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 15.29 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 3.79 TOTALS BY TAX CATEGORY Received By: SALE NBR 386 %RATE TAX %RATE TAX r/��v LANE NBR 03 The perishable agricultural b commodities shown a this invoice are sold subject to the l\J �"( USER ID 76255 statutory trust 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 bust claim over DATE 08/05/2018 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) 12:21:00 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 rale of$.08 per dozen .A............. Page:1 of 1 Gordon P,O.Box1787 INVOICE GrandRapids,MI 49501-1787 FOOD SERVICE STORE www.gfs.com INVOICE# DATE 1-800-968-7500 926111242 08/05/2018 TAIL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE MP# MP LOCATION TERMS N 100133245 4040 73406 1905 Fishers Net 30 Days Kristoffer Miller#73406 SHIP TO: Brookshire Golf Club 12120 Brookshire Pkwy Carmel,IN 46033 ITEM CODE CITY DESCRIPTION CAT COST GUIDE SPECS UNIT PRICE TAX AMOUNT 6058910 4 CASE 1-16CT HOT DOG BUNS MARKETPLACE 1 2.50 2.50 10.00 PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 10.00 1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD 7F.E.R 1U COOLER WRREXOUSE MISC, TOTAL TAX 5-POULTRY 6-DAIRY 7-DISPOSABLES "ANITATION - th etemefs signature 5.Gusto 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 10,00 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 dram for a fee up to the maximum permitted by law. PAID 0,00 TOTALS BY TAX CATEGORY Received By: SALE NBR 416 %RATE TAX I %RATE TAX 1 � LANE NBR 03 The perishable agricultural commodities shown on this invoice are sold subject to the USER ID 76255 statutory trust authorized by section 5(c)of the Perishable Agricultural Commodities Act,1930(7 U.S.0 499e(c)).The setter of these commodities retains a trust claim over DATE 08/05/2016 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) 13:08:00 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$.0e per dozen