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Home My WebLink About330386 09/25/18 `%'�� CITY OF CARMEL, INDIANA VENDOR: 365677 `! CHECK AMOUNT: $********98 24* .I_ �, ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CARMEL, INDIANA 46032 PO BOX 88029 CHECK NUMBER: 330386 ,,,..__,- CHICAGO IL 60680-1029 CHECK DATE: 09/25/18 �roN�°' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 926112365 98.24 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 365677 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GORDON FOOD SERVICE, INC IN SUM OF$ _ 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 $98.24 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 926112365 42-390.40 $98.24 1 hereby certify that the attached invoice(s),or 9/5/18 926112365 Food $98.24 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 Wednesday, September 05,2018 1J� 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Page:1 of 1 Gordon P.O.Box1787 INVOICE MI 49501-1787 FOOD SERVICE STORE wwwwgffs.com INVOICE# DATE 1-800-968-7500 926112365 09/05/2018 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 REM CODE QTY DESCRIPTION CAT COST GUIDE SPECS UNIT PRICE TAX AMOUNT 6171510 1 CASE DRINK ASST FIERCE WM 24-20FLZ GATOR 9 0.58 13.99 13.99 1446110 1 CASE POWERADE ZERO MIXED BERRY 24-20Z 9 14.99 14.99 14.99 1967000 1 CASE ENERGY DRINK RED BULL 24-8.3Z 9 1.46 34.99 34.99 4930661 1 EACH GFS CLASSIC FRANKS 4/#3 MEAT FRESH 3 6.99 6.99 2483601 1 EACH NUTRI-GRAIN BAR STRAWBERRY 1 8.29 8.29 6058910 2 CASE 1-16CT HOT DOG BUNS MARKETPLACE 1 2.50 2.50 5.00 4351940 1 CASE DRINKASST PK WM 24-20FLZ GATOR 9 0.58 13.99 13,99 PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL r 98.24 1-GROCERY 2-FROZEN 3-MEAT 4SEAFOOD 13,29 6.99 TAX FREEZER COOLER WAREHOUSE MISC, TOTAL 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 98.24 9-0ISP,BEVG 10-PRODUCE 11-TABLETOP payment fTransaction')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 muimum permitted by law. PAID 0.00 77.96 TOTALS BY TAX CATEGORY Received By: SALE NBR 34 %RATE TAX %RATE TAX 1 LANE NBR 04 The perishable agricultural commodities shown on this invoice are sold subject to the ` USER ID 65122 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 trust claim over DATE 09/05/2018 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) 09:59:00 full payment is received.Eggs delivered In the state of Illinois include an Illinois Egg Signature: Inspection Fee in the price.Meryland MDA Inspection Fees at a rate of$.08 per dozen _'Acceetance constitutes agreement to a timeclrice differential of 1 1/2%r month on the unpaid balance after the due date ____________ 4 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 CUSTOMER# INVOICE# Chicago,IL 60680-1029 PAY THIS AMOUNT DATE 100133245 926112365 09/05/2018 98'24 IIIIIIIiI III VIII III VIII I IIIIIIII IIIIIIIIIIIIIII I II III III 100133245910926112365000009824400000982440