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HomeMy WebLinkAbout331643 10/25/18 CITY OF CARMEL, INDIANA VENDOR: 365677 CHECK AMOUNT: $********67.98* ONE CIVIC SQUARE GORDON FOOD SERVICE, INC CARMEL, INDIANA 46032 PO BOX 88029 CHECK NUMBER: 331649 CHICAGO IL 60680-1029 CHECK DATE: 10/25/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 926113789 67.98 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 365677 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GORDON FOOD SERVICE, INC IN SUM OF$ 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,numberof units,price per unit,etc. CHICAGO, IL 60680-1029 Payee $67.98 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 926113789 42-390.40 $67.98 1 hereby certify that the attached invoice(s),or 10/12/18 926113789 Food $67.98 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, October 15,2018 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 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Page:1 of 1 GordonP.O.Box 1787 INVOICE GrandRapids,MI 49501-1787 FOOD SERVICE STORE www.gfs.com INVOICE# DATE 1-800-968-7500 926113789 10/12/2018 TAIL ROUTING# STOP# CUSTOMER# PURCHASE ORDER SALES# REPRESENTATIVE MP# MP LOCATION TERMS N 100133245 4040 73406 1905 Fishers Net 30 Days Kdstoffer 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 1914850 1 CASE 24-20FLZ COCA-COLA REGULAR COKE 9 1.42 33.99 33.99 1915070 1 CASE 24-20FLZ DIET COCA-COLA 9 1.42 33,99 33.99 PRODUCT CATEGORY SUMMARY NUMBER OF PIECES SUBTOTAL 67.98 1-GROCERY 2-FROZEN 3-MEAT 4-SEAFOOD FREEZER COOLER WAREHOUSE I MISC. TOTAL TAX S•POULTRY 64DAIRY -DISPOSABLES 8-SANITATION signature evidences receipt of all items listed and Its promise to pay the am INVOICE TOTAL 67.98 the amountunt due to GFS.Customer agrees that If a check,draft and/or order of 9-0ISP.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 67.98 TOTALS BY TAX CATEGORY Received By: SALE NBR 174 %RATE TAX %RATE TAX 1< LANE NBR 04 The perishable agricultural commodities shown on this Invoice are sold subject to the ivJ �� USER ID 68860 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 10/12/2018 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) 17:06:00 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$.08 per dozen ________•Acceetance constitutes agreement to a time�rice differential of 1 1/2%Per month on the unpaid balance after the due date ___________ 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 Chicago,IL 60680-1029 PAY THIS AMOUNT CUSTOMER# INVOICE# DATE 67.98 100133245 926113789 8�] IIII IIIIIIIIIIIIIIIIIIIII'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIII 100133245910926113789000006798300000679830