185974 05/26/2010 a CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
ONE CIVIC SQUARE SYSCO FOOD SERVICES
CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $2,106.39
INDIANAPOLIS IN 46206 -7137
CHECK NUMBER: 185974
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 005190570 523.75 FOOD BEVERAGES
1207 4239040 00520597 1,582.64 FOOD BEVERAGES
Good things
S�fVIE__R ORl �ihIAEL �NV�I� CONFIDENTIAL PROPE^TY OF SYSCO
S ff W C7 t/ d ;:.CUSTbME3i
BROOKSHI RE GOLF CLUB... 1 p `d i
12120 BROOKSHIRE PKWY TR 12 412940 005120597 9 1
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST A °<E
INDIANAPOLIS IN 46268 nASr' SUE. 33aaNCES ARE: svB EcT:: TC3
317 846 -7431 30 DAYS FROM DATE OF INVOICE o
MANIFEST� 378078 NORMAL DELIVERY
CI CIVIIC SQUARE DRIVER; PARKER, JEFF
QTY f'AC SfZr_ I €ERA DF SCRIPFION ITEm Ntr TAx Ex,T:eNV a c
y T.: GOi3 PRICE AmbLINT P.RICG X
DAIRY
C S NL 5 LB CL
,BRLS CHEESE AMER, YEL I20 SLT_ 281316697.114 14'.'0 6,` 14'.'0
GROUP TOTALS
6
m
1.:4 0
MEATS b
F CS 605 3302. AB BEEF GRND STKBRG PTY FRZN 9 7,63151.,6703049 .56.79.. 113, Z
F .CS. 110 LB HNSVLE BRATWURST 4X1 PRECOOKED 199_.1611.243 .29 44 58 88 n
or
GS.. 110 LB BRLCLS FRANK ALL MEAT 5X1 6 IN 37 36 070.1 37736 17 75, 35.50 0
mo
CS. 42. LB BRLCLS HAM SLI 2 /3OZ H NY' 20660.1963289 39 29 39 29 A
GROUF TOTAL 24:7 25 .I q.
POULTRY
w
C CS BBRLCLS TURKEY BREAST SLI OVEN RSTD 20643'1960434 39.98 39.98
FROLEN
GROUP TOTAL 3
CS,. 244 OZ ARALEE MUFFIN BLUEBERRY LW 0$625,11 8 1 6 1 3 19.97 19 97
Jrmq
CS„ 722_:$ OZ MUCKER SANDWICH PEANUT BUTR &JELLY 06650 3038031 38 78 38 78 o
GROVP .TOTAL
CANNED DRY
J
S NL� 4$ CT NICKER CANDY BAR SNICKER 2.07 OZ 01202 434838'9 29.30 58:60
n
CS 23 CT L AYS CHIP VARIETY PK BAKED BFY 32198 5581863 29 15` 29 15 m
L
CS 160 CT LAYS CHIP VARIETY SYSCO /FRLTO LAY 318 6586721 26.98 26 98_ A
CS. 1 240Z SE RE KETCHUP SQUEEZE BTL OUYA24; 9617218 26 70` 26 70 A
m
D 1 CS 1212 OZ RENCHS MUSTARD YELLOW CLS SQUEEZE
415 4736 20 50 20 50 m
m
C PL i5; GAL CHWRTZ ,PICKLE 'C RS CUT KO 2,965 270756" 1028 "919 34 00` 34 00.'
CS„ 135 LB ACK ,SHORTENING FRY LIQ CLR 5205661 22 43 67.29
CS: 101' LB BRLCLS SNACK MIX SPCY CREOLE 91069 9960'329 31 36 62 72 Z
OPEN" CLOSE: 00 PM REMk7.Tq
P.O. BOX 7137
2 3 23 1$.5 378 INDIANAPOLIS IN SUB
4206 -7137 TOTAL
TAX
DRIVER'S NO. PCS OUST. SIGN D INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCS TOTAL
O ELVD. SIGN REC. INVOICE
SIGN
IMPORTANT PACA PROVISION: THE z PE p RI g SHA g B E LE A TURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLD SUBJECT TOTAL
Tpp T7HyEE STATUTORY TRUST F�UTHO OM DTESCTETN 5f CA Q THT' PERISHA &9 AGRICULTURAL 9F V ITIES ACCT7 1 30bU S.C. PAYABLE ON OR BEFORE rt
4S SEICp. THE SELLER OF TH SE C O y! RETAINaa A RUS CLAAIM O TFIESEE OMM D LL INVENTORI F ON a ON PAGE 2
F000 OR OTHER PRODUCTS DEAIVEO FROM THESE COMMODITIES, AND pNY RECEIVADLES OR PROCEEDS FROM THE SALE OF
THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.