HomeMy WebLinkAbout190011 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
ONE CIVIC SQUARE SYSCO FOOD SERVICES
CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $1,466.06
INDIANAPOLIS IN 46206 -7137
CHECK NUMBER: 190011
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 009030575 1,466.06 FOOD BEVERAGES
Good things CONFIDENTIAL PROPERTY OF SYSCO
come from o�tu [SATE CUSTOMER CE LIMBER PAGE
BROOKSHIRE GOLF CLUB �l 1
12120 BROOKSHIRE PKWY T� Ge.s °P 6 1 412940 009030575
5YSC0 INDIANAPOLIS, LLC o
CARMEL IN 46033 4000 W 62ND ST R�It :E
INDIANAPOLIS IN 46268 PAS DLfE.BAI4NtES Asie s33,ECT:?xn
317 646 7431 30 DAYS FROM DATE OF INVOICE
0
D
l SQUARE DRIVER: DIALED, THIERNO Z
SIZE IT,EI1r1 1)ESGRIPT,ION 1NfT TA}4. EXTEND ED R c
QTY K PAC 1TM
C r.. CDDE::. PRICE AMOUN.I: BR{CC X
r MEATS m I.
F 5. 605.3302 AB BEEF PATTY GRNb STKBRGR FRZN 9 753151 6 03049 56 79. 113 58
i m 1.
F,. CS,_ 110 LB. HNSVLE BRATWURST 4X1 PRECOOKED 199,1611243 29 44 58 88 1.
F CS. 110 LB_,BRLCLS FRANK ALL MEAT 5X1. b IN 37 36 070 37736 20 .09. 60 27, I I.
F CS 246.5 OZ YS CLS PORK FRITTER F 6.5201$ 8652018 '26 55' 26 55 n rl,
'i:GR7UI' fiO AL. -.1- 25;9 28
FROZEN
0
F CS.. 244 „OZ ARALEE MUFFIN IW 08625 119 19 97. 19 97
n
F CS. 2,.5 hB YS IMP ONION RING BATTERED 3/8" 4 010044 9272469 36 24. 36 24 p 1.
.......I
1.
F S 45 LB BRLCLS PORK BBQ PULLED WJSAUCE 09634 7691140 79 98 79 98 1. I
1.11
A
F CS 5., LB YS IIMP POTATO FRY ,5,/16 SKON �PHANTM PL STOP 3109' 4356473 28 24 28 24'
R Ug .TOTAL �r 16 4.4 3 0
CANNED DRY
A 1.
D CS 31`6 CT ELLOGG BREAKFAST BAR ASST NUTRI GRAIN 380 005872 4215893 26 45 26 45
0
C,:..:,.,,. S.: NM 4$ CT NICKER CANDY BAR SNICKER_2 07 OZ 01202 4348389 29 30 29 30 I
J
A
D CS. 641.5 O AYS CHIP POTAT REG LSS 44359'6725273 24 76 24.76
D "CS 241'0 OZ` ERYFIN JUICE CRNBRY`CKTAIL� 97207 7 54222 19.17 19 17" m I.
C,..,. L 15, GAL CHWRTZ PICKLE CRS CUT KO 2965 270756 1028 34.00 34 00 -1-11-111
$81`OZ OLGOLD PRETZEL TINY TWIST CLS SS 32430 8083164 28 55: 28 r.
P
D CS 5009_GM SE REC RELISH SWEET PKT 6 1609064 29.25 28 25 x I. m
m
D 101' BRLCLS SNACK MIX SPCY CREOLE 91069 9960329..31 36.: 62 72
Z 11
D..........CS 2423 502 RIZONA TEA ICED ARNOLD PALMER LITE 74009 70494 21 59 '129 54
GROUP T. 2 74 m -11
A
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o I :fRE:M1T TQ3.`: m I.
P.O. Box 7137
2 1 27 24.9 552 INDIANAPOLIS IN SUE!
46206 -7137 TOTAL
TAX
ND, PC SIGN 5 CUST. D INVDICE EVIDENCES RECEIPT of ALL ITEMS, NO. PCS TOTAL
DRIVER'S CELvD. SIGN REC. INVOICE
SIGN
IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLO S TOTAL
Tpo THEE THE SE S7gTU7pgY TR gT q�T�{ORIZE� By SECTIpN �5�C� p Tf F '�fi�CUI C {ORIESOIUES,C. PAYABLE ON OR BEFORE
499EICI)LLER �F THESE COMMODI IES RETM E O
A I A RU C CL MMOD I LL NV O
FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF O ON PAGE 2
THESE COMMODITIES UNTIL FULL PAYMENT 15 RECEIVED.
Good things CONFIDENTIAL PROPERTY OF SYSCO
S ii oEt DATE cuS cmEa tau
1 Tft �K ?s °P 412940 Ofl9030575 6 2
SYSCO INDIANAPOLIS, LLC A
CARMEL IN 46033 4000 W 62ND ST R- r3..:E
INDIANAPOLIS, IN 4626$ PAS1 oUE eA aNC aRe sU itIft Ta
317- 846 7431 30 DAYS FROM DATE QF INVOICE
0
m
1 SQUARE DRIVER; DIALED, THIERNO Z
I S1 ITEM DI SGRIRFIUN 3 FEM UNIT 7Ax Ex.T.ENDED p o 1 aTY ti r; :PAC cd� P.iiICE AMOUNT.: iD ICS x
PAPER &DISPOSABLE r .11
3
T3..:.. CS. 2 200 CT.WHEART CUP PAPER WTR CONICAL 4 OZ R- 2050..9289711 d5 71 211 42
i
D 128.0 CT YSCO. CUP PEAS TRANS 1602 SOFT Y 1605YS.7358304 59,98. 59,98 1
-4 1. D_ S NL 500CT. YSCO„ FO.I.L SHEET 9X1O.751N SILVER. W69372 6938500 12 9$. 25,96.,, z 1.
D CS. 4IOOCT. YSCO.. GLOVE LATEX PWDRFREE ME 100 H14 CP. 39796. :35 05. 35 05.` D 1. 1. J)
D CS 25033 GAL, ...9 LINER TRASH 3 U.....5M� x 639MBS 4075958 38 78.. 38 78 1.
0
„CS 10056 YSCO LINER TRASH 4.3X47 7ML_.BLK H 647HBS 4075966 .2 83 65 66
D. CS.. 12500 CT ORKADV.NAPKIN DI SP XPRESSNAP WHT 0X900.1330687 59 26. 59 26 1.
D CS 800 FT EORG P TOWEL ROLL ENMOTION LRG 4AUT0 89460 9627761 70 99' 70 99
GROUP TOTALS 567 10. p
CHEMICAL I. CD I. N
D CS. 43202 EYSTON CLEANER SURFACE RTU 100063: 7682802 29 58 29 58
GROUP.TQTAL 29,58 1. ID
PRODUCE Z 1-1-11
C
S I5: LB ACKER BANANA FRESH 6 66.221 6 65 6 65. 11
c: SSE p
C S 45 °LB YS NAT LETTUCE `SAL MIX TOD FRESH 675586 1675586 19 70 19 70''
11
C CS 25 LB BRLIMP SALAD CHICKEN 51071 2510717 36 58 36 58 m
GROUP. TaTAL 62, 93._::
O
DO
o
CORD S 65569.. A
m 111.
E I
m
T
2 m
a
m
i REMIT �q!% m 1.
P.O. BOX 7137
1 2 15 16.0 214 INDIANAPOLIS IN SUB
4206 7137 TOTAL 1466.06
3 3 42 40.9 766 TAX
NO. PCS -JST. X INVOICE
SIGNED INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCS TOTAL
DRIVER'S DELVD. SIGN REC.
SIGN
IMPORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLO SUBJECT TOTAL 1466.06
Tpp 77yyEE S7g7U7p�V TRUST 'PIP E� gy gECTIpN 5+C) �F THE PERISH E q��ICU`TURA C�MMOpI71 S qCr 19305Uf5.C. PAYABLE ON O R BEFORE
499EIC11. THE SELLER OF TH SE cowo I71ES RETAINS A TRUST CLAIM R THE =SE COMM6DITIES, ALL9NVEtJTdRIES 1D�D3 /1D LAST PAGE
FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF
THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED.
VOUCHER NO. WARRANT NO.
ALLOWED 20
''Sysco Indianapolis LLC
IN SUM OF
4000 W 62nd Street
Indianapolis, IN 46268
$1,466.06
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1207 009030575 42- 390.40 $1,466.06 1 hereby certify that the attached invoice(s), or
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
�Tuesday, September 07, 2010
Director, BrookshireVolf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Stale Board of Accounts city Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/03/10 009030575 Food $1,466.06
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
Clerk- Treasurer