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190491 09/29/2010
CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1 0 f ONE CIVIC SQUARE SYSCO FOOD SERVICES a CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $1,333.78 <ro c INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 190491 CHECK DATE: 9/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 009170327 771.58 FOOD BEVERAGES 1207 4239040 009240602 562.20 FOOD BEVERAGES Good things C T R SRI 'iNAL INt as CONFIDENTIAL PROPERTY OF SYSCO come from pELV RATE cU5raM1 ,I NV i7 ER PAG Iz: BROOKSHIRE GOLF CLUB ��'�O® TR cK s aP 412940 009170327 2 1 y 12120 BROOKSHIRE PKWY SYSCO INDTANAPOLIS, LLC o CARMEL IN 46033 4000 W 62ND ST D INDIANAPOLIS, IN 4626$ 317 846 7431 30 DAYS FROM DATE OF INVOICE AL DELIVERY a 0 CITY OF CARMEL 1 CIVIC SQUARE DRIVER: PARKER, JEFF 9 QTY !PAC SIDE ITEM DESGAIF'Tf01�1 x NO p o c T:..> cooE P "cF an E �PRre x DAIRY�� I 3 C S NL 5 LB _BRLCLS CHEESE AMER YEL'12,0.SLI:. 2$131 66971.1 14 63.. 14 63 GRt7Uk� TOTAL 14 63. m *ar MEAT$ 1. F... CS... 110 LB HNSVLE BRATWURST 4X1. PRECOOKED. 199 29.44 „8$ 32. z .11 F C.S. .1I0. LB BRLCLS 5X FRANK ALL MEAT ,1 6 IN 37 36 070.1 37736.20 09. I—— �80 36 1. C CS. 42'5LB BRLCLS HAM 5LI 2�30Z HNY 20660 1963289 39 29. 39 29 1. GRO `01'AL 207 1. POULTRY I. C CS. 42,5LB BRLCL5 TURKEY. BREAST SLI OVEN '20643 1960434 39 98. 39 98 11.1 GRaUP 39,. 9$ o FROZEN I CS 612CT COOKIE CHOC CHNK DWNHM IW 8349439 57 82.. 57 82 0 1 F CS 243 OZ 'KRSIMP DANISH ASST RND IW 15919. 52597 1$ 72 18 7.. 0 C.:. A Ij F CS 244.25OZ„KRSIMP MUFFIN ASST BL /BANJCHOC %CH I/W 07347 021825_7 13114 21 25 21 25 a CD F CS 85 LB IMP POTATO 5/ 16 SKIN PHANTM PL S 003109 4356.473 28 2 4 28 24 J F CS 241 *940Z NPRIDE SANDWICH SAUS EGG`CHS CROIS TW 482 5 965$1 29 15 29 15` TOTAL 155 18 CANNED DRY m Z C S NL 3b CT ARS CANDY BAR MILKY WAY 01101 4367363 24 74 24 74 A C 5 NL 4:8 CT NICKER CANDY BAR SNICKER °.2 07 OZ 012 4348389 29 30 29 30 I 11 I— o C 5 NL 48 CT &M CANDY M &M PI 1 69 OZ 01231 4364774 2$ 93 28 93 m 1. CS 641.5 OZ.AYS,_ CHIP POTA R G LSS 44359 "6 25273 24 76. 24 76 tol CS 1 240Z SE REC KETCHUP SQUEEZE BTL OUYA24 9617218 26 70 26 70 T m D CS' 1:8 CT AT VLY SNACK BAR GRANOLA :OATS HNY 33530 3660370 47 35 47 35 m J:L I RW4lT TO:: m P.O. BOX 7137 1 4 21 14.2 239 INDIANAPOLIS 20 IN SIB 46 -7137 TOTAL TAX NO. PCS OUST, SIGNED INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCs TOTAL DRIVER'S OELVD. SIGN X REC. INVOICE SIGN IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU{ TURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLO SUBr TOTAL Tp 7yE STTqq UTp RY TRUgT q�THORIZEp By SEC7IpN S +CI F TWA PERISHABLE q�pICULTURAL COMMODITIES qC7 1930, pgygBLE ON OR BEFORE 493EfC)I. 7H� SELLER OF THESE COMMODITIES RETAINS A7RUST CLAIM OVER THESE COMMODITIES, ALL INVENTORIES OI ON PAGE 2 FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SAL THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. Good things CONFIDENTIAL PROPERTY OF SYSCO come rom DEiX R cLtSTOMF,R NV I 'N'fVIBER PAGE BROOKSHIRE GOLF CLUB... Ta c1.3 6P r 12120 BROOKSHIRE PKWY 412940 009170327 2 2 SYSCO INDIANAPOLIS, LLC m CARMEL IN 46033 4000 W 62ND ST Rat 'e F n INDIANAPOLIS, IN 4626$ PAST sue BataNC�. Jae sIbkp :m 317 846-7431 30 DAYS FROM DATE OF INVOICE 0 39036'/ NORMAL DEL ERY z CITY OF CARMEL MA* S';N GARY LEVERENZ DRIVER: PARKER, JEFF 1 CIVIC SQUARE QTY ti ::PAC SIDE. [TEkVI DE.SCRIPTIO1� i�EFw iJN1T TAx exrsN� D x GROUP TOTAL 181.78 :CDbE.:;... ".'PRIG€ :..:'.X r PAPE2 &.3T51?OS ABI�.. 3 D 5 NL O.CT;. Y5C.0:.. 'F:01L SHEET 'UIG. 751N: S11 VER F169372! 6 3'8:500 ;12.• 98 25:96 m D CS' 4 <OO.CT: YSCO< Glst?VE LATE& PWDRFRE .I41EI) ....!I 1:00. H14. CP;': 9 3'9796 35.05< 70,10'' 0 z D.. CS: 4I0U C: Y$CQ!i;. GL:QVE. POLY. T1ZSP..CAST M.E.I? n 11 104FHC..!4C'PSY;! 77;671 ;17...3;1 17 73', GROUP TOTAL 113.79 FRODUC:E CS 1 :'2CT.. PACKER APPLE..RED. D FCY ::FRESH; 1 O94 8.98 1 8.98 0 C CS 15 T,H ACKER '.11ANAA RESH 65 6 6:6221. 6 65 6 T C.. CS 110 LB;' YS NAT LETTUCE RaMAINE..CR:dWN LEAVES 6;40494:',:6 4:04494.. 29. 4.9 29. 4.9 0 C YS ONION RED. FRESH JUMBO i f ES LB .1 .39494 13 33 3'. 33 C pU CS UT STOCKOMATO SLICED 114" .....:I 404 6.11 :765 l GROUP ,TQ:TAL ORD Z S RY 75748 p n m 0 D V D Z j T D WT 70 P.O. BOX 7137 2 9 3.4 56 INDIANAPOLIS IN SUB 41206 -7137 TOTAL 771.78 2 6 30 17.6 295 TAX DRIVER'S No. PCs COST, SIGN D INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO pC5 TOTAL SIGN OELVC. SIGN REC. INVOICE IMPORTANT PACA PROVISION: THE PERISHABLE AGRICULTURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLO SUBJECT TOTAL 771.7 7p 7H S7gTUTp RY TRUST q�7H0R1z�p gy gECT ppN 511CI pF TAE p RISHqq LLEE AGRICULTURAL, Cp�gMOp ITIE$ EA 1 0!U S.C. 499EI1. THE SELLER OF THESE COMMODITIES RETAINS A TRUST CLAIM O�ER THESE COMMODITIES, ALL INVEtdTORIE.S OF PAYABLE ON OR BEFORE /1710 LAST PAGE FOOD OR OTHER PR OOUCTS ❑ERIVE❑ FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PRO CEEO$ FROM THE SALE OF 1 0/17/10 THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. VOUCHER NO. WARRANT NO. ALLOWED 20 'Dysco Indianapolis LLC IN SUM OF 4000 W 62nd Street Indianapolis, IN 46268 $7 .28 1 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club '1 PO# Dept. INVOICE NO, ACCT #/TITLE AMOUNT Board Members 1207 009170327 42- 390.40 8 I 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 Monday, September 20, 2010 Director, Brookshi olf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State 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)) 09/17/10 009170327 Food $771.28 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 ,20 Clerk- Treasurer Good things CONFIDENTIAL PROPERTY OF SYSCO e from fSELY 4 T 1 cesTC�1�eR rvV `u ac BROOKSHI RE GOLF CLUB siisco. .1 12120 BROOKSHIRE PKWY TR cK:s pP 412940 009240602 4 1 SYSCO INDIANAPOLIS, LLC o CARMEL IN 46033 400D W 62ND ST aa :E I NDI ANAPOL i S I N 4 6 2 6 RaS D.0 "sA ANCES ARE sue�EC T0. 317 846 -7431 30 DAYS FROM DATE OF IALOICE I 0 CITY OF CARMEL MA: SRI 9 GARY z 1 CIVIC SQUARE DRIVER: MAY, JEFF I a ITEM WNfF TAX EXTENO£D P QTY 4 F PAC SIZE DESGRIPTIOIY ..CC)bRl> FRiCE 2AMOUNT. ERIC£ X k z r. n DAIRY T c 3 I. C S NL 5 LB BRLCLS CHEESE AMER YEL 12:0 SLI 28131.6697114 14 63 14 63` 1. m C ..GS :...81 5 LB BRLIMP CHEESE PROV SLI INTLF ,75 490142 9232265 39. 64. 39 64 I 1 r C C$ 39031 OZ. HLFARM CREAMER, HALF HALF CUPS ESI, 162400 9 35 14.22 22 L z GR?.UP TTAL 68. I. MEATS CO F Cs.. 2150 CT YS C.LS BACON PRECOOKED .THICK. SLICE 1 39..98 39 98 o 11 T S I. I'...... C... 110 LB BRLCLS FRANK ALL MEAT ,5.X1 6 IN 37 36 ..1 37 20 09 40 18 F CS. 208 OZ DVANCE PORK FRITTER.SOLID D 66, 7 95476 34 36 34 36 GROUP TOTAL 11:4..52 0 I. *k FROZEN F CS 246 4 OZ BRLCLS SANDWICH'BI�SC�SAUS /EGG /CHS..IW 1703:3381092 40 30 40 30 0 1. OU TOTALI 40 30 N CANNED &DRY D..... CS 16 CT AYS. CHIP VARIETY SYSCO�FRITO LAY 31831 6586721 26 98:` 26 98 D CS. 1212 OZ RENCHS MUSTARD YELLOW CLS SQUEEZE "415 075677'4 36070 20 50 20 50, 11 C PL 15'GAI CHWI2TZ PICKLE _CRS CUT K0 2 965 1028919 36 34" 36 34 A .GRO.UP T03IAL�t 8.3.82 rn PAPER &DISPOSABLE r. D CS_ 25033 GAt YSCO LINER TRASH 33x39 5ML BLK H 639MBS 4075958 38 78 38 78 1. I D C S 800 F'P EORG`P TOWEL ROLL ENMOTION LRG 4AUT0 89460 9627761 10 99` 141.98 1 GROUP "AL�;� :1:8:0 76.:' I I. SUPPLY &EQUIPMENT D S 12CT YSC6` MOP HEAD B'= LPD "ALL'PURP MED M 181SY5 '4179 545 18 71 1 z 1. GROU TOTAL 71 1. PRODUCE m 1. I C "S 15. LB YS IMP ONION RED FRESH JUMBO 1039494 13 33 T3 33 m I RE Mkr 70.; 00 PM P 0 BO% "713 7 1 1 16 13.7 217 INDIANAPOLIS IN SUB 4206-7137 TOTAL TAX SIGN D INVOICE EVIDENCES RECEIPT OF ALL ITEMS. TO TAL DRIVER'S NO. PC CUST. No. Pcs SIGN DELVE. SIGN REC. INVOICE 4 IMPORTANT PACA PROVISION: THE PERISHABLE ArRICU7T�UFRAL ECOMMODII TIE LISTED ON THIS ARE g SCO 7 LD SU TOTAL 99E{ STgTUTQRY E �R gr AUTHOf�I ED D TE CT i? N Ia TRU CLVIM THE I E U OMMbDITIESLI INVEN o 112 00uFS.C. PAYABLE ON OR BEFORE TFIE SELI. ciF rHESE c M a I s ONT ON PAGE 2 F000 OR OTHER PRODUCT$ DERIVED FROM THESE COMMODITIES, AND ANV RECEIVABLES OR PA OCEEDS ,aR FROM THE SALE OF THESE COMMODITIES UN71L FULL PAYMENT IS RECEIVED. Good things CONFIDENTIAL PROPERTY OF SYSCO rom ©v21nT 1 cHSroM:ER n iv Ic iv'`` OOKSHIRE GOLF CLUB S ij$ co TR erc.:s OP 412940 009240602 4 2 YSCO INDIANAPOLIS, LLC A CARMEL IN 46033 4000 W 62ND ST .1-I INDIANAPOLIS, IN 4626$ aas_r':o�E'gAiarilc>s.aR sveJeci:ra: o 317 -$46 7431 30 DAYS FROM DATE OF INVOICE 0 M CITY OF CARMEL 1 CIVIC SQUARE DRIVER: MAY, JEFF z Q7`. x:F... $ICE'.: ITEM DESCRIPTI,03�! o 1TM UNfT 7AX EXTENDED C T: CODE:: PRICE 7tMDLIN7:: PRICE X A T C C5! 1'Al 8 .Y z IP..PEP.P. GREEN ::D GED. l f 4 P:GDl /4 6 41'348 75., i8 75 T 3 n C x:...25:: LB BRLZ >11? SALAD CHLCKEN. 51071 2 10717 3.6:58 36:58 m G Fc...,15x6 YS IMP TOI+3A'0. LAYER F:RESH 1 08630. :19. $7'. 19.87 1. GROUP.TOTAL .,,8 I 1. 1- n C C3RD. ..:5 RY ..7.8168 1 6: m I G:. r. i ZI Ln Z I_: A 1. 41 A 1. r. O O I. n .1 O I Z x M :.r n ?REM17 M P.O. BOX 7137 3 1.2 27 INDIANAPOLIS IN SUB 4246 -7137 TOTAL 5 .13 1 1 19 14.9 244 TAX NO. PDS OU S G INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCS TOTAL DRIVER'S ❑ELVD. SIGN REC. SIGN INVOICE IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMOOITIES LISTED ON THIS INVOICE ARE SOLO SUBJECT TOTAL 13 Tp THE S7qq7UI? TRUST gOTHCI EV gy gECTIpN 5 C� pF THE PERISH LE p�RICULTURAL C�MMOpITIES qC7 7 D(U S.C. P 499EICI), THE gELLER OF THESE COMMODITIES RETAIN A TRUST CLAIM ��ER THESE COMMODITIES, ALL INVENTORIES Of LAST PAGE FOOD OR OT HER PRODUCTS DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEED$ FROM THE SALE OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. VOUCHER NO. WARRANT NO. ALLOWED 20 S'ysco Indianapolis LLC IN SUM OF 4000 W 62nd Street Indianapolis, IN 46268 $562.20 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# I Dept. INVOICE NO, ACCT #(TITLE AMOUNT Board Members 1207 009240602 42- 390.40 $562.20 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 Monday, September 27, 2010 Director, Brook hire Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund I Prescribed by State 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)) 09/24/10 009240602 Food $562.20 1 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