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190974 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1 0 ONE CIVIC SQUARE SYSCO FOOD SERVICES CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $1,042.22 INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 190974 CHECK DATE: 10/13/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 010010795 475.44 FOOD BEVERAGES 1207 4239040 010080304 566.78 FOOD BEVERAGES Good things CONFIDENTIAL PROPERTY OF SYSCO comefrom flEtY;RA7E CUSTfJMER V "U R'I PAGE BROOKSHIRE GOLF CLUB.. Ws 1 1 12120 BROOKSHIRE PKWY TR �k s OP :412940 010080304 1 SYSCO INDIANAPOLIS, LLC p CARMEL IN 46033 4000 W 62ND ST °E INDIANAPOLIS, IN 46268 PAS:r Dt1E BaiANCES.RRE suR��cr Ta o 317 846 7431 30 DAYS FROM DATE OF INVOICE DELIVER �MANI T4 392446-NORMAL o D CITY OF CARMEL Z 1 CIVIC SQUARE DRIVER: PARKER, JEFF CARMET. IN 4151032 D P TAX EX TENDED. I a QTY s': FAC SIZE l ITEM DESGRIPTION o ITEM UNIT s: CODE' PRICE AMOUNT PRICE X I n DAIRY C S NL 5 LB BRLC..LS CHEESE AMER. YEL :120 SLr 28131 6697114 14 63 14 63 MEATS GROUP' TOTAL 1!4 63 .GS 6Q5. 3302 AB BEEF PATTY GRND STKBRG. FRZN 9 763151 6703 56.79 1.13 58. Z F C5 110 LB. H NSVLE BRATWURST 4X1 PRECOOKED X99 1611243 29 44. 88 32: F CS 110 LB. BBRLCLS FRANK ALL MEAT 5XI 6 IN 37 36 07 7 7 3 6 20,52. 61 -56 GROLI P..TOTAL r F CS 5 LB YS IMP POTATO FRY 5116 SKON PHANTM PL S 003109 4356473 2$ 24. 28 24 C5 246 4 OZ BRLCLS SANDWICH BISC SAUVE pS IW 1703 3381092 40 30 40.30 A F CS 243 9402 NPRIDE SANDWICH SAUS EGG CHS;CROIS IW 482 51 29.15 29.15 ROiIF :TOTAL 97, 69 N CANNED DRY N D CS 230 CT LAYS CHIP VARIETY PK BAKED BFY 32198 5581863 29.15 29. 15 0 D CS 160 CT AYS CHIP VARIETY SYSCOIFRITO LAY 31831 65 86721 26'.98 26.98 D 3 BRLCLS SNACK MIX 'SPCY CREOLE "91069 9 .960329 31'.'36 31 36 D D CS20001NDV PLENDA SUGAR SUBSTITUTE 1 GRAM 20004 0 30745 39 30 39.30 Z GROUP.: `FOTAIr :1:2 7 9 PRODUCE C CS 112 CT PACKER LIME FRESH 1283:787 8 78 8 78: C CS 15 LB SYS IMP ONION RED FRESH JUMBO 1039494 13 33_ 13 33 m C CS 42.5 LB YS IMP TOMATO SLICED 1 4` 1 40451 '6111765 42.10 42 10` Z OT L* :.644: 21 m 7 j sm A m P.O. BOX 7137 1 1 19 14.8 217 INDIANAPOLIS IN sue 4206 -7137 TOTAL TAX N0. PCS GUST• IGNEb VN VOICE EVIDENCES RECEIPT OF ALL ITEMS- NO. PCs TOTAL DRIVER'S DELVD. SIGN REC, INVOICE SIGN IMPORTANT PACA PROVISION: THE E SHABLE AGRICU R E RI TURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLD SUBJECT TOTAL Tp 7�E 1 S77A77U7p RY TRUST AL�THO IZF�D BV SECTI�N 5�C� p� T�—IE PFARISH g AGR COhSMO�ITIF E A�CT 1g3O PAYABLE ON OR BEFORE 499EIC1. THE SELLER OF THESE COW ODITIES RE A A TRL T CL IM O ER TFiE E COMM DITIES LL NV TORIES �F :ON ON PAGE 2 FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. Good things CONFIDENTIAL PROPERTY OF SYSCO come from Mv!.L�ATE Cll &Tt?M.ER ..,:;fu cE� BROOKSHIRE GOLF CLUB sc 12120 BROOKSHIRE PKWY la cKSGP 412940 010080304 8 2 S_ SYSCO INDIANAPOLIS, LLC o CARMEL IN 46033 4000 W 52ND ST °'E INDIANAPOLIS I N 46268 PAST DIfE !B/sLANCES AIRE' $ttBJECT TO O 317 846 7431 30 DAYS FROM DATE OF INVOICE MANIFFFW 3924 DELIVERY 0 CITY OF CARMEL z 1 CIVIC SQUARE DRIVER: PARKER, JEFF z Q7'Y .a PAC. SIZE: tTEh? ©E$GRIPTIOfU �auty EX ED P a j:l C 1T. &IN bDE PRICE AM T ORD S RY 1511 M 1. n r. m is 1 D i.. n 9 s: m 11-1-111- I 0 y:: 11 .o-.. :o- C, L 0 r a rllr 1. Z Ir: i m A A S: b .1. O O D m Ra m c Z p IT REMIT TO, n P•O. BOX 7137 INDIANAPOLIS IN SUB 4206 7137 TOTAL 566.78 1 1 19 14.8 217 TAX NO. RCS CLIS T. 5I jD INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCs TOTAL DRIVER'S DELVD. SIGN y REC. INVOICE SIGN TOTAL 566.78 IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMOOITI ES LISTED ON THIS INVOICE ARE SOLO SUBJECT T TTEEHCe7 $T UTSpE RY TRU 7 ORI ED DgY E §SeCTEI N N 5 S `C� p T PERISHABLE AGRI CU LTURA C ITN A T7 19 S. C, FOOO OR OTHER L PFO DUCTS DERIVED FROM COMMODITES, ANtsD MANOYV E R R EC T EIIVABBLE C O OR�PR L FROM�THHE I SALE OF PAYABLE ON OR BEFORE LAST PAGE THEE COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. I VOUCHER NO. WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF 4000 W 62nd Street Indianapolis, IN 46268 $566.78 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 010080304 42- 390.40 $566.78 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, October 11, 2010 r' Director, Brookshire 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)) 10/08/10 010080304 Food $566.78 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 hings CONFIDENTIAL PROPERTY OF SYSCO come from f7E14. :E?AT cuSTnME vv cE BROOKSHI RE GOLF CLUB T.R cK: s oP 12120 BROOKSHIRE PKWY 1 ...1 1 412940 010010795 2 1 SYSCO INDIANAPOLIS, LLC p CARMEL IN 46033 4000 W 62ND ST Rou n 1. I NDI ANAPOLT S I N 4 6 2 68 PAS,. DUE BALANCES ARE st3RJEcr To 317 846 7431 30 DAYS FROM BATE OF INVOICE IBM 0 CITY OF CARMEL a 1 CIVIC SQUARE DRIVER: AVERS, AARON z C2TY a PAC SIZE ITEM:: UNIT 7AX E.... i�EA P ITEM flSCl�]PTION o C s. T.- CODE: PRICE AMOUNT PRICE X I DAIRY Im C S NL T LB BRLCLS CHEESE AMER YEL 120 SLI 28131 6697114 14 63 14 63 MEATS GRQUP TOTAL 14 .63 m 1. 1 1. C GS 42 5LB BRL BEEF ROAST TOP RND SLI C /OFF 20614 1962$69 ,56.67 56,67 z n F CS 110 LB_. BRLCLS FRANK ALL MEAT 5X1 6.IN 37',3 20 52 20 52 a I. CS 42 5 LB BRLCL$ HAM SLI 2f3OZ HNY 20660 1963289 39 29 39.29 N 1. GROUP. T0;`PAL I1. POULTRY p C CS 42 5LB BRLCLS TURKEY .BREAST SW OVEN RSTD_ 20643 1960.434 39 98. 39 98. GROUP. fiO :.3.9 98 o FROZEN CS 2CT RCTYBK COOKIE CHOC CHNK DWNHM 30Z 57 8349439 82 57 82 .H OUP.::TOTAL :5;7 0 2.: N 1. CANNER &DRY VD CS 230 CT AYS CHIP VARIE'T'Y PK BAKED`BI'X 3219$ 5 8 6 $13 29.15 29.15 z o r-r D CS 160 CT LAYS CHIP VARIETY SYSCO "FRITO LAY 31831 6586721 26 98 26 g 1. A D CS 135 LB OLDCHF SHORTENING `FRYING` CREAMY 10 '065 WG 9956426 "2Z 43' 89 721 1. GRQUP,.TOTAL 14!5 $S I L: PAPER &DISPOSABLE m D CS 24100CT YSCO LID PLAS CLR F/1 5 2.5OZ PRTN YL 2FRSYS 7790795 45.11 45 11 33 D C5 8500 C. YS CLS NAPKIN BEV 9 °.3$X9.38�1PLY 414T 811 IA SYS 6049847 1$ 99 18 99 GRO.TjP..TOT I1. 64.10'!L.. o PRODUCE P 1. C CS 25_ LB BRLIMP SALAD CHICKEN 51071 2 10717 36 5$: 36 58 Z GROUP? .TO'AL 36 a8:;: 11 m M fiEMtT To; m P.O. BOX 7137 1 1 15 14.1 260 INDIANAPOLIS IN SUB 4U206 -7137 TOTAL TAX DRIVER'S NO. PC S COST, SI IN OI E EVIDE CES RECEIPT OF ALL ITEMS. NO, pC5 TOTAL SIGN OELVO. SIGN Z REC. INVOICE IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMOD LISTS N THIS INVOICE ARE SOLD SUBJECT TOTAL Tp THEE 5T U7pFjY TRUST THORIZ�p gy gECTIIppN 5 C� pF THE PERIgHgqggLEE qq��}}{{II CCULTURAL Cpry�MOpIIIES AC7 1 O U S.C. PAYABLE ON OR BEFORE 499E {cll. THE SELLER DF THESE COMMODITIES P.ETA IN� A TRUST CLAIM OVER THESE COMMODITIES, ALL INVENTORIES b� O NT, ON PAGE 2 FOOD OR OTHER PRODUCTS DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF COMMODITIES UNTIL FULL PAYMENT IS RECEIVED. Good things CONFIDENTIAL PROPERTY OF SYSCO come OELY BATE C31STtIMER ICE;. AGI BROOKSHIRE GOLF CLUB I� cK.. aP 12120 BROOKSHIRE PKWY 412940 010010795 2 2 CARMEL IN 46033 4000 WND62NpPOTIS, LLC -ROB. b INDIANAPOLIS I N 4 6268 FAST DUE BA3 ANCES AR Si bjt T TC 317 846 7431 30 DAYS FROM DATE OF INVOICE 0 M I SQUARE DRIVER: AYERS, AARON z Q 47�R $ICE ITEf�A DESGRIPTION ITeM" UNrT Tax xr�r�o �r F L3UE PRICE .'AN10UN7 R] CE::: 'c x Z 0 n ORDER SUMMARY 86245 r 3 a m 0 D h ?I 0 m N R 1. -.7 T 11 ..1....::. m I I I I 1, O A 1. z ':I; -I:.. m 1. A n 9 1. m I. :.6...: i O 1. 9 D 1. m z c F .:i[ m 1 2: S J6 m 11 m .'r> o: P::. C I :REMIT TQ: P,O. BOX 7137 INDIANAPOLIS IN SUB 4206 -7137 TOTAL 475.44 1 1 15 14.1 260 TAX O. DRIVER'S N PCS CUST, SIGN P INVOICE EVIDENCES RECEIPT aF All ITEMS NO. PCs TOTAL SIGN DELVD. SIGN REC. INVOICE IMP7270 PROVISION: THE PEg15HABLE AGRICU TURAL COMMODITIES LISTEC ON THIS INVOICE ARE SOLO SUe JECT TOTAL 475,44 Tpp Ti2UST A ORIZED gY SECTIpN SrC� pF THE PERI�SHA�,L �IGRICULC7URAL COMMODITIF�S ACT 1930( PAYABLE ON OR BEFO 499ER OF TH� COMMODITIES RETAINS A TRUST CLAI O t ESE OMMODITIES ALL NVENTbRIES 1/31 /10 LAST PAGE FOORODUCTS DIVED FROM THESE COMMODITIES. AN❑ ANV RECEIVA @LES Oq PROCEEDS FROM THE SALE OF THEES UNTIL FULL PAYMENT I$ RECEIVED. VOUCHER NO, WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF 4000 W 62nd Street Indianapolis, IN 46268 $475.44 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# I Dept. f NVOICE NO. ACCT #MTLE AMOUNT Board Members 1207 010010795 42- 390.40 $475.44 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, October 04, 2010 Director, Brooks ire Golf 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)) 01/10/00 010010795 Food $475.44 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