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165449 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1 0 ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $400.17 CARMEL, INDIANA 46032 PO BOX 7137 INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 165449 CHECK DATE: 10/29/2008 DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1150 4239040 810220487 400.17 FOOD BEVERAGES �r r= CONFIDENTIAL PROPERTY OF SYSCO V BROOKSHIRE GOLF CLUB... 1 22 P:. 12120 BROOKSHIRE PKWY TR e< s oP. 412940 810220487 5 1 SYSCO FOOD SERVICES o CARMEL IN 46033 O F INDIANAPOLIS LLC a °uE 4000 W 62ND St P.li�ST flklE::$ALANCES::ARE st]6VECT TO 317-844 -1415 INDIANAPOLIS, IN 4626$ 30 DAYS FROM DATE OF INVOICE Xt DELIVERY 0 a CITY OF CARMEL GARY LFjVLRFNZ Z 1 CIVIC SQUARE DRIVER: MAY, JEFF rAPMFL IN 46032 b QTY ti RAC': SiZf_: iTErvl urrT EXTENDED:; D H t7EiVI DESGRIRT .DN o C. ;r...,. ::CbflE PR'FCE LPRtCE_:_I: i( DAIRY C S NL. 5 LB BRLU'5 CHEESE AMER YEL 120 SLI 2813:1 6697114` 14 78 14 ALI�NOSHOW08 000D73385 P /UN 05 0:5 GROUP TOTAL 14,73 D ;MEATS`:; 0 F CS 1- .Q ..LH: RMC#UR.... `RANK ':ALL, MEAT 5!X1..GItILL. 5.01003121::..1074384 21 21 ..4:4 ..4:4 r D BRI;CLS.: S.li .3 ;4t3Z HNY CKD W A ::i 48 41..5'0 4I. 50... N ALLNOSHOW08 000.07338 P /CS .25 .2.5 RQUP 'I` 52.69:: o POULTRY r* A C CS 42.5 LB BRLCLS TURKEY BREAST SLI 3f459443 42.42 42.42 XLLN ©s xow� s 02 4$ 0000 Pf.C';S 2. 2!5 GROUP TOTAL 42 17 F�RO.EEN.. A O:S 48. NO LN H0 Ow081 FRZ.S.F CY 3. 0��83385.P3 .5438. 59 .25 58 .25 OS GRC}UI?..TTAI, 59 10;':1. A PAPER DISPOSABLE D Z D CS 2501602. ERENE CONTAINER PAPER RND W /PA Pk `LID 7194;9 7587132 $9 98 89 9$ ALIfNOSHOWO$ OQ40733 &7 P CS 25 25 A D XX C. 2500 ..0 YSC0 .FILTER COFFEE 12:CUP 481025513 S. S: 595:0670 9,9:5 9.5:5. m D. <i S'.:. NL 'SO.00'I'il. YSCO ':DIL SHEE' ?9X1{1.75IN: SILVER W69.3:7 ;2. 69.38500: is 13x3:3 39 9!g Z ALLNOSHOW08 000073387 PUN 04 12 D..... C S 4100 Cfi YSCO GLOVE :POLY DISP CAST POLY FH CTI6CPS 847797$; 16 76 f 6 7 6 n DISPENSER GROUF TOTAiI* 1 31 D S 4 OZ BESTCF COFFEE GRND SEATTLE HEST 00092302:2 0726414' S$ 17 58 117 2 GROUP TOTAL 5 17: MIS CHARGES HGS FOR FUEL SURCHARGE 7 00 m m m RfMtT to n 4 12 7.2 108 P.O. DIANAPOLIS IN sua 4206 7137 TOTAL TAX NO. PCS CUST, S INVOICE EVIDENCES RECEIPT III ALL ITEMS. NO. PCs TOTAL DRIVER'S DE.VD. SIGN X REC. SIGN INVOICE IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMODITIES LISTED ON THIS INVOICE ARE SOLD SUBJECT TOTAL 9EIC11 7 HEE S7p7U7O TRUST A TH(!RI E ,S CTIpN S C THE PERISHABLE gGgICULTUBAL CpMMODITIES qC7 7�4�D�U�S,C, pgyggLE ON OR BEFORE 49 THE SELLER OF THE; LJ tT,I RETAIN A TRUST CL0.1M NH THESE COMMODITIES, ALL INVErJTbRI ONT 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.