163003 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
ONE CIVIC SQUARE SYSCO FOOD SERVICES
CHECK AMOUNT: $136.74
CARMEL, INDIANA 46032 PO BOX 7137
INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 163003
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
1047 4239040 807190224 136.74 FOOD BEVERAGES
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DELIVERY COPY CONFIDENTIAL PROPERTY QF SYSCO
V a oA7E CIjsuA R.
CARMEL CLAY PARKS RECREATIO
1235 CENTRAL PARK DR TR GK UP 429670 807190224 4 1
SYSCO FOOD SERVICES �v�
CARMEL IN 46032 OF INDIANAPOLIS LLC
4000 W 62ND S'� o
317 523 4023 INDIANAPOLIS, IN 462b8 30 DAYS FROM DATE OF INVOICE
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CARMEL CLAY PARKS &RECREATION p
1235 CENTRAL PARK DR DRIVER: 9
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TAMS�tiATIflA! G11 L3P1 E? t3 EN�I 1J
PR PRICE
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EACH AYL.OR MACHINE IGE CRM SOFT S.ERVE_ 161 91Q6782 3$..74 .136.74 z°
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GRbUP TOTAL 7413 74:
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2 38.2 660 INDIANAPOLIS IN sue
4�20b 7137 TOTAL 7413.74
2 38.2 660 TAX
NO. PC$ OUS T. 15, GryE0 INVOICE EVIDENCES RECEIPT OF ALL ITEMS. NO. PCs TOTAL
DRIVER'S DELVD. SIGN x REC.
SIGN INVOICE l n
IMPORTANT PACA PROVISION: THE PERISHABLE AGRICU TURAL COMMODITIES u$TE❑ ON THIS INVOICE ARE SOLD S TOTAL 741 4 1
Tpp 77HE S7gTU7pRY TRUU,$T T C7IpN SIC 7 PERT H IJLTURA �1�.10�ITI�SN�bRI�S�DOu S. c. pAVABLE DN OR BEFORE
439EIC)I. THE SELLER 0.� THESE COMMODITIES RETAINS A TRUSd LLAIM OVER THESE COMM6DRI LL V P 8/18/08 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.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
359366 Sysco Food Services Terms
P.O. Box 7137
Indianapolis, IN 46206 -7137
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7119108 807190224 Food Beverages is 13674
Total 136.74
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
1 20_
Clerk- Treasurer
Voucher No. Warrant No.
359366 Sysco Food Services Allowed 20
P.O. Box 7137
Indianapolis, IN 46206 -7137
In Sum of
136.74
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 807190224 4239040 136.74 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
12 -Aug 2008
Signature
136.74 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund