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Home My WebLink About203632 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1 ONE CIVIC SQUARE SYSCO FOOD SERVICES INDIANA 46032 CHECK AMOUNT: $880.41 CARMEL PO BOX 7137 INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 203632 CHECK DATE: 11/9/2011 DEPARTMENT A PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 110280299 880.41 FOOD BEVERAGES CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO Good things come from DELV ;(SATE s,:. CUST,Otd1ER BROOKSHIRE GOLF CLUB... TR CK::s oP 412940 110280299 6 1 12120 BROOKSHIRE PKWY SYSCO INDIANAPOLIS, LLC CARMEL IN 46033 4000 W 62ND ST R qRpFR INDIANAPOLIS, IN 46268 317 846 -7431 DUE FRIDAY 4 WEEKS AFTER ORDER MANIFUT4 42777 RMAL DELIVERY CITY OF CARMEL 1 CIVIC SQUARE DRIVER: PARKER, JEFF rARMET, IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE. r QTY SAC SIZE I DES CRIPTION �oDE PR cx ?f3ic� A r. x DAIRY �C NL 5 LB,. 8 RLCL5 CHEESE YE L 120 SLI 28131 6697114 18'38 18 38` C NL 5 LB ASAS.OL CHEESE CHDR JACK SHRD FCY 10999CS 2406.189 15 9$ 15,98. �C S 5 LB HLFARM CREAM SOUR CULTRD GRADE A 3396200 5020193 13.98 13 GROUP TOTAL MEAT5 F S 110 LB HNSVLE BRATWURST 5X1 PRCK SKLS 3188 2199 199198 29 99. 89 9T F S 10..LB BRLCL5 FRANK ALL =MEAT 5X1 6 IN 37736 070 1137736 22 74 45.48 xx FROZEN GROUP .'IO:`AL* 13:5.45 h mjmisj F 1 S 5 LB TM CHILI TEXAS JACK S 43030 4871372 49.60 49d 00 GROUP::TOTAL x.9:6 DO.: CANNED DRY �'C NL 36 CT ARS CANDY BAR MILKY WAY 01101 4367363 24 74 24 74 C NL 48 CT NICKER CANDY BAR SNICKER 2 07 OZ 01202 43483$9 32 61 32 hl vD S 1215. 2OZ ROPCNA JUICE CRNBRY CKTAIL PET 00864 4760062 16 33 16 33 D S 5009 GM SE R:EC RELISH'SWEET PKT 1609064 160 064 28.25' `28 :5 GRO TOTAL* 1 k DISPOSABLE D.... M L 2050CT YSCO LINER TRASH 24X33 RL 6MC HDNAT _Z4833RNSR01 5881966 55.47 55.4 PRODUCE' GROUP TOTAL 55 47 C S 12 CT PACKER LEMON FRESH 1039478 1039478 7.98 7 X38 C S 112 CT PACKER LIME FRESH 1283787 9 9 44 C S 15 LB YS IMP ONION YELLOW DICED 1/4" 6167866 10 90 21 80 CROUP TOTAL 39 Z�` MIS _RG HGS::FOR FUEL SURCHARGE 5 00 P.O. SOX 7137 A vm I 2 4 27 9.0 361 INDIANAPOLIS IN SUR p IMPORTANT: PERISHABLE PRODJ( ARE NOT ELIGIBLE FOR RETURN MI 46206 -7137 TOTAL E FFOR V ANY SHOR AGE AFTER YOU HAVE E $IGNED. PIECES ECEIV EO MUST TAX NO. PCS CL15T. NO. PCs TOTAL DRIVER'S DewD. SIGN REC. SIGNS 1gg}� RC pI7 5 p pN HI E g 7 U INVOICE og p gg Sg T V O IJ ry L T 5IC) q Op7�HMEOPERIIEE$gHA``�ggII L, EAGRICIJ7 LTUSRALVOCOMMAp�ITISEgL{D�[TUBI Eg C gO {7 499 IC�J R T}�E 7R S L ER p TOTAL 7 THESE tIQMMODIT E RETAINS A TRUST CLAIM OV R THESE COMMODITIES, qLL INVENTORIES OF FOOD 0 O�(WER PRO UCTS PAYABLE ON OR BEFORE I DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2 c FULL PAYMENT IS RECEIVED. CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO Good things come D�IV':VAr� CUS7oMER <I BROOKSHIRE GOLF CLUB �l Y�co' rtt cK;s or 412940 110280299 6 2 12120 BROOKSHIRE PKWY YSCO INDIANAPOLI5, LLC CARMEL IN 46033 4000 W 62ND ST INDIANAPOLIS, IN 4626$ 317 846 DUE FRIDAX xjTA AFTER ORDER CITY OF CARMEL 1 CIVIC SQUARE DRIVER: PARKER, JEFF EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 FIR 60 -1.4 60 -250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE. I rTEJVI *l EXTtNbIaD (3TY ,PAC SIZE ITENE RESCRIPT'ION or9E PR�cE P.RiC 'I`H ALQWANS AND; CHARG)1S. >1 00 ORD RY r 10308 N P.O. BOX 7137 1.00 INDIANAPOLIS IN U n IMPORTANT: PERISHASLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN S5 ��ggAFTE 46206 -7137 TOTAL 880.4.1 B 2 4 2 9 0 361 FOR V ANV SHORTAGE AFTER Y U HAV E SIGNEO I P ECE RECEIVED MUST TAX DRIVER'S N PC S OUST. N0. PCs TOTAL DELVO SIGN REC. INVOICE slcN 880.41 1 TH P A RRIICC LT R L CO Op TI S TED N T INVOICE ARE SpLD gU@ T 7O 7I�E s7ATL�TORV TRUST TOTAL o U g g�y E S 5 of T PE Rl LE AG� T qAL CDMMppITIES AT 193p17 U.S.C. 499E {Cll THE SELLER PAYABLE ON OR BEFORE C 1 TH SE COMMODITIES RETAI A TRUST CLAIM OVER THES oMMODITIES pLLL INV riTORRIEEES OF FDOD OR OYHER PRRODUC S 11/2J/11 LAST PAGE 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL o FULL PAYMENT IS RECEIVED. VOUCHER NO. WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF 4000 W 62nd Street Indianapolis, IN 46268 q ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1207 110280299 42- 390.40 $880.41 materials or services itemized thereon for which charge is made were ordered and received except Tuesday, November 01, 2011 i Director, Brooksh' 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. 199`_ 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)) 10/28/11 110280299 Food $880.4 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