206023 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC
CARMEL, INDIANA 46032 PO BOX 660088 CHECK AMOUNT: $2,434.68
INDIANAPOLIS IN 46266 -0088 CHECK NUMBER: 206023
CHECK DATE: 1/3112012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 2188519 1,213.18 FOOD BEVERAGES
1095 4239040 2455815 484.28 FOOD BEVERAGES
1095 4239040 2784868 737.22 FOOD BEVERAGES
1 �'n•
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER F SALES SALES DATE
NO. NO. DAT ;NO. NUMBER LOC. REP. ORDERED
90569 22 219EiS 19 12/
x(356957`5 1054 0062 i2/19/11
Your partner beyond the plate' DELIVERY 'ROUTE: 28.51 4 O R NUMBER: 400074
41;
BILL CARMEL CLAY PARKS &RECREAT SHIP CARMEL CLAD' PARK$gxRECREAl REMIT US FtlodB,
TO: 1411 E. 1167'H ST TO: 1235 CENTR PARK DRIVE E
CARMEL IN CARMEL IN BOX 660088
460:32 46032 INDIANAPOL IN
317 843 38t
1 46266 -008
ATT. MICHELLE COMPTON DEPT 00 ,�4 800 428 118
SHIPPED FROM: 12301 CUMBERLAND RD FISHERS Iikl SHIP DATE: 12/2O/11 Page 02 of 0 2
FREIGHT TERMS: SPECIAL ENTER OFF OF 111TH STREET I 11
PAYMENTTERMS: NET 30 DAYS
INSTRUCTIONS:
QTY. QTY. SALES PRODUCT C PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER DESCRIPTION PACK SIZE LABEL D WEIGHT UNIT PRICE PRICE
E
101 AL _'FROZEN PIECES ORDERED: 1b SHIPPED: 16 ITEMS SHIPPED: 7 472.26
INVOICE SUMMARY
FUEL SURCHARGE. 6.25
TOTAL WGT SHIPPED: 494.64 PIECES ORDERED: 43 PIECES SHIFTED: 43 ITEMS SHIPPED: 66
PRODUCT TOTAL 1206.93
CHARGES 6.25
TAXABLE AMOUNT .00
OEM SALES TAX X .00
PLEASE REMIT THIS AMOUNT BY 01/19/12 AMOUNT 1213.18
Purchase nn
Dascription
F.O. IIa�n r F �f
V 1. 0 p Im
n •c Iriet lJ J V 4 20 ...r/
I i_irle Descr
Purchaser Data
BY:
rneperishable agrk,r twr>il eemmaiaea ll,tea on tbl, irl�e ara Sala suble�,mme stawmrY Va�taw�r+ =ea by seen slelmma Visit www.usfood.corrm for a�fastrand: easy way to order.
Perishable Pgrlcubral Commodities Pc4 1930 U.S.C. 499e1c)) The seller of mesa commodNes reialns a tout claim war these t x„ X
urommodilie% all Irnentodes of footl or other producLS derNed tmm mesa commotlroes, end erry receNables or pmceatls ham the sale of i. „r
these commodilles urltll full payment Is receNed
n
terestshaheccmeon a�aances eseGished credittermsalerate ualtoNelesse of a 1 h% xT CUSTOMERS SIGNATURE:
pe ry eq 1 1 per monN or f
.1 (b) the maximum rate Net the customer may lawluly contrecl to pay, end In all wenU ralalated In aaordance wAh epplicaDla law. r S� j &eAA# w4& *a. V64,ew" r
ACCOUNT INVOICE INVOICE CUSTOMER. PURCHASE ORDER SALES SALES DATE
NO. NO, DATE :'6' ��1 NO. NUMBER LOC. REP. ORDERED
400 90569922 P-188519 12'120Y`11,.��? "t�s9375` 10 4 0062 12/19/11
Your partner beyond the plate. a
DELIVERY ROUTE: ORDER NUMBER: 40007
BILL CARMEL CLAY PARKS&RECREAT SHIP CARMEL CL+ Y PARKS&RECREAT REMIT US Foods, Inc.
TO: 1411 E. 116TH ST TO: 1235 CENTRAL.. PARK DRIVE E TO:
CARMEL IN CARMEL BOX 660088
IN
TN
46032 46032 INDIANAPOLIS
317 843 3873 46266 -0088
ATT. I MICHELLE COMPTON DEPT 00 800'428 2118
^f SHIP DATE:
"'SHIPPEDFROM: CUMBER RD FISHERS IN 12!20/11. Page OY of 02-
FREIGHT TERMS: SPECIAL ENTER OFF (3F i 117H G`aTC�
PAYMENTTERMS: NET 30 DAYS INSTRUCTIONS: A
QTY. OTY. SALES PRODUCT 0 PRICING'" UNIT EXTENDED'
ORDERED SHIPPED UNIT NUMBER DESCRIPTION PACK SIZE LABEL D WEIGHT UNIT PRICE PRICE
E
DRY
1 1 CS 0814541 CUP, FM 20 Z UHT 25/20 EA MONOGRAM CS 21.8300 21.83
1 1 EA 0841080 CUP, SFLE PLST 2 Z TNSLT PTN 250 EA MONOGRAM B .EA 5.0880 5.09
1 1 CS 1287747 SNACK BAR, CRL ASST IW SS 3/16/1.3 OZ KELLOGG'S- CS 27.1300 27.13
1 1 EA 4053336 CANDY, BAR MILK CHOC 36 EA HERSHEY EA .26.2100 26.21
J. 1 1 CS 4180923 COOKIE, VNL CREME SNDWH SNCWL 48/1.7 OZ SNACKWELLS CS 23.3100 23.31
4 4 CS 4260238 SAUCE, CHS NACHO SHL.F STABL 4/,107 OZ ORTEGA CS 49.0000 196.00
1 I CS 4371571 CAPPUCCINO, FRNCH VNL INST 6/2 LB RITUALS CS 52.0800 52.
1 1 CS 5429303 JUICE, ORNG 100% PET PLST BTL 24/10 OZ THIRSTER CS 19.74100 19.74
1 1. CS 55854876 CHIP, PTATO BKD ORIG GLTN /FR 64/1.125 OZ BAKED LAYS. CS 28.5500 28.55
1 1 CS 5601679 CHIP, PTATO REG PLN SS BAG 6411.5 OZ LAY'S CS 25.5500 .28.55
1 1 CS 5601927 CHIP, PTATO KTL.JLP SS BAG 64/1.375 OZ MISS VICKI CS 29.8500 29.85
1 1:`v'• CS 5605472 CHIP, MULTGRN CHEOR SS BAG 64/1.5 OZ SUN CHIPS CS 29,8500 29.85
1 1: CS 6260665 COOKIE, FUDGE STRPE MINI SS ,0/2 OZ KEEBLER CS 22.1900 22.19
i 1 EA 8036576 CANDY, M &M PNT,'1.74 OZ 49`EA .M M EA 34.2000 34.20
.2 .2 CS 9089079 POPCORN, RAW Kr W/ OIL SALT36 /5 OZ FANCY FARM ACS 22.5700 45.14
1 CS 99.87956 COOKIE, DEVIL FOOD FT /FR CH /FR40 /1.1 OZ SNACKUELLS CS 23.3100 23.31
5 5 CS 9463668 CHIP, TORTLA CORN,.YLW RND 6/.2 LB EL PASADO CS 15.8200 94.10
REFRIGERATED
1 1 CS 5332242 LETTUCE, ICBRG SHRD 1/4" CLND 4lP,LB CROSS VALY B CS 17.7800 17.78
READY TO.EAT Please Refer to Return Polic{1
i 0 CS 7197775 YOGURT, ASST STRWBNA 8 RSPBRY 1216 07.. �+OFL.AIT
'SUB .1 CS 1199298 YOGURT, ASST LIGHT RBST FREE 12Y6 OZ YOPLAIT CS 9.7600 9•.76
FROZEN
5 .5 CS 2011218 PRETZEL, KING SOFT BKD FZN 50 5 OZ SUPR PRTZL CS 28.7000 143.50
i 1 CS 2014652 MUFFIN, BLBRY .IW 204 OZ SARA LEE CS 20.2900 20.29
2 2 CS 3041423 CORN DOG, AM CN FZN 4884 OZ STATE FAIR CS' 32.8500 65.70
5 5 CS 3330099 HOT DOG, AB 6:1.6" RLR GRIL 10fi,LB PATUXENT CS 28.9600 144.80
1 1 CS 5741228 BUN, HOT LOG 6 ".HINGE SLCD TFF13'12 EA HILLTOP HR CS 29.9600 27.96
1 I. CS 6153027 BROWNIE, CHOC 2.5 Z UNSL BKD 48/2_5 OZ OREO CS 4 53.6800 43.68
1 1 CS 8187999 ICE CREAM BAR, CHOC TACO VNL24i/4 OZ KLONDIKE CS 24.3300 24.33
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 25 +j'IECES SHIPPED: 25 ITEMS SHIPPED: 17 707.13
TOTAL PIECES ORDERED: 2 •'PIECES SHIPPED: 2. ITEMS SHIPPED: 2 27.54
The perishable agricultural commodities listed on this imolce are sold V0W to the statutory torsi authorized try sedlon `i(c�of itre Visit www.ustood.com for fast avid easy way to order..
Perishable Agdmtwral Commodities Pct, 1930 (7 U.S.C. 499e(c)). The seller of these commodities retains a oust claim over X
mmmoddes, all Inventories of food or other products delved from these commoddleg, and any receivables or proceeds from the sale of
Mesa commodities until full payment is received. f CUSTOMERS SIGNATURE:
Interest shad accrue on all unpaid balances exceeding established aedd! �N
arms at a rate equal toe lesser of (a) 1-�h %per rrronth or
(b) the maximum rate that the customer may lawlulty contra. to pay and in all events calculated in accordance with appllcable law. t �BCCC(C,� �OLK �wq,(,Q•
dA
ACCOUNT INVOICE INVOICE' CUSTOMER PURCHASE ORDER SALE! f SALES DATE
NO. r A NO. NUMBER LOC. REP. ORDERED
1 1 1, 59
2c 699 245581: .12/30/ 1 1 056 1054,'. j 0062 1
Your partner beyond the plate.'
y
f..
ROUTE: 5c� 4
BILL CARMEL CLAY PARKSE<RECREAT S CARMEL CLAY PARKS &RECREAT RE IT US Foods,
TO:' 1411 E. 116TH ST TO: 1235 CENTRAL PARK DRIVE E O:
BOX 660 088
CARMEL IN CARMEL IN
46032 46032 i` I I ANAP OL I.$:<, IN
a` 317 843 3873 4366-00 8�'�'y
ATT:' MICHELLE COIVIPTON DIEPT 00 Rf�n etc
SHIPPED.FROM:'1 CUMBERLAND RD FISHERS IN SHIP DATE: 12 /30/11 Page 02 t �f 02
FREIGHT TERMSi SPECIAL ENTER OFF OF 111T T!
PAYMENT TERMS: NET 30 DAYS 'INSTRUCTIONS:
QTY. QTY. SALES PRODUCT p WEIGHT PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER DESCRIPTION PACK SIZE LABEL E UNIT PRICE PRICE
INVOICE SUMMARY
FUEL. SURCHARGE
TOTAL.UGT SHIPPED: 184.69 PIECES ORDERED: 15 PIECES SHIPPED: 15 ITEMS SHIPPED: 13
PRODUCT TOTAL If .478.03
CHARGES 6.25
TAXABLE AMOUNT .00
t c GEN SALES TAX 2 .00
Purchase4. /1�1 �J� C� w»,'•~
Description l.lJ
P.O.# Pc F
G.L.
PLEASE REMIT THIS AMOUNT PY 01/29/12 AMOUNT 434.2
l
Lire Descr
Purchaser Date D tmg 9
Approval Date
JAN 20 12
BY.....................:.�
The perishable agdculluml commadlUes Aed on this invoke are sdtl sub)ect staway WStaWgrlEedby section 5(c) of the Visit www.usfood.com for a fast and easy way to order.
Perishable Pgrk p ultural Commodities Pct 1930 U.S.C. 499e(c)). The seller of these commodities retains a tout claim over t X
commodNes, all invents of food or other pxxUls derived from gene commodities, and any receivables a proceeds from the sale Of
these commodities until full payment isreceied. V U OMERS SIGNATUR
Interest shall accrue on all unpaid balances exceeding established credit terms et a rate equal to the lesser of (a) 1!&% per month or
(b) the maximum role that the customer may 1, wlulty contract to pay, end in all event oalwlatad in accedence wtih applicable law.
Zf/er ectate Zlewc $uatreaa
r
la
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO. DATE NO. NUMBER LOC. REP. ORDERED
N,,4»�g 9575,942c 24558# 7 1'2'/30/ 1 1 905 0062 12/E9/11
E,9575 /�/t/ C 104
%Your partner be and the
Y DELIVERY ROUTE: 5283 4 DFR N t JMR F (*)F,'75t
BILL CARMEL CLAY PARKS &RECREAT SHIP CARMEL CLAY PARKS&RECREAT REMIT US Foods, Inc.
TO: 1411 'E E. 116TH ST TO: 1235 CENTRAL PARK DRIVE E TO:
BOX 660088
CARMEL.. IN CARMEL IN
46032 46032 3873 46266- 0088IS :[N'
ATT. MICHELLE COMPTON DEPT 00 800 42
SHIPPED FROM: 12301 'CUMBERLAND RD FISHERS IN "SHIPDATE: 12/30/11 Page 01. Of 02
•.FREIGHT TERMS: SPECIAL ENTER OFF OF 111TH STREET!!!
PAYMENT TERMS: NET 30 DAYS INSTRUCTIONS:
QTY. QTY. SALES PRODUCT C 0' PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER DESCRIPTION PACK SIZE LABEL D WEIGHT
UNIT PRICE PRICE
E
DRY.
1 1 G 0445098'. PE HRML GA S R 0 R S TA T R 5
T
G T MONOGRAM
L
H S WHT CS 0. 85 67
2,' 2 CS, 2404325 GLOVE, POLY.LIS TXTD'.AMBDX 10/100 EA MONOGRAM B CS 38.5800 77.1.6
1 1 CS 570407 COOKIE, NUTTR 'BU'fR _1 Z SS 48/1 OZ NUTTR BUTR GS 28.2500 28.25
1. 3: CS 908907,•, POPCORN,. i�AW KIT td/ OIL SALT36 /8 OL FANCY FARM.. �s. CS.. 22, 5700. X2.57
I' 1 CS 9.328311 WRAP, FOIL 12X10.75_INFLD P 12/200 EA MONOGRAM B CS '-78.9800 78.98
REFRIGERATED
1 1. CS 0654269,.. HUMMUS, RSTD RED PPR NONDARY 12/4.56 OZ SABRA CS 22.9000 22.90
READY TO EAT .P -1eate Refer to RetU.rn Polio
1 I CS 4800843 MILK, 2% REDUC FAT -PLST REF_ 12/1 PT PRAIRIE.FM CS s 10.3800 10.38
1 1 CS 4800884' MILK, -CHOC IX-LOU FAT. PL�a' T REF12 /1 '.FT PRAIRIE F!9 CS 11.0500: :1�1: 05
1 1 CS 5;332242 LETTUCE, ICBRG. SHRD. 1/4.'.' CLND 4/5 Lt CROSS VALY B CS 1,7.8700., 1.7.:87:
READY. T0. EAT .,Please Refer to Return Policy
FROZEN
4 h CS 2011278 PRETZEL, KING SOFT BKD FZN 50/5' '0! SUPR PRTZL CS 28.7000 57.40
1 CS 405870.7 MUFFIN, BANA NUT IW •FZN 24/4, 1' SPUNKMEYER CS. 24.3;300 74.33
1.
1. 1, CS 5218862 ICE CREW SANDWICH, SANDWICH, VNL 24/6:OZ (BLUE BUNNY CS :17. 1400 17.14
1 1. CS 83.87999 ICE CREAM BAR, CHOC' TACO VNL /4.. 7Z KLONDIKE CS 24.3300 24.33
PRODUCT CLASS RECAP#
'TOTAL DRY' PIECES ORDERED: 6 PI.ECE'S SHIPPED: 6 ITEMS SHIPPED 5 292:63
TOTAL' REFRIGERATED PIECES ORDERED:. 4. PIECES SHIPPED: 4 ITEMS SHIPPED. 4 62.20
TOTAL FROZEN PIECES ORDERED 5 PIECE'S SHIPPED: 5 ITEMS SHIPPED: 4 123.20
The perishable agricultural commodities listed on this Invoice are sold subject to the statulory iZouaarized by section 5(c) of the Visit www.ustood.com for a fast a nd easy 'way to order.
X
Perishable Agricultural Commodities Act, 1930 (7 U.S.C. 499e1C)). The seller of these commodities, retains a bust Calm over mesa
1 commodities, all imentaries of food or omer pmducls de/ivetl fran tlrese mmmotldles, and arty receivables m proceeds hom the sale of
mesa commodities ulNl full payment is received, �w�rnnraER� SIGNATURE: 7
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of (a) 1 /z% per month or
(b) the maximum rate that the astomer may awfully contract to pay, and in all events calculated in accordance whh applicable law.
f O
INDIANAPOLIS /3V 3V
Indianapolis Division
Flsher6 jN46038
I I FINAL INVOICE
BIII To Shlp.Irs
CARMEL CLAY PARKS-RECREAT CARMEL CLAY PARKS RECREAT
1411 E. 116TH 57 1235 CENTRAL PARK DRIVE E
CARMEL, IN 46032 CARMEL, IN 46032
000 000 0000 317 843 3673
Attention; MICHELLE COMPTON Attention; MICHELLE COMPTON
Customer order pepta; Dept Name: Numben Number;
90569575 0413830
Invoice Invoice PON:
Number; Date;
2784668 01/10/2012
Payment Frelght
Terms; Terms;
NET 30 DAYS
r
DELIVERY SUMMARY
AS SHIPPED DELIVERY AMOUNT $761.SS
Product Total Adjustment $24.33 CR
;3
Total Charges Adjustment $0.00
Total Allowance Adjustment $0.00
Saks Tax AdJ 40,00
TOTAL ADJUSTMENT $24.33 CR
DE, •IVERED 44OU $737.
T N,69 Y ADJUS'VMENTS
(IV Sales UN t Nm
t Producuber nescrlplion Pack She Code Unit
Price
1 CS 8187999 I LOhIGG E, IC C FEAM BAR, CHOC T VP✓L 29(4 02 24.33
I� INVOICE SUMMARY
Product Level
Product Total $731,97
r
i
I Allowance
$0,00
Charge
Invoice Level
Allowance
Charge 0;00
CUS TOMER ACCEPTANCE I
aarest shaP acaua on aY unpad Balances eaeadin7 estatAshed aeGt terms at a rata equal to the lesser of (a) 1112
/o par month i u (b) u
rnaxuruxn rate that the custaner rtry law(lMy contract to paY, and n aY events [dY:LtdIBd Yl dCCIXddflC6 Wlth d�lhLdlNB law,
pnxnuuonal allowmxes. cash drscounts, prompt paY dsCarlts, growth proprar 5 3!1(� Other MKentry
�io xnsr. �aduce product cost. FrodtxY cost is deru,�d d5 the SW*' pdCkBl a 3rly YB 6ll 3 COST 1 6 16fd adby U SA f�lset
Iris a nd i h ce discourns or off nvaxe atlowans�s (i, e., manufactwer penBrdfBd y f p B, rM drl�
tme and wtdc are spen(Kapr redacted on the inutviceJ, h l,wt
dsco�lts IX abwances on parnaim itemspVls stdnda•d nepltf
f' Set periods of
MICFZLLE
Gale Tua Jan IU 0];U9;y1 F, t 2L)12 We apa..at. Your 6 usu�ass. W
e not au wabnta
a fast and eas
cedar' cattact vau :ales rewesentauva.
i f r f f i twt't_'r'q+ I tw t f•,) p "t SALES 'S-„ L P
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tihC.. �YrY� ?1..,c,- #3'c..,;G��,- .:#tt. �1 4?t.* �iE.: 3t�3t� �.•.s' `$tw�'i.tis��k,.r.r�rt�,ts�3*�. ....t;�^��2t#;•Di•)�fiir;•�t±',
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rte:(). v!r 0 a y i n P or F
m
G.L. I OG 5 23�ut -1 D ,gam`_ La
t
Sudget
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Purchaser
Approval
JAN
8� 012
ACCOUNT I E INVOICE CUSTOMER PURCHASE ORDER SALES SALES D ATE
WO. _NO, DATE N0` NLAi8ER LOC REP,
90569922 278486S O1/1O�l2 90569575 1D54 DO62 O��--`�~
Route: 2251 ji ORDER NUMBER:
8 ill Sb��' Remit
To: 1411 E. 116TH wr To: 1235 CENTRAL.PARK DRIVE E To:
i BOX 660088.
CARMEW
46032 46032
217 843 3873 46e%-00%
INDIANAPOLIS x`
Att: MICHELLE COMPTON DEPT 00 800 428 2118
7hi Fr 123O1 CUMBERLAND e-
»n� D FISHERS IN ShipD: 01/10/12 Page 01 of 02
Sh ipFrm�
r�T s�
rm
Spcia2 ENTE OFF OF=1 STREET|
FrtTrms: r
1 ytTrms: NET 30 DAYS 2nstm
PytTrms:
Qty Qty Sales Product Descrjpton, Pack Bile Label C Weiqht Pricing Unit Extended
nrdered Shipped Unit Number D Unit� Price- '^Price
I CS 3429305 JUICE, GRAPE 100% PET PLST BTL24/10 OZ. THIRSTER CS 10.1600 18-06
2 CS 4260238 SAUCE, CHS NACHQ,SHLF STABL 4/107 OZ, ORTEGA CS 49.0000 98.00
1 CS 5597851 'CHIP, TORTLA MACHO CHS 64/1.7S OZ DORITOS CS 28.8300
1, (:,S 5601943 CHIP, PTATO KTL BBQ SS BAG 64/1.375,GZ MISS VICK! CS 30.15
1 CS 5605431 CHIP, MULTORN GADN SALSA SS 64/1.5 OZ SUN CHIPS' CS 29,5000 29.50
1 CS S605522 CRIP, nULTSMORIP SS PAS 64/1.5 OZ SUN CHIP& 29.5000. 29.50
1 CS 6260665 COOKIE, FUDGE STRPE MIN! SS 60/2 OZ KEEBLER CS. 22.1900 27,19
1 EA 8053126 CANDY, RESES PHT BUTR CUP 36 EA REESE'S, EA 250200 25.92
1 CS 8429292 JUICE, APPL 100k VITMM C ADDED24/10 OZ THIRSTER CS 20.0600 20.06,
REFRIGERATED
CS 0654301 HUMMUS,.GRLC RSTD NONDARY REF 12/4.56 OZ. SABRA 7. Q 22.0000 2230'
READY FG EAT -,Please Refer to Return P014
1. CS 4800843 MILK, 2% REDUC FAT PLST REF 1211 PT IRAIRIE FM 7171 .2cs 10.5200. 10.52
1 CS 4800894 MILK, CHOC 1Z LOW FAT PLST REF12/1 PT PRAIRIj FM 'LS 11.300 11.30
1 CS 5326426 LETTUCE, ICBROALWA TRIMD 416 EA CROSS VALY B _CS -19.3600 19.36
READY TO EAT Please Refer to Return PolicV
I CS 7197775 YOGURT, ASST STRURNA S RSPBRY 12/6 OZ YOPLAIT CS 1071100 10.0
3 3 CS 2011278 PRETZEL, KING SOFT BRD FZN 50/5 OZ SLUPIR 26:7000.. 86-10
1 1 CS 2014652 MUFFIN, SLBRY IW 2414 OZ SARA LEE CS 20.290011 �20.29
2 2 CS 3330099 HOT DOB, AB 6:1,6u,RLR GRIL 10 LB, PATUXENT CS 29.a2QO Re. 64
I I CS 5741228 BUN, H"CYT COG 6" HINUE SUDIFF12112 EA HILLTOP HR CS 20.9600 96
''m PRODUCT-eLASSARCAP
TOTAL REFRIGERATED PIECES ORDERED: 5 PIECES SHIPPED: 5, ITEMS SHIPPED: 5 74.24
TOTAL FROZEN PIECES ORDERED: io PIECES SHIPPED: 10 IMS SHIPPED: 6 306.66)
4
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.
353824 U S FoodService, Inc. Terms
Box 660088
Indianapolis, IN 46266 -0088
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/20/11 2188519 Concessions 30331 1,213.18
12/30/11 2455815 Concessions 30336 484.28
1110112 2784868 Concessions 30366 737.22
Total 2,434.68
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
Voucher No. Warrant No.
353824 U S FoodService, Inc. Allowed 20
Box 660088
Indianapolis, IN 46266 -0088
In Sum of
2,434.68
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1095 -1 2188519 4239040 1,213.18 1 hereby certify that the attached invoice(s), or
1095 -1 2455815 4239040 $W 484.28 bill(s) is (are) true and correct and that the
1095 -1 2784868 4239040 737.22 materials or services itemized thereon for
which charge is made were ordered and
received except
26 -Jan 2012
Signature
2,434.68 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund