206839 02/28/2012 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: $1,263.45
INDIANAPOLIS IN 46266 -0088
CHECK NUMBER: 206839
CHECK DATE: 2/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 664360 64.20 FOOD BEVERAGES
1095 4239040 664363 725.22 FOOD BEVERAGES
1095 4239040 863371 474.03 FOOD BEVERAGES
ACCOUNT INVOICE' IN'V'DICE CUST01JE PURCHASE ORDER SALES SALES DATE-
NO. NO. DATlE NO. NUMBER LOC, REP ORD
9O569922 O66436O O2/O7/12 9O569575 Special Order 1054 0062 02/01/12
�-7�
Route, �cu� 3,�°/+~
�ill Ship Remit
T
To� To: o-
_3fEJX 6)600883
31.7 843 3873 -46266-002a
Att:
3hipF 12301 CUMBERLAND RD FISHERS IN ShjpD. 02/07/12 Page 01 of 01
l t t bl
�rtTrms� Spcja2 Special orders are no re urna e.
Trms. NET 3O DAYS Instr:
Qty Qty Sales Product Descriptpn Pack Size Label C Weight Pricing Unit Extended
hdered Shipped Unit Number D Unit Price Price
44 FRODUICT CLASS RECAP 4
CES SHIPPED: 1 1 33. ?15
FUEL SURCHARGM 5. 25
'TOTAL t SHIPPED: 12-00 PIECE ORDERED: I PIECES SHIPPED: I ITEMS SHIPPED: I
Purchase PRODUCT TOTAL _58. 95
Description Qjaz"
LP C-PARGES 5.25
Budget FEB 0 9 2012
Line Desc TAXABLE AMOUNT .00
GE14 SALES' TAX 7 .00
Purchaser Date
Approval Date
This ammiDt is a-, fe9timilte at time of -..hippin.g pr-ior to any adjustmentsmade at delivery: 64.20
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES S ALES DA
NO. NO. DATE NO, Ni. MBER L.00 7 REP. ORDERED
?056 ??22 066436 0'E Q7/ 1 E ?Cf5'u-?57 3 1 054 006 0210
Ro f e: 2251 3 ORDER NUMBER: 43627
Sa E
rA w Rem �E L C LAY Sa E c' r
F?;e1E:L_ CLAY PA�tt��,•.:�F�EC:R:_f��:', f �.,;,R�iE. C;,._A f ar�n� {L�•.�f��t�R�:A, 1-US Foods, Inc.
To: 1411 E. 116TH ST TO: 1235 C ENTRAL PARK -DRIVE E To
PCB ��l i5f��3
C ARMEL 1N CARMEL IN
46032 46032 INDIANAPOLIS
00 S
317 4 x 873 46;r 66- -�008a
DEPT Aft: 1Il:C;l4E'•_!_E ��'C]f�fF'TE}t�i �"i .c'0 28 2118
3hspFrm: 12301 CUMBER RD FISHERS IN Sh.ipD: Oa/07112 P 02 of 02
"'r t'Trm s sp4 .i a 1 ENTER OFF OF 111TH STREET
'fitTrms. NET' 30 DAYS Instr:
QQ Qty Sales Product C.e cr•ipton Pack Size Label C Weight Pricing Unit Extended
Mdered Shipped Unit Nuinber D Unit Price Price
;t R
INVOICE SUMMARY Rix 1
i
TOTAL WGT SHIPrPEEr: 2?7.37 PIECES ORDERED: 26 PIECES SHIPPED: 26 ITEMS SHIPPED: 22
PRODUCT TOTAL
TAXABLE AMOUNT fit
aEN SALES TAX .00
This amount f
is an s= s•t:f3tate at time of s++a.plsint3 prior to any adjustments f7f.:Ide at delivery: 72
s'2
7 777
�1 F E8 0 9 2012
Purchase
Description
P.O. —vnLA y q r F
G.L.
Budget V ei
Line Deser
Purchaser Date
Approval
Date
ACCOUNT INVOICY INVOICE CUSTOMER PURCHASE ORDER SALE
DATE
NO- NO. DATE NO. N1.11"I8ER LOC. R EP. ORDERED
9O569922 0664361 O2/07/12 9O569575 1O54 0062 02/06/12
ORDER-NUMBER: 436276
8ill Ghip Remit
To: 1411 E. 116TH ST To: 1215 CENTRAL PARK DRIVE E To:
-BOX 660088
46032 46032 INDIANAPOLIS 1N
i 317 943 387 46266-0088
Attl
MICHELLE COMPTON DEPT 00 800 428 alig-
3hipFrm: 12301 CUMBERLAND RD FISHERS IN Shipi. 02/07/12 JPage 01 of 02
OrtTrms. Spcja2 ENTER OFF OF 111TH STREETiI!
ytTrms: NET 30 DAYS Instr:
Qty Qty Sales Product Descripton Pack Size Label C Weight Pricing -Unit Extended
}rdered Shipped Unit Number D Unit Price Price
DRY
I EA 40042891VE BAR SNCKR 2.07 OZ
fill 42 EA SNICVERS EA 34.2700 34:27
1 1. CS 4573747 -SNACK MIX, CHOC CRNL SS SNPLY 60/12 OZ CHEX CS 32.1100 32.11
1. CS 1029073 v
QHICE, ORNG 100X PLST SHLF 24/10.0Z TROPICANA CS 19.7500 17.7
1. CS 5597968 �CH P, CORN QRIG,TFF SS DA5 64/2 OZ FRITOS CS 280400 28.84
FUDGE STRPE MINI SS 60/2 OZ kEEDLER CS 2Z.7200 22.72
1 CS 6260665 ilk, HOT CHOC PWOR POUCH12/2 LB RITUALS CS 53.1000- 53,10
1 CS 8370314 Qj(OA
REFRIGERATED
1 CD 400OS43 019Q0 2%. 1 WDUC FAT PLST REF 12/1 PT PRAIRIE FM CS 16.4106 10, 14
RgADY TO EAT Please Refer to Return Poll(,". -:1600
FROZEN
1 1 CS 2014652 -KAUFFIN. BLBRY IW 24/4 OZ SARA LEE CS 20,2900 20,29
2 2 CS 3041423 RN DOG, AN CH.FZN 48/4 OZ STATE FAIR- CS 33.41DO 66.82
2 2 CS 3330099 IT DOG, AB 6:1 61 RLR GRIL 10 LB PATUXENT CS 29.3200- 98.64
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 13 PIECES SHIPPED: 13 ITENS SHIPPED: _12- 37h9s
TOTAL REFRIGERATED PIECES ORDERED: 3 PIECES SHIPPED: 3 ITEMS SHIPPED: 3 37.47
TOTAL FROZEN PIECES ORDERED: to PIECES SHIPPED: 10 ITEMS SHIPPED: 7 309.77
ACC01JNT INVOICE INVOICE CU STOMER PURCHASE ORDER SALES SALES DATE
NO. ,,O DATE NO— NUMBER LOC. REP. ORDERED
?0566922 0863371 02/14/12 9 0 561575 10354 0062 02/13/ 0-
Route= 251 •4 CINDER NUMBER:- 44 311=3
SI i R e m i t
CARMEL. CL AY PARKS&Rg'CREA4' ;'ARME:L. CLAY E'ARK a&REC,F';:AT_ �t_]S Foods, Inc
To: 1411 E. 116TH EST Trot_: 1235 CENTRAL PARK DRIVE E To:
BOX 660088.
CARMEL I N CARREL_ I h#
46032 4603F- I- NDI:ANAPOLIS TON
317 243 3873 462 66-0088
Att: MICHELLE COMPTON DEPT 00 800 428 2 118
h pFrm: 1 2301 CUMBERLAND RD FISHERS 1 N Jh .i pD: 02/14/12 Page 02 of 02
7 rt rx71s: Sp za r ENTER OFF OF 111TH STREET a
OytTrms. NET 301 DAYS 1'r,;, y-r
Qty: yty Sales Product Descr•ip Pack-Size Label C Weight Pricing #isdt Extended
3rdered Shipped Unit Number D Unit Price Prise
i
FUEL SURCHARGE 5.25
j TOTAL WGT SHIPPED: 212.4Q PIECES DRDERED; Is PIECES SHIPPED: 18 ITEMS SHIPPED: is
PRODUCT TOTAL 46a. 'i£i
CHAR 5.25
j FEB 16 2012
TAXABLE AMOUNT .00
GEN SALES TAX
This amC.wt is an estimate at time or shipping prior to any adjustment= made at delivery: a 474.0
Purchase
.Description
P.O. "Jl�y-lC� P orQ
G.L.
Budgget F
Line Descr
Purchaser Date
Approval Date
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO, DATE NO, NUMBER LOC RE ORDE:=RED
9056`:%g2R 0863371 02114112 ?0561575 1054 0062 02/13/12
OS
I?(
ORDER NUMBER 443
To: I CARMEL CLAY PARKSs. NECREA T C'ARMETL CLAY PARKS&RECRE:A,T` US Foods, Inc.
1.411 E. 116TH ST Tw 12:35 CENTRAL PARK DR.IV -E To: BOX 660088
CAi?i"IEL IN CAE2h1EL IN, INDIANAPOLIS 1 h�E
46032 46032 P
843 38*73
A t t: MICHELLE- C
13 -CEP �tbf-'E�62 21
.�..Ii I>�1 "Uhl DEPT CiG n
:3 ipFrm: 12301 CUMBERLAND RD FISHERS IN Ship 021140:12 Page 01 of .02
7 rtTrms: spci.a1 ENTER OFF OF 111TH STREET!!!
st Trms: NET 10 DA'`t^
Qt v Qty Sale_. Product; C ?esc;-a.C,•> ort Pack Size Label C Weigh. Pricing Unit Extended
)rdired Shippe Unit Number C? Unit Price Price
r.._...___ ._�_r..........
r
i
DRY
1 I EA 0841080 CUP, 5i LE:. PLST 2 Z 1€'•ISI... t PTN 250 EA MONOGRAM B EA 3.9730 3.9
1 1 CS 1287747 SNACK BAR, CRL ASST IU SS 3/16/1.:3 OZ 9ELLOGG'S CS 27.7400 27.74
1 1 CS 4180923 COOKIE, VNL CREME SNDWH SNCWU 4811.7 OZ_ SNACi;:WELLS CS 26.2300 26.23-
1 1. CS 4647806 DETERGENT, DISH _I'INE_ DAWN LIQ 0/38 OZ DAWN CS 41.8600 41. 86
1 1. CS `.597851. CHIP, TORTLA NACHO CHS TROLE 64/1.75 OZ DORI.iOS CS 28. 28 -f 3
1 1 CS 6094395 �iANITIZER, SINK TABLT 150 CT 6/150 EA PACKER CS 30 000 30.:30
2 2 CS 9089079 POPCORN, RAW KIT W1 OIL SA!_�?a6/8 OZ FANCY 'r'�£�M CS ';_`.ui00 =15...14.
REF Rl ERATED
I t
i i EA 2000453 SALAD, CHIX C:RI'Y REF B. LB PIERCE P. EA 26. 9900 26. -0
READY TO EAT Please Refer to Ret urn Polic:j
i 1 CS 2:340875 CHEESE, CRM i-'LN. SS PLS T CUP 100/1 OZ_ i�LMVII FR�1S i:5 ?1.91300 :1.98
READY TO EAT Please Refer to Return Pol,iw
1 i CS 4800243 MILK, 2X REDUC FAT PLST REF- 1211 PT 1'RAIRIC:E FM CS- 10:-4006 10AS
1 i CS 4800884 MILK( CHOC IX LOW FAT RLST REF; '.11 PT PRAIRIE FM CS 11.3010 11.30
FROZEN
2 2 CS 2011278 PRE TZEL, KING SOFT SKD FZN_ 5005 t7Z_ SUP i:'RTZL CS 31.1006 63.20
2 2 CS 3330099 HOT OR; AB 6:1 6" RLR GRIL 10 LB PATUXENT CS 29 ,;.200 58.64
I 1 1 CS 4636718 SOUP•`, LHIX NDL TFF RT'U POUCH 408 LR CLSC TURCE CS 4 7.7900 47.79
1 1 CS 8187999 ICE CREAM BAR, CHOC 'TACO VML24:4 OZ KLONDIKE CS ?j3.3300 24.33
**.PRODUCT CLASS RECAP t1
T OTAL DRY PIECES ORDERED: S PIECES SHIPPED: 8 ITEMS SHIPPED: 7 204.07
TOTAL REFRIGERATED PIECES CtI;DE ED: 4 PIECES SHIPPED: 4 ITEMS SHIPPED: 4 70.75
TOTA FROZEN PIECES ORDERED: 6 PIECES._SHIPPED: 6 ITEMS SHIPPED: 4 173.9A-
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
2/7112 664360 Concessions 30449 64.20
217112 664363 Conce 30449 725.22
2/14/12 863371 Concessions 30470 474.03
Total 1,263.45
I 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
1,263.45
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1095 -1 664360 4239040 64.20 1 hereby certify that the attached invoice(s), or
1095 -1 664363 4239040 725.22 bill(s) is (are) true and correct and that the
1095 -1 863371 4239040 474.03 materials or services itemized thereon for
which charge is made were ordered and
received except
23 -Feb 2012
Signature
1,263.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund