179875 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC
CARMEL, INDIANA 46032 PO Box 660089 CHECK AMOUNT: $979.86
INDIANAPOLIS IN 46266 -0088 CHECK NUMBER: 179875
CHECK DATE: 11/24/2009
DE PARTMENT AC COUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
it'047 4239040 1604200 506.14 FOOD BEVERAGES
1047 4239040 1710222 473.72 FOOD BEVERAGES
ACCOUNT /mvoxCs /mvoICs ouoTOMsn PURCHASE ORDER SALES SALES oxTs
mo uMosn Loc. REP. onosnEo
-a
9056992 1054 0062 11 0
r
ORDER NUMBER: 762,696
BILL SHIP REMIT U.S. FOODSERVICE, INC.
TO: J 1 411 E 116TH ST TO: 1235 CENTRAL PARK DRIVE E TO:
BOX 660089
CARMEL IN CARMEL IN
460 46032 INDIANAPOLIS IN
ATT. MICHELLE COMPTON DEPT 00 900 428 211e
SHIPPEDFR»M: 12301 CUMBERLAND RD FISHERS IN SHIP DATE: 11/O6/O9 P�ge O2 of O2'
FREIGHT TERMS: ��x DRIVER CANNOT DELIVER ON THE We OUT IN
PAYMENT TERMS: NET 30 DAYS INSTRUCTIONS:
QTY. CITY. SALES PRODUCT DESCRIPTION PACK SIZE LABEL 0 WEIGHT PRICING UNIT EXTENDED
ORDERED SHIPPED V' UNIT NUMBER D UNIT PRICE PRICE
INVOICE SUMMARY
FUEL SURCHARGE 3.25
TOTAL WOT SHIPPED: 242.63 PIECES ORDERED: 21 PIECES SHIPPED: 21 ITEM6 SHIPPED: 16
CHARGES 3.25.
TAXABLE AMOUNT .00
PLEASE REMIT THIS AMOUNT BY 12/06/07 AMOUNT 506H)
Purchne
Interest shall accare on all unpaid balances exceeding established credit amna at a rate equal to the lesser of (a) I. per month or 'Promotional allowances, casindiscounts, promptgaydiscoun growth programs and all other incentives are retained by U.S. Food'en'lce'"
(b) the maximunn rate that the customer may lawfully contract to pay, and in al his calculated in accordance with applicable law and do not reduce pro uct cost. Product cost is a ned a or any r delivered cost or f.o.b. unit l 8 0 a
-invoice discounts or off-invoic as the su c' X
andard it less off a all-ani, discounts or allowances on particular
Items for se ods of time and which are specifically reflected on the ini CUSTOMERS SIGNATURE:
Visit www.usfood.Corli io� iast and easy way to order.
-a CUSTOMER COPY
ACCOUNT INVOICE INVOICE oueToMsn PURCHASE.ORDE�ff` SALES SALES DATE
A0 0 14I" NO. NO. DATE NO. NUM LOC. REP. ORDERED
90569922 1604200 11/06/09 90569575 105� 0062 11/05/09
m°,=^"~�r.. d t �m
DELIVERYROUTE: DRIMER NUMBER: 762696
BILL SHIP
TO: 1411 E. 116TH ST TO: TO:
46032 46032 INDIANAPOLIS
ATT.
SHIPPED FROM: 1230 1 CUMBERLAND RD FISHERS IN SHIP DATE: 1 1/06/09 Page 01 of 02
FREIGHT TERMS: SPECIAL DRIVER CANNOT DELIVER ON THE ROUNDABOUT OUT IN
PAYMENT TERMS: NET 30 DAYS INSTRUCTIONS:`
OTY. QTY. SALES PRODUCT DESCRIPTION -i PACK SIZE LABEL 0 WEIGHT PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER D UNIT PRICE PRICE
DRY
1. CS 5597604 CHIP, CHS CHCHY PLN BAS 64/2 OZ CUHEETPS CS '-7.4000 27.40
I I CS 5601679 CHIP, POT REG PLN BAG 64/1.5 OZ LAY"S CS 26.95
1 1. CS 5605472 CHIP, MULTGRN HRVST CHEDR BAG 64/1.5 OZ SUN CHIPS CS 27.1200 27.12
1 1. CS 8040669 BOX, PIZA 16X16X1.75 CRBRD 50 EA PACKER it's 25.4800 2L5.48
1. EA 80!331.26 CANDY, RESES PHT BUTR CUP 36 EA REESE'S-X EA 23. 4000 23.40
I I CS 9463688 CHIP, TORTLA CORN YLU RND 6/2 LB EL PASADO CS 18.7000 18.70
I I EA 0761940 MILK, UHL CRRG PLST REF HNONZ I GA 01-NVU FRNS B EA 5.5400 5.54
READY TO EAT Please Refer to Return Polic
I I CS 3254901 MILK, LOW FAT 2.`% PLST REF CHUG12/1 PT 6N'S CS 11.4900 11.49
READY TO EAT Please Refer to Return Polir.
I I CS 5006556 BANANA, ORN FRESH 10 LB 6CKER' CS 7.7100 7 .71
1 i CS 6291207 MILK CHOC LOW FAT 1% PLST REF*12/1 PT DEAN'S-` CS J.1.4900 Ii.49
READY TO EAT Please Refer to Return Policy
FROZEN
4- CS 1404391 PIZZA, 4 CHS 16" FZN 9/47.92 OZ F*RESCHETTA--' CS 69.7500 139.50
1. 1. CS 2333276 SAUSAGE, ITLN SPICY CRBL CKD 10 LB ROSELI CS 26.3600 26.36
4 4 CS 4875571 HOT DOG, AB ):1 6" CKD FZ14 10 LB TYSON-- CS 25,1500 100.60
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 7 PIECES SHIPPED: 7 ITEMS SHIPPED: 7 161.
TOTAL. REFRIGERATED PjECES ORDERED: 7 PIECES SHIPPED: 7 ITEMS SHIPPED: 6 75, 1 18
TOTAL FROZEN PIECES ORDERED: 7 PIECES SHIPPED: 7 iTENS SHIPPED: 3 266.46
rterast shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lasser of (a) I. per month Of 'promi stlewar"oes, cash dscou,"" ""'i "O"11, ranuiti,dallothfurmoemli are retained by U.S. 'OOdservice"
b) the maximum rate that the customer my lawl fly ocrinaci to pay, and in all events calculated in accordance with applicable law and do not reduce product cost. Product coatis ne as, er, packer or any other vendor delivered cost or fo,o u n i t price p us
items ght less off-invoice discounts or off-invoice allowances (i.e., manufacturer generated discounts or allowances on particular
for set periods of time and which are specifically reflected on the ini CUSTOMERS SIGNATURE:
Visit www.us food.com for a fast and easy way to order. CUSTOMER COPY we' '*n4n vi"441e"
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO. DATE NO. NUMBER LOC. REP. ORDERED
90569922 1'710222' 11/13/09 90559575, 02 O 105 0062 1 1/12/09
Your partner beyond the plate.' DELIVERYAOUTE: 8 3 GIRDER NUMBER: 769055
BILL CARMEL CLAY PARKS&RECREAT SHIP CARMEL CLAY PARKS &R:ECREAT REMIT U.S. F'OODSERVICE, INC. J
TO: 1411 E. 116TH ST TO 1235 CENTRAL PARS, DRIVE E" TO':
BOY, 660088
CARMEL IN CARMEL IN
460 46032 INDIANAPOLIS IN
ATT. MICHELLE COMPTON DEPT 00 800
SHIPPED FROM: 12301 CUMBERLAND ,RD FISHERS I SHIP DATE: 11 413/09 Page 0. of 01
FREIGHT TERMS: SPECIAL DR CANNOT DEL ON THE 'ROUNDABOUT OUT IN
POMENTTERMS: NET 30 DAYS INSTRUCTIONS:
QTY. QTY. SALES PRODUCT DESCRIPTION' PACK SIZE LABEL O WEIGHT PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER E UNIT PRICE PRICE
DRY
1 1 CS 5605522 CHIP, MULTGRN ORIG BAB 64/1.5 OZ SUN CHIPS CS 27 1200 27.4
1 1 EA 6214777° CANDY, KID' KAT VNDG STD 1.5 Z EA KIT KAT -EA 23.1800 23.18
REFRIGERATED
1 11 Ca 4331302 APPLE, RED TLC 113 FCY :tdA OR .1131A CROSS VALY C5 29.. 29.'47
FROZEN
2' 2 CS 1404391 PIZZA, 4 CHS 16" fZN 9/47.92 OZ FRESCHETTA CS 69.7500 139.50
2 2 CS 4875571 .,,,HOT• DOG, AEI 5:1, 6 CKD F7N 10 LB 'TYSON CS 25.1500 SO. 30
1 I CS 5741228 BUM, HOT 000 PLN 6" SLCD 12/12 EA HILLTOP HR "CS 27.6000 27.
3 3 CS 7364763 PIZZA, 4 CHS 8 FZN 24 EA FRESCHETTA. CS 57. 5'000 t73; 70
4* PRODUCT CLASS RECAP
-TOTAL: DRY PIECES ORDERED: 2 PIECES SHIPPED: 2 ITEMS SHIPPED: 2. O 30
TOTAL'REFRIGERATED PIECES ORDERED: i PIECES SHIPPED: 1 ITEMS SHIPPED: 1 29.;0?
TOTAL FROZEN PIECES'ORDEREQ: 8 PIECES SHIPPED: 8 ITEMS
SHIPPED 4
INVOICE SUMMARY?t
FUEL SURCHARGE 3:25
TOTAL IJGT SHI' PP D: 194.59 PIECES ORDERED: 11` PIECES SHIPPED: 11 ITEMS ,SHIPPtb: 7
Purchase PRODUCT'TOTAL
Description
P.O. u CHARGES 25
O
:L
�U
V Budget TAXABLE AMOUNT 00
Line Descr GEN SALES TAX t�(}
Purchaser Date
Approval Date
PLEASE REMIT THIS AMOUNT BY 12/13/49 AMO 473.72
x �r�Lz
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of (a) 1- per month or "Promotional allowances, cash discounts, prompt pa discounts, growth programs and all other incentives are retained by U.S. FoodservlceiP
(b) the maximum rate,that the customer may lawfully contract to pay, and in all events calculated in accordance with applicable law. and do not reduce product cost. Product cost is defined as the supplier, packer or any other vendor delivered cost or f.o.b. unit price plus
standard freight less off invoice of or ott invoice allowances manufacturer generated discounts or allowances on particular 'X
items for set periods of time and which are specifically reflected on the invoicet' CUSTOMERS SIGNATURE:
Visit www.usfood.Com for a fast and easy way to order. �/ef��ate�ou��uQd��c
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.
i
a
Payee
Purchase Order No.
353824 U S FoodService, Inc.
Box 660088 Date Due
Indianapolis, IN 46266 -0088
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/6/09 1604200 Concession /food beverage 22870 F 506.14
11/13/09 1710222 Concession /food beverage 22906 F 473.72
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 TOTAL 979.86
1 20
Clerk- Treasurer
)ucher No. Warrant No.
Allowed 20
353824 U S FoodService, Inc.
Box 660088
Indianapolis, IN 46266 -0088 In Sum of
979.86
a
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 1604200 4239040 506.14 1 hereby certify that the attached invoice(s), or
1047 1710222 4239040 473.72 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
19 -Nov 2009
Signature
979.86 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund