207250 03/13/2012 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: $1,305.77
INDIANAPOLIS IN 46266 -0088 CHECK NUMBER: 207250
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 1076481 447.17 FOOD BEVERAGES
1095 4239040 1076482 644.12 FOOD BEVERAGES
1095 4239040 1312622 214.48 FOOD BEVERAGES
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EEE CARMEL
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TAXABLE AMOUNT T 00=
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Approval Date
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i C l A L FRDZFN d �'G� ORDERED: 5 i 7 EC.`ES. SFi r WED: 5 1:�'C3` S SHIPPED: `_ti 1 ,94 9a
i
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO. NUMBER LOC. REP. ORDERED
90569922 1312622 2/2£3/1" 90569575 1 1054 0062 02/28/18
Your partner beyond the plate'
vnour 9676 1 ORDER NUMBER: 4516538
BILL CARMEL CLAY PARKS&RECREAT SHIP CARMEL CLAY PARKS &F ECREAT REMIT US Foods, Inc
TO: 1411 E. 116TH ST TO: 1235 CENTRAL. PARK DRIVE E TO:
BOX 660088
CARMEL IN CARMEL IN
460322 46032 INDIANAPOLIS IN
317 843 3873 46266, -0088
ATT. MICHELLE COMPTON DEPT 00 800 428 2118
SHIPPED FROM: 12301 CUMBERLAND RD FISHERS IN S HIPDATE: 08/28/12 Page 01 of 01
FREIGHT TERMS: SPECIAL CUSTOMER PICK UP
PAYMENT TERMS: NET 30 DAYS INSTRUCTIONS:
QTY. QTY. SALES PRODUCT O PRICING UNIT EXTENDED
ORDERED SHIPPED UNIT NUMBER DESCRIPTION PACK SIZE LABEL D WEIGHT UNIT PRICE PRICE
E
DRY
1 1 CS 0791616 CUP, FM 32 Z WHT 25/20 EA MONOGRAM CS 35.4300 35.43
1 1 CS 5704077 COOKIE, NUTTR PUTR 1 Z SS 48/1 OZ NUTTR BUTR CS 28.8200 28.82
1 I CS 6260665 COOKIE, FUDGE STRPE MINI SS 60/2 OZ €(EEBLER CS 22.7200 22.72
1 1 CS 9463688 CHIP, TORTLA CORN YLW RND 6/2 LB EL PASADO CS 18.8200 18.82
FROZEN
1 1 CS 2011278 PRETZEL, KING SOFT HKD FZ4d 50/5 OZ SUPR PRTZL CS 31.6000 31.60
1 1 CS 3041423 CORN DOG, AM CN FZN 48/4 OZ STATE FAIR CS 33.4100 33.41
1 1 CS 6153027 BROWNIE, CHOC 2.5 Z UNSL BBD 48/2.5 OZ OREO CS 43.6800 43.68
INVOICE SUMMARY
TOTAL WOT SHIPPED: 70.50 PIECES ORDERED: 7 PIECES SHIPPED: 7
PRODUCT TOTAL 214.48
BAR 0 5 2012
TAXABLE AMOUNT .00
GEN SALES TAX x .00
Purchase �y
p7scription PLEASE R EM I T T THTS AMOUNT BY X33/29/12
P.O. G c� 7 �O�F$ e AMOUNT 214.48
G.L. 4 12 5 -1-- 4-93GC4
Bu _Pt.
Line Des
Purchaser Date
Approval Date
JL-2
f�
The penshah agricutaral commodities listed an thisimmlce are sold subject to me staatary m,st atmwrusdw section s,g of the Visit www.ustood.com for a fast and easy way to order.
F' ratable Agricuttural COmmodltieS Act U.S.C. 1930 f7 49Wcll. The seller of mete commodities retains a trust claim over these
tommoditles, all irventories of food or other' products derived from these commodities, and airy -ail or prmeeds from the sale of
Mom wmrrrodides until full payment is received.
Interest shall accrue on all tin d balances exceedi established credit terms at a rata oq ual1D the lesser of a hp CUSTOMERS SIGNATU REi: a
pei ng I 1 per nwnlh or
(hl the manimum rate that the customer may lawfulty contract to pay, and in all events calwlated in accordance wnh apptkzhla law. �r r 9�� ��QQ
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
2/21112 1076481 Concessions 30484 447.17
2121/12 1076482 Concessions 30484 644.12
2128112 1312622 Concessions 214.48
Total 1,305.77
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 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
1,305.77
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1095 -1 1076481 4239040 447.17 1 hereby certify that the attached invoice(s), or
1095 -1 1076482 4239040 644.12 bill(s) is (are) true and correct and that the
1095.1 1312622 4239040 214.48 materials or services itemized thereon for
which charge is made were ordered and
received except
8 -Mar 2012
Signature
1,305.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund