208076 04/10/2012 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: $4,704.19
INDIANAPOLIS IN 46266 -0088 CHECK NUMBER: 208076
ON
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 1860994 936.92 FOOD BEVERAGES
1095 4239040 2075313 892.42 FOOD BEVERAGES
1095 4239040 2283947 2,874.85 FOOD BEVERAGES
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER -DATE
O� DATE NO NUMBER LOC.
ORDERED
90569922 2075313 03/23/12 90569575 105~ 03/12
8ill Route:5291 9 ORDER NUMBER: 478452
Ship Remit
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT
To: 1411 E 116TH ST To: 1235 CENTRAL r*MK DRIVE E Tw
46032 46032 INDIANAPOLIS IN
317 843 3873 46266-0009
Att:
ThipFrm: 12301 CUMBERLAND RD FISHERS IN Ship& 03/23/12 p-------- 02
>tTrms�
Spcia2 ENTER OFF OF 111TH STREET!!!
`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
*a PRODUCT CLASS RECAP I
TOTAL DRY PIECES ORDERED: is PIECES SHIPPED: is ITEMS SHIPPED: 10 403-89
TOTAL REFRIGERATED PIECES ORDERED: 7 PIECES SHIPPED: 7 ITEMS SHIPPED: 7 138.40
TOTAL FROZEN PIECES ORDERED: 12 PIECES SHIPPED: il ITEMS SHIPPED: 9 349.84
WOICE SUMMARY **-k
FUEL SURCHARGE 6.25
TOTAL WGT SHIPPED: 394.08 PIECES ORDERED: 34 PIECES SHIPPED: 33 ITEMS SHIPPED: 0
PRODUCT TOTAL 892.13
cp
CHARGES 6, 25
Purchase
Description 2012 GEN SALES TAX .00
Budget 0
Li ne De.scr.-,.-. an estimate at time of shipping prior to any adjustments made at delivery: 00.38
Purchaser Dale
Approval
/\CC T INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SAL DATE
N] NO DATE NO NUMBER LOC. REP ORDERED
qO5 2O75� 13 03/23/12 90569 ~7
75 ~7 105 006 03/22/12
Route:5291 9 ORDER NUMBER: 478452
8ill Ship Remit
A R M E L C L A P A A RK S R R CLAY PARKS&RECREAT US Foods, Inc,
To To: 1235 CENTRAL PARK DRIVE E To:
BOX 660088
CARMEL IN. CARMEL IN
46032. INDIANAPOLIS
317 843 3973 46266-0088
Att: MICHELLE COMPTON DEPT 00 800 A-28 21,18
;hipFrm: 12301 CUMBERLAND RD FIS IN Ship& 03/23/12 Page 01 of 02
rtTrms� spcial ENTER OFF OF 111TH STREET!{!
`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
I I CS 0 UP, FM 32 Z WHT 25/20 EA MONOGRAM CS 35.4300 35,43
I C 004236,-CUP, FM 16 Z WHT 20/25 EA MONOGRAM CS 17.5100
1 4053336 ANDY, BAR MILK CHOC 36 EA HERSHEY EA 26.2100 26.21
1 1 CS 5605472 eHIP, MULTGRN CHEDR SS BAO 64/1.5 OZ SUN CHIPS CS 29.8500 29.85
I I CS 6818819% PAPR FOOD 5 LB CLAY 2/250 EA MONOGRAM CS 461500 46.15
2 2 CS 9089079 �PGPCORH, RAW VIT W/ OIL SALT36/8 OZ FANCY FARM CS 23.4500 46 ?0
4 4 CS 9463688 431P, TORTLA CORN YLW RND 6/2 LB EL PASADO CS 18,8200 7128,
EEFRIGERATED
QKADY TO EAT Please Refer to Return Polic
READY TO EAT Please Refer to Return Folic
READY TO EAT Please Refer to Return Polic
READY TO EAT Please Refer to Rehrn.Polick
READY TO EAT Please Refer to Return Polict/
FROZEN
I I CS 2014652 MUFFIN, BLRRY IW 24/4 OT", SARA LEE CS 20,2900 20.29
2 2 CS 3041423 CORN DOG, AN CN FZN Q/4 02 0 STATE FAIR CS 33.4100 6i.82
I I CS 3330099 HOT DOG, AB 6:1 6" RLR GRIL 10 LB J' PATUXENT CS 29.6900 29.69
yl 0 CS 5218962 ICE CREAM SANDUICH, VNL 24/6 OV; :BLUE BUNNY
I CS 29.9600 29.96
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO, NO� DATE NO. NUMBER LOC. REP. ORDERED
90569922 1860994 03/16/12 90569575 1354 0062 03/15/12
Route:5291 10 ORDER NUMBER: 471883
8ill 8hip Remit
To: 1411 F. i16TH ST To: 1215 CENTRAL PARK DRIVE E To: BOX 660088
46012 46032 !NDTANAPOLIS IN
317 841 3873 46266-0088
Att: MICHELLE COMPTON DEPT .11: 00 800 428 2118
QjpFrm: 12301 CUMBERLAND RD FISHERS IN Shjp& 03/16/12 Page 02 of 02
7 rtTrms: Spcia2 ENTER OFF OF 111TH STREET}!!
/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
INVOICE SUMMARY
FUEL SURCHARGE 6.0,
TOTAL UST SHIPPED: 367.53 PIECES ORDERED: 29 PIECES SHIPPED: 29 ITEMS SHIPPED: 22
PRODUCT TOTAL 930.67
CHARGES 6.25'
lop JOIN
MAR 2 2 2012 TAXABLE AMOUNT .00
GEN SALES TAX .00
This amount is an a stimate at time of shipping prior to any adjustments made at delivery: 936.?2
Purchase
Descripton
L#
Budget If
Purchaser Date_
Approval Date_-___'
'a.
INVOI ACCOUNT .t Cif 'h }.t, A- ,�`,J 4, 1i 5.]i� (L.4't F ,x G t i E) ALES L..E =...1 Li h` d C T�,(., 4�.
rrq
r
i'' R.1- f.=A f__ NO, :w(.r, £_OC 1"�.{::'Y" }�3 R I.r' i.',.RJ_,. d.,
90569 .r`'. J i 6 �.}"�f' 4 i.33 1.6/ 9 1054 006 03/151
R o s..5 r<• :.i c- 9 .l r' Cr ORDER NUMBER: 47 :i.... S
t^� C f..+ n �r r.., ir••. i ;'-5 5
t" t�"'T 1° t 'y` f7 r, i'•t F� F 1. r: r`, ..3 a C.: Foods,
C t�R E _:L._A hit 1'�..]`,::i'R_.. c EA r. t hit G.:. I_. 5 1_ i t h•f'��.,_t•..f r... ..c# it•x# �i,.�•.�
(i
To: :L 4 1.:E E 1 16TH `-i.4" TO: i 1235 CENTRAL t, i.` D j
F-•-� p q k to i 6 0 0 j. i...J
1
46032 46032. I NDIANAPOLIS
J ti ii'_ ,7:3
it %t:
f' t'I i 1 I -iLi L f >t7irila C�f'E DEPT Y't c.t ,t
80 4 28 2118
3h.r. pt• rm: 12 CU R FISHER IE'`.i Ship& 03/1 ,..r. 2 01 oP 0
7rtTrms: spcial ENTER OFF OF 111TH STREET!!'
O f;'t'1`T'm s t• 30 DA''t';._ J•,,., str•-
Qtv Qty S ales T'i`CRC,Iuct De ��t j,i;}-{•-� -,ti Pack size 1,.c! 1.�: .fi 7
We ight 3 +i ?r I 7' C: `s, i't i:1 Unit r1 rJ is Unit Price Price
1 CS 0814236 CUP, FM 16 Z °fi` .t EA 1'tt1 ,CI'..ii�.. CS yti'i t) ;s E'
r t CS 1
PO T ART ^nl f'Q ,i >'i i' KE Ai' 9,c.. �.5'.
i. 1 C 1 206 4 24 .�F�'f :r t �.i;'` i "t f I= �•;'i'i:. J is i,(_L,...si(:�;'; .>�r�' ;r
EA 4004289 ANDY r rPt C K1 2 .07 OZ EA SNICKERS EA f 00 i r 'T 1'
2 CS J 7 tiS0 a l v.'�8 k.lf.::i:, CH NACHO SHLF STABL 1E .#07 OZ ORTEB,'S, k..S 49,9100 19:02
r q :.=1 4 4 i I t•�f::; 6/2 RITU CS 52, 0800 ._,:T s'r
-....J rlit7•� ,/i �.d l�:i C,P`it.: �'i,,,i�i .s :v 1� L� 6 4/ 2 de_ L:i�...,";' y
S -_,.Y 96?r l.: -1, i'' CORN r{,`N ;,,iR TF F SS i7h 64/2 i a i 3 3'-: 2B
I 1 EA 621077 �.:t'ND KIT 4-G+::T .�!*4DG STD 1.5 Z 36 [,A KI K T 2 -fir0 2y
1 EA 8053 �r �'i i.a +�J .c.. ::r r,. s` t' i'�i 8: #•_�7 �'l CUP EA !"4L�" L:. -5 {l (+s }r,
1 CS 8914855 iS1r�:,AW, ,_ND A CLR UWRPD 24/ 500 EA !`#Oi~?06 AM P CS 72.7700 72
2 2 CS 9089079 vfDPCORM, RAW KIT W/ OIL 3 SALT3618 OZ FANCY FARM CS 23.4500 12/4,56
1
REFRIGE
1 f
L` �7�Yi: Z`,9 q"�L7f It fed i.33 #`t ,'?)LY RED F`�i•R i`t i.�F`4 f_ }�3 i"�S 4..`.i.. ,,,��•F.".t 3��1 t., ir;J 7- t }Fu:6F3
.A#JY 1O 1.,.. +t i.. ,I.ease Refer to Return Pei' i
1 CS.' 0654301 11U iE° US L'iRL:.: E�i;:�`f D 1•`i� AR Y REF 12/4. CI. `�ABR S 22.9000 2200
l e R L s A 1"(^} i:.FiY r�::�ci %sa iry -��Y` 'r: r:.i Return €'C ?1. 7.1"ir' l
1. J J,.7 �E, tiA�,S^ :tiv FAT i..:1 a I 'R IR F CS
1 CS 4 }00884 ,1 1I L, K, CHOC 1Z !_OI'd FAT P ST ,1 r r PRAI i- i C i 3 1
Y- L.:.;� REF 12 /1 n:: J i 4�i C l 1 „?t.•
1. 1. CS `S_i,:122 42 {...E` TUC E, 1C.:BRG `:ri•aRD :Y 14" CL ND '5 B CROSS VA 00 r i TO EAT Please Refer to Return PalicV
READ 1'd Ir r L s• ,1~.'qJ' It C: S :i. to
i
t
C "i=4C: EIN
2t .5 ,S 2 i1 P �^iFs' 7.. .tt SO FT B i ..y y i t Sij t
u:. t,. E.r•_} •:.21.1 5....5 t iff iR.l�.l r,.Fi...J K t �'Yq_1 #I L t L' +t' \l.r 1'w.�` ,.�11''..l F d.. ,.7!_71 h CS 31.6000 fz
1 1 CS 2 372928 �.,�'�.1. E t 1' BE AN HEA i A f t q•-..f 4 r 5 r t! ir S 55 .9700 55 ^f S
;•,ra' t <t E':� r..1`E ,.r 1_S:{ t�1! °i T Y�i,4 i, C 1
1 1. C S 3041423 t'tlR i�ClG AM CH FZN 40/4 OZ %TAT FAIR S ':3 4 3 0 3 4
L• c. C to •,r F 'Y ,i. 9
4 4 CS 333009 ✓HOT DOG, AB 6::1 6" RE._ GRIL 10 LB PATUXENT 29 ,15,x,} 1.c3 76
W
1 1. CS �'�41 n. 5 .28 ''r'r~ UM, HOT 000 6" HINGE #._CD 1"FF:1::'a`?.'2 EA HILLTOP HR CS :2 9600 9
1. 1 CS 61..3' _''i :E�1';t:1#•,}''i�IE, 1"E 2.5 Z UNSi, r,i,tD 40/ O OREO CS 4 �,<:00 3 i
,;.t to
1 CS 81.ia,/999 ICE Y_,Etf:.AN BAR, CHOC, TACO ��Iji!..2 4,/4 i„ s KLC1ri1sI CS r_-�. 3:3 4. ti
i
f-t (j�
TOT q DRY PIECES ORDERED; ED; 13 P IEC ES SHIPPED: 1;f ITEMS MS SHIPPED 11, 476. 3
TOT REFRIGERATED PIECES CES lDE RED: 5 PIECES SHIPPED: 11 Ems =HIC!ED .5 84.7B
TOTAL FROZEN PIECES C13' =.1; #I::RED: 11 PIECES SHIPPED: 11 1TE4' S S HIP PED: 369 =•1:1. 3
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER ES SALES DATE
NO. NO, DATE NO NUMBER LOC. REP ORDERED
90569922 2283947 03/30/12 90569575 1054 0062 03/29/12
Route:5291 8 ORDER NUMBER: 484921
~�3ill Ship Remit
|o: 1411 E. 116TH ST To: 1235 CENTRAL PARK DRIVE E To:
46032 46032 INDIANAPOLIS .1 N
317 043 3873 46266-0088
Att: MICHELLE COMPTON DEPT 00 800 428 2116
3hjpFrm: 12301 CUMBERLAND BD FISHERS IN ShipD� 03/30/12 Page 02 of 03
7 rtTrms: Spcia2 ENTER OFF OF 111TH STREET!!}
"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
I CS 4800884 'MILK, CHOC 1% LOW FAT PLST REF12/1 PT FM CS 10. 9000 10.
I CS 5332242 LETTUCE, !CBRG SHRD 1/4" CLND 4/5 LP CROSS VALY B CS 17.1900 17.19
FROZEN
10 CS 2011278 PRETZEL, KING SOFT DKD FZN 50/5 OZ S U PR R T ZL CS 31.6000 316.00
I- CS 2014652 MUFFIN, PLBRY IW 24/4 OZ SARA LEE CS 20.2900 20.29
6 CS 3041423 -CORN DOG, AM CN FZN 48/4 OZ STATE 'AIR CS 33.4100 200.46
HOT DOG, ATJX
0 CS 3330099 AB 6:1 61 RLR GRIL 10 LE PATUXE�.
2 DOG, AB 8:1 6" RLR GRIL 10 LB PATUXENT CS 28.3500 283.50
ROSELI CS 30,9400 30.94
I CS 4058707 MUFFIN, BANA NUT 1W FZN 24/4 UZ SPUNKMEYER CS 24.3300 24.33
CS 6005003 BAGEL, PLN 2 Z SLCD TFF HEAT 872 EA CS 24.4800 24.48
CS 6153027 -BROWNIE, CHOC 2.5 7 UNSL BKD 48/2.5 OZ OREO CS 13.6800 87.36
1 1 CS 6450852 -COFFEE, LIQ PREM RST 40:1 FZN 4/1 LT MAXWELL HS CS 148,9000 148.90
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 39 PIECES SHIPPED: 38 ITEMS SHIPPED: 25 1172.14
TOTAL REFRIGERATED PIECES ORDERED: I I PIECES SHIPPED: 11 ITEMS SHIPPED: 10 228.56
TOTAL FROZEN PIECES ORDERED: 44 PIECES SHIPPED: 44 ITEMS SHIPPED: 14 1474.15
ACCOUNT INVOICE INVOICE CLsS PURGI ORDER SALES SF,F.._ES DAT
N(]. 114E_3. DATE O. 1' €W'(i3ER LO C. REP. ORDERED
90569922 2203947 03/30/ 9056g575 1 0 0062 03/29/12
Route: 5291 a ORDER }k11:1f"BER: 484921
Cr��21' €EL CLAY €��',F�€j;S&REC�€�� (.,�t€-dME CLAY ('F�R4�:�aY:f��t ftEe� US Foods, Inc.
To: 1411 E. 116TH ST To:. 1235 CENTC"?Al.... }~'ARK I' To: BOX 660088
CARMEL IN CA RMEL 1N
46032 46032 INDIANAPOL113 IN
317 843 3973 46266-0088
Att: MICHELLE Ci;MPTf:N 3 DEP" 4 00 J E300 426 21.1;3
h r pt: 123 >j IL :i ?1. ND RD .;`h.i pD: 03/30/12 Page 03 of :13
P ta"r"s,- spc.ial ENTER YF OF 111T STREET!!!
NET 30 PAYS Ingtr:
Qt;• Qty Saws:. Product De__•::•ripy"n Pact; Sipe Label C Weight PPicing unit Ex4e•r,ded
#rdered Shipped Unit Number Unit Price Price
f
TOTAL,. WOT SHIPPED: 1087.38 PIEC ORDERED: ?4 PIE SHIPPED 3 ITEMS SHIPPED: 4?
PF,DiJl.3CT TOTAL 2874.85
TAXABLE AMOUNT .00
GEN SALES TAX .00
I
t
6
p .pct any adjustments made at delivery: ,,.874.85
_...__.._T a m ount i 2� csrYF5p��7lrsd4L d� s1!!3E i�E�_ p �'1C ?r e1
TO
Purchase
Description t ao ctrl 3 012
P.O. (yw P or F
Budget
By
Line escr
Purchaser Date
Approval Date
i
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO. DATE NO, NUMBER LOC. EP ED
90569922 2283947 03/30/12 90569575 1054
006 03/2 9/12
Route:5291 G ORDER NUM8ER� 484921
8ill Ship Remit
To: To: 1 1235 CENTRAL PARK DRIVE E To BOX 660088
46032 146032 INDIANAPOLIS 1N 1
1 317 843 3073 46266-0088
Att: MICHELLE COMPTOh4 IDEPT 00 :80 428 2118 AipFrm� 123g1 CUMBERLAND RD FISHERS IN ��i D O3/3O/12
p Page 01 of 03
'rt&ms�
Spcial ENTER OFF OF 111TH STREET!!!
"yt7rms: NET 30 DAYS Instr.
Qty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number B Unit Price Price
DRY
1 11 CS 0373423 SNACK BAR, CRL COCOA PUF SS 96/1.4 OZ GENL MILIS CS 34.2400 34.24
1 1 CS 0814541 CUP, FN 20 Z WHT 2S/20 EA MCIN66R�m CS 21.5500 21.55
11 EA 1103599 CANDY, MaN PLM 1.61 OZ 48 EA N H B EA 51,2900 51.29
1,, CS 2404325 GLOVE; POLY LO TXTD AMBDX 10/100 EA MONOGRAM R CS 39.7100 39.71
1. CS 3256104 LID, CUP 12-24 Z BBL PLST 1000 EA UINCUP CS i6.5900 16.59
CS 3429305 JUICE, GRAPE 100Z PET PLST BTL24/10 OZ THIRSTrR ___CS 16.7500 13.75
4004289 CANDY! BAR SNCKR 2.07 OZ
,/EA 48 EA SNICKAS EA 34.2700 68. 511
I CS 4S MIX
1 CS 539"1604, CHIP, CHS CNCHY PLN SS BAG 64/2 OZ CHEE-TOS CS 29.8500 29.85
i cc 5597851. CHIP, TORTLA NACHO CHS TRGLE 64/1.75 OZ DORITOS CS 23.5500 28.55
1. CS 560167?, CHIPI PTATO REG PLN SS BAG 64/1.S OZ LAY/S CS 28.5500 28.55
i CS 5601927. CHIP, PTATO VTL JLP SS BAG 64/1.375 OZ MISS V1.CKI CS 29.8500 29.85
1 CS 5605431 -CHIP, MULTGRN GRDN SALSA SS 64/1.5 OZ SUN CHIPC
CS 29.5000 2950
CS 5605522 CHIP, MULTGRN ORIG SS BAG 64/1.5 OZ SUN chips WZ CS 29.5000 29.50
I EA 6210777 CANDY, KIT KAT VNDG STD 1.5 Z 36 EA KIT KAT
5 5 CS 908?079 &OPCORN, RAW KIT U/ OIL SALT36/8 OZ FANCY FARM CS 23.4500 117. 25.5
1. i CS 9187956 -COOKIE, DEVIL FOOD FT/FR CH/FR43/1.1 OZ SNACXWELLS CS 26,7700 26.7,7
REFRIGERATED LIZ
READY To EAT Please Refer to Return Policy
READY TO EAT Please RePer to Return Polic
READY TO EAT Please Refer to Return Policy
READY TO EAT Please Refer to Return Polic
I I CS 4800843 -MILK, 2% REDUC FAT PLST REF 12/1 PT NRAIRIE FM CS 10.4200 10-42
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
3/16/12 1860994 Concessions 30585 936.92
3/23/12 2075313 Concessions 30604 892.42
3/30/12 2283947 Concessions 30633 2,874.85
Total 4,704.19
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
4,704.19
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1095 -1 1860994 4239040 936.92 1 hereby certify that the attached invoice(s), or
1095 -1 2075313 4239040 892.42 bill(s) is (are) true and correct and that the
1095 -1 2283947 4239040 2,874.85 materials or services itemized thereon for
which charge is made were ordered and
received except
5 -Apr 2012
Signature
4,704.19 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund