HomeMy WebLinkAbout209363 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
0 ONE CIVIC SQUARE SYSCO FOOD SERVICES
CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $2,655.31
INDIANAPOLIS IN 46206 -7137
CHECK NUMBER: 209363
CHECK DATE: 5/2212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 205040315 990.73 FOOD BEVERAGES
1207 4239040 205101137 790.83 FOOD BEVERAGES
1207 4239040 205171188 873.75 FOOD BEVERAGES
P 1 r I
Good things. CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
S ij sC b me from DEIV, CSATE CUSTOMER,
1.6 'BROOKSHIRE GO LF CLUB
1 12120 BROOKSHIRE PKWY TR .11 oP 412940 205040315 9 1
SYSCO INDIANAPOLIS, LLC
CARM EL IN 46033 4000 W 62ND ST °R O.. E
I INDIANAPOLIS, IN 46268
RE: 317 846 7431 DUE FRIDAY 4 WEEKS AFTER ORDER
i. I CITY OF CARMEL
I 1 CIVIC SQUARE DRIVER: MAY, JEFF
EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60 -1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE.
Cl:TY PAC SIZE IlEM RESCRIPTION ITEI/f urutT Ex?ENDED T PNTS t... C06E PRICE PRICE I x
DAIRY
NL 5 LB BRLCLS CHEESE AMER YEL 120 SSL 28131 6697114 16 98 16 98
GROUP TOTAL 1:6 98
1 MEATS... �(I
Arl S 605.3302 AB BEEF PATTY GRND STKBRGR FRZN 99.763151 6703.049 67-8 67.8$
j S 110 LB.. HNSVLE BRATWURST 5X1 PRICK SKLS 3188 2199,198 31 .98' 31 98 16 5....6"' ,;S 10 LB BRLCLS FRANK ALL MEAT 5X1 6 IN 37736 070 1137736 22.74 .4 .66
S 276 OZ DVANCE PORK FRITTER BRD RAW 6606 2205383 39 7$ 39 78
GROUP TOTAL 18:5 12 666
FROZEN
S 12CT RCTYBK COOKIE CHOC CHNK DWNHM 30Z IW 8349439 `58.32' H.32 1 S 246.1 OZ BRLCLS SANDWICH BAGEL EGG /CHS`SAUS I 3365145 3365145 40.30 6 6.6
0.30 66
166
S 243 9402 N PRIDE ANDWI
SCH SAUS EGG CHS CROI8 IW 482 5196 29 96 29 96
GROUP TOTAL 128.5$
CANNED &DRY
NL 36 CT ARS CANDY BAR MILKY WAY 4367363 27 7 .6 4 27.74 111.1-11-6 111.1 11 1- DIM 21 CT ERSHEY CANDY BAR PAY DAY` 80723 7030414 16.59` 16.59` 66666 NL 48 CT NICKER CANDY BAR SNICKER 2. 07 OZ 01202 4348389 32.61' 32 bl 1.
S 1 2402 SE REC KETCHUP SQUEEZE BTL HOUYA24 9617218 26.76 26 76
5 1 12 OZ RENCHS MUSTARD YELLOW CL$ SQUEEZE 4150075677 4736070 20 50 20.50 6.666
S 481.7502 CANTER PEANUT SALTED 07708 9549379 21 98 21 9$ 666666
-6666 S 101 LB BRLCLS SNACK MIX SPCY CREOLE 91069 9960329 33 101 91'
GROUP TOTAL 248.09 66 PAPER &L DISPOSABLE 1666
S 1280 C T YSCO CUP PLATS TRANS 1602 SOFT YE160SYS 7358304 59 98` 119.96
.11 I'll ��pii REM17 7Q 6 1 1
P•0. BOX 7137
z 1 4 20 15.3 239 INDIANAPOLIS IN SUB
I IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN g AFTE 46206 -7137 TOTAL
e �OR ANV SHORTAGE AFTER 169 U HAVE SIGNED WILL BE VED MUST TAX
DRIVER'S NO. PCS CUST. NO. PCs
TOTAL
SIGN C DELVD. SIGN E o g REC. INVOICE
I g TU 7 E HO PER AggLyE g OF H ACTUBiiEg C 30(7 0 �J S 4,9 OR HETRS E p TOTAL
17HtSE RR OA
RETAINS�A TRUST CLAIM OVER THESE L�OMMODITIES, ALL INVENTORIES OF FOOD ORTHER PRODUCTS PAYABLE ON OR BEFORE
1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT• ON PAGE 2
o FULL PAYMENT IS RECEIVED.
Good things
CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
come from a�LV ;bard cusrol�ER
BROOKSHIRE GOLF CLUB
1212'0 BROOKSHIRE PKWY TRUCK S O Kxxx 412940 205040315 9 2
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND STuE
INDIANAPOLIS, IN 46268
317 846 7431 411, DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: MAY, JEFF
CARMEL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF' 41 CFR 60-1.4, 60-250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE.
C2:7 Y PAC SIZE ITEM DESCRIPTION EXTENDED: T
q E RN E
NL 5;00CT; YS CO; FOIL SHEET 9X10.7 SSLVER; W69372; 6938 :500 ;12.98!; 98
I2.1
S C. S 1 100 CT YS C!LS GLOVE POLY CAST D!ISP MED 303:363112 348!245 42.60 42.60;!
y 5 125CT YS I!MP PLATE PLAS B I,K IMPACT 10.25" PI HEM: 2818110 109,96 109.98.
t
NL.. soo.C,T ROWN: WRAP PAPER DRY...WAX 12X10.75
2212' 0894;432 6, 99 20.97
PRODUCE
GROUP TOTAL 3.0.6.49
S 1;2 CT ACKER LEMON FRESH 1;039478' 039:478 10, 56; 10.56;:
)are I S 12 CT ACKER LIME FRESH 1283787 7.75: 71. 75
S 5; LB BRLTMP ALA CHICKEN 510711 251Q717 41 08. 41 08;
i S 5 LB YS CL SALAD TUNA W' //CELERY PICKLE 71117 .;,68049 672 4;249 ;41.08; 41 .08;:
GROUP TOTAL 100.47
M1 S CHARGES: HGS ::FOR FUEL SURCHARGE 5 00'
ORD 5 RY 59784
i
Xxx
REMIT TQ?
P.O. BOX 7137
Z IE 4 10 3.6 79 INDIANAPOLIS IN SUB
p IMPORTANT: PER PRODUCTS ARE NOT ELIGIBLE FOR RETURN gE TAX
AFTE 4206 -7137 TOTAL 990.73
e 2 8 3O 18 318
DELIVERY. V SHORTAGE AFTER I
THIS HA� E $IGNE0 IPIEC NOT BE MUST
V DRIVER'S NO
PC
CUST. NO. PCS TOTAL
DELVD. SIGN REC. INVOICE
SIGN C M Eg I) p E p g J C 7 990.73
o PE�LSD �L`� S RIICUNL SIC� O LI LE TE AGRfC�J T LT I URAL V COM S ACT 6 1 30170U THE 49 g A E T�1 C (DRY ETRSUEgLT�ER TOTAL
EN? R C O ud 1 R A TRUST CLAIM OVER THESE COMMODITIES AL INVEN'TO IES OF FOOD OR THER PRODUCI°S RAYABLE ON OR BEFORE
I DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 6/01,12 LAST PAGE
o FULL PAYMENT IS RECEIVED.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF
4000 W 62nd Street
Indianapolis, IN 46268
$990.73
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 205040315 I 42- 390.40 I $990.73 1 hereby certify that the attached invoice(s), or
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
Wednesday, May 09, 2012
Director, BrooOMIe Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/04/12 205040315 Food $990.73
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
CUSTOMER'S ORIGINAL INVOICE
CONFIDENTIAL PROPERTY OF SYSCO
Good things I
come from DELV, ;DATE CUSTOMER
BROOKSHIRE GOLF CLUB 1 1412940 205101137 3 1
12120 BROOKSHI RE PKWY TR cK s 0P
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST RO E
INDIANAPOLIS, IN 46268 I li f
317 846 -7431 I DUE FRIDAY 4 WEEKS AFTER ORDER
ii
CITY OF CARMEL"
1 CIVIC SQUARE li
I ��i EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES!I.OF 41 CFR 60 -1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE. 1.
ITEM UNET. EXTENDED
qTY RAC SIZE ITEM RESCRIPIION
CO.C3E ::PRICE RRICE x
DAIRY I 1.
NL 5 LB BRLCLS CHEESE AMER.YEL 120 SLI 28131 6697114 16 98 33 96
II MEATS
GROUP TOTAL 33 96
VF S 605.3302 AB BEEF PATTY GRND STKBRGR FRZN 99763151 6703,049 67_88 1.35.76 1.1,11 I. I —.I S ,,10 LB.... HNSVLE BRATWUR..ST 5X1 PRCK SKLS 31$8 21199198 31 98.. 95 94
S 10 LB BRLCLS FRANK ALL MEAT 5X1 6 37736 070 1137736 22 74 6$22
GROUP TOTAL* 29' 2 .11 FROZEN
S 244 2502 KRSIMP MUFFIN ASST BL /BAN /CHOC CH I/W 073473021825 7813114 23 94 23 94 1.
23.94
CANNED &DRY
GR.O.UP TOTAL
✓C NL 24 CT ERSHEY CANDY 1 AR PAY DAY 80723 7030414 16.59 1 6 59
�C' NL 48 CT NICKER CANDY BAR SNICKER 2.07 OZ 01202 413483$9 32 61: 12.61
1.
✓C NL CT EESES CAN PEANUT BUTTER CU.P 44000 5197769 22.61 22.61
NL 36 CT &M
CANDY SKITTLE FRUIT CHEW 2 172 7009251 24.74 24 74
ID S b 1.1252 KDLAYS CHIP POTATO BKD REG BIG GRAB 443968 6725313 28 88: 28.88 1.
SI 160 CT AYS CHIP VARIETY 5YSC0 /FRITO LAY 31831 65$6721 26 98 53.96 1.
'"6� S 2161 ARFARM COOKIE CHOC CHIP IND 23110 4443925 45.93 45 93
`�D' 5 50 9 GM SE REC RELISH SWEET PKT 1609064 1609064 28 25 28 25 1. I GRO:UP..T�TAL *x 25:3 57
PAPER &DISPOSABLE
I c
„S 100 CT YS CLS GLOVE LATEX FDSVC MED 304750022 8347841 39.96 39 96:
D S 1 250 CT YS CL5 NAPKIN DINNER 15X17 1P 1 /8F WH N5181A SYS 5917770 45 65 45.65
.1 I GROUP TOTAL g5 61
-X: [::::i :::::X::: :,�,.......:''.:�'...,...".."",.,....,.................I r I r._.
REMIT T¢3
P.O. BOX 7137
1 6 22 19.1 224 INDIANAPOLIS IN sub
IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN gE
AFTE 46206 -7137 TOTAL
E FOR V ANV SHORTAGE AFTER I
VO U HA SI G NE WI LL PIEC RECE VED MUST TAX
v I TOTAL
NO. PC$ COST. f10. PCs
DRIVER'S o1LVD. SIGN REC. INVOICE
SIGGN C p E p p H g g EC
I TUTHpPE I R gEFdA�L S T I SN LT SIC OF O 7H M E O P E I LE TE AGR ICU TL INV OOM E M A pDITIE� L ACT 6 1 9 3 01 7 0 SH 49 PC UCTORTHtTRS ESLT ER p TOTAL
THEESE R CMM ITI A TRUST CLAIM �vER THESE COMMODITIES, ALL INVEN70 RRIEEES OF FOOD OR I �THEF, PRODUCTS PAYABLE ON OR BEFORE
I D ERIVED FROM $HESS OM AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2
CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
Good things
come
from Dew. DAr� cusro.rER
BROOKSHIRE GOLF CLUB... �l TR cK s OP
12120 BROOKSHIRE PKWY 412940 205101137 3 2
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST aou
INDIANAPOLIS, IN 46268
317- 846 7431 !IDUE FRIDAY 4 WEEKS AFTER ORDER ORMAL DELIVERY
CITY CARMEL
1 CIVIC SQUARE i; DRIVER:
ARMEL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSESiOF 41 FIR 60 -1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE.
ITEM
'UNIT EXfiENDED T
C1:TY PAC S12E ITEM DESCRIPTION cQE PR1cE PRICE 11 PRODUCE
S 15 LB YS IMP ONION RED FRESH JUMBO 1039494 1039.494 8.76. 8 76
5 LB. BRLIMP SALAD CHICKEN 51071. 2510.717 41,08. 41,
I S 2,5 LB YS I. MP TOMATO SLICED 1�4.." 40451 6113.765 38,99 38 99
GROUP O 88, 3
MIS H RG S HGS,.FOR FUEL .SURCHARGE. 5.00
OR S RY b4 z;0 b
i
i
1
a
L
II
IT TQ
P.O. BOX 7137
Z�I 3 1.5 28 INDIANAPOLIS IN sus p
IMPORTANT: PER PRODUCTS ARE NOT ELIGIBLE FOR RETURN g AFTE 4206 -7137 TOTAL 770.03
E 1 6 25 20.6 252
DEL SHORTAGE RAFTER THIS U HAVE E $I GNEO IPIECEOS BE MUSTS TAX AGREE \A 11— PiFrFq R11—
DRIVER'S NO. PC S COST. NO. PCS
TOTAL
0ELVD. SIGN REC. INVOICE
TSIGN EIVED 7Ep IZ g E H p M g g�y E ggEGC I C M MDI7ET G UL L MM E E SOLD
S EC3 U 7 C q gE E TRUST
SEL�E p TOTAL 790.83
ESE COM S R OVERTH ESE T OMMOD TIES, INVEMfOR iE s OF S FOOD 9 0R� C THER PRODUCTS PAYABLE ON OR BEFOR 6 R FROM 5 ESE VOEpMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL
TOUCHER NO. WARRANT NO.
ALLOWED 20
>ysco Indianapolis LLC
IN SUM OF
1.000 W 62nd Street
ndianapolis, IN 46268
$790.83
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 205101137 I 42- 390.40 I $790.83 1 hereby certify that the attached invoice(s), or
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
Wednesday, May 16, 2012
P /j
Director, Brookshl Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
escribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
,n invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
Thom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/10/12 205101137 Food $790.83
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
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
come from oav, DATE cusro.�eR
BROOKSHIRE GOLF CLUB �cG
12120 BROOKSHIRE PKWY rRCK oP 412940 205171188 1 1
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST RPtT:
INDIANAPOLIS, IN 46268
317 846 -7431 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: MAY, JEFF
CARMEL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 FIR 60 -1.4 60 -250.4 AND 60 -741,4 ARE INCORPORATED HEREIN BY REFERENCE.
TEIVi: IJNET EXTENDED T
M PAC SIZE I EM A SCRIPTION cgrxE F?R10E 0RIGE
DAIRY
C NL 5 LB BRLCLS CHEESE AMER YEL 120 SLI 28131 6697114 16 98. 33 96
GROUP TOTAL 33 96
ic MEATS
F S. 6,5 ,3302 AB BEEF PATTY GRND STKBRGR.. FRZN. 99763151 6703049 67.88 135.76; 11
F S 110 LB HNSVLE BRATWURST 5X1 PRCK SKLS 3188. 2199198 33.97 33 97' 1.
F S 110 LB BRLCLS FRANK ALL -MEAT 5X1 6 IN 37736 070..1137736 22.74 68.22 1. I C S 2,5 LB BRLCLS HAM SLICED HNY WTR ADD FRESH HHN850SLB 8286429 44.26 44 26
I 11 11 I
I GROUP TOTAL 282 21 11 FROZEN
F S 2 4.2502 KRSIMP MUFFIN ASST L /BAN /GROG /Gil I /W OT3473021825 7813114 23 94 23.94 11
F S 2'.5LB ANTLZR ONION RING BEER BTR 5/8" 30423 0855296 26 Il 26 71 1. I'll 11
111. F S 5 LB YS IMP POTATO FRY 318 SKON PHANTM PLU SY003108 4356465 31 24 31.24
GROUP TOTAL 81.89 I 11 CANNED DRY
D S #'10 USH BEAN BAKED OVEN 001619`4000873 48 38 48 38
1 C NL 48 CT' NICKER CANDY BAR SNICKER'2.07`02 `01202`4348389 32.61° 65.22 1.11
C NL 36 CT EESES CANDY PEANUT BUTTER CUP 44000 5197769 22.61` °22.61
D S 6 1.1252 KDLAYS CHIP POTATO BKD REG BIG GRAB 443968 6725313 28 88 28.88
D S 160 CT JAYS CHIP VARIETY SYSCO/FRITO LAY 31831`6586721 26 98 80.94
GROUP TTAL 246.03 11 PAPER DISPOSABLE
D S 2 200 C WHEART CUP PAPER WTR CONICAL 4` OZ 4R- 2050'9289711 96.31 96 31
CHEMICAL
1. GROt3P TOTAL 96.31 1
D S' 2:5GAL EYSTON DETERGENT DISHWASH LIQ 6100039 "7670118 59 87' 59.87`
*:HAZARD 11 RBMIT ra:<
ry
P.O. BOX 7137
2 1 5 22 22.8 309 INDIANAPOLI4�206 -7137 SUB
R IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE TOTAL
E DELIVERY. PLEASE CHECK THIS INVOICE WE WILL NOT BE RESPONSIBLE
V FOR ANY SHORTAGE AFTER YOU HAVE SIGNED. PIECES RECEIVED MUST TAX
DRIVER'S NO. PC GUST. NO. PCs TOTAL
SIGN DE L SIGN EE SS 7 7 REG. INVOICE
I g TH 7 E' PP FR I SAEGCRIIC UNL SIC OF� H R T LR I U S R N\OCOMEMAQDITIEOLDq C SU61 Eg C30170u THE 499E R THE T R S U E S L T �ER p TOTAL
1 THESE CUrv'MODITIES ROETAINS q TRUST F CLAIM OVER THESE COMMODITIES ALL INVE IES OF O'OD OR OTHER PRODUCTS PAYABLE ON OR BEFORE
I DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT ON PAGE 2
0 FULL PAYMENT IS RECEIVED.
.4, 5
CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
Good thins i r`+
s ij$ca e rom;r' DEIV 3AT� CUST:D37E:R
BROOKSHI RE GOLF CLUB TR CK:soP ;412940 205171188 1 2
YSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST R :E
INDIANAPOLIS, IN 46268
317- 846 7431 DUE FRIDAY 4 WEEK5 AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: MAY, JEFF
EQUAL OPPORTUNI AND AFFIRMATIVE ACTION CLAUSES OF 41 FIR 60 -1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE, 1.111-1 CITY PAC ?SIZE TAM LINE. ExT ND�D
ITEM DESCRIPTION CODE PRICE PRICE
PRODUCE
GROUP TOTAL 5, 7
C 5...... 1!0 LB:< YS :NAT:.LETTUCE'ROMA!INE :CROWN LEAVES! 66 :40494:: 6640 >494 `::29.49' 29 49
C 5 25 liB YS IMP .T()NSATO:!SLICED 1 4" 40451:: 6113;765 38,99: 38. 9
GROUP TOTAL 65�OQ
1.
I MIS RG S HOSFOR FUEL SURCHARGE
ORD 5 RY
b9869
REMIT 7Or:
P 0 BOX 7137
Y 2 1.9 23 INDIANAPOLIS IN SUB p
n IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE 4 206 -7137 TOTAL 873.75
E 1 5 24 24. 332 F ANY .S HORYAGE H A FT ER Y U H E IG N EO WILL RECE ED MUST TAX
I
DRIVER'S NO. PC CUST. NO. PCs TOTAL
DELVO. SIGN REC. INVOICE
g ZIp gg E p ES g E G U M p E S� qC E g� 7 U gE E gE p 873.75
THESE RCOMMOL IS CSTRIICUTASU�C�AEOTUST P CLAIM A OVER D THESE LT CO M MOD T IE S, SINVENTORIEOSI OF FOOD OR� PRObEUCTS PAYABLE ON OR BEFORE TOTAL
0 DERIVED FROM ESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 6/15/12 LAST PAGE
VOUCHER N WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF
4000 W 62nd Street
Indianapolis, IN 46268
$873.75
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1207 I 205171188 I 42- 390.40 $873.75 I hereby certify that the attached invoice(s), or
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
Friday, May 18, 2012
D
Director, BrookshiX Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/17/12 205171188 Food $873.75
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