HomeMy WebLinkAbout209678 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
ONE CIVIC SQUARE SYSCO FOOD SERVICES
CARMEL, INDIANA 46032 PO BOX 7137 CHECK AMOUNT: $2,500.18
INDIANAPOLIS IN 46206 -7137 CHECK NUMBER: 209678
ON
CHECK DATE: 6/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 205250793 69.99 FOOD BEVERAGES
1207 4350100 205250793 1,314.14 BUILDING REPAIRS MA
1207 4239040 205311138 1,116.05 FOOD BEVERAGES
Good things CUSTOMERS ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
S ii efYOm DELv<bgT�i CUS7;DMER 1.
BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PKWY TR QP
412940 205311138 7.... l
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000. W 62ND ST R flu E
1.
INDIANAPOLIS, IN 46268
317- 846 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: J HN TON, LEWI
EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CF 60 -1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFERENCE. I 1.11 11 TEM UNIT EXTENDED
(Ty PAC SIZE ITEM DESCRIPTION CODE PRICE PRICE x 11 DAIRY
C NL 5 LB BRLCLS CHEESE MER EL 120 SLI 28131 6697.114 16 98. 16 98:
GROUP TOTAL 16 98
MEATS 1.
F 05.3302 AB BEEF PATTY GRND STKBRGR FRZN 99763151. 6703049 67.88 203.64 11 F 9 1 LB HNSVLE BRATWUR.ST 5X1 PRICK SKLS 3188. 2199198 33 97. 67 94 1.11
11 11 I
F iT10 LB BRLCLS FRANK ALL MEAT 5X1 6 IN 37736 070 1137736 .22 113.70 11 C S 2 5 LB BRLCLS HAM SLICED HNY WTR ADD FRESH HHNS50SLB 8286.429 44.26 44.26
11 11
POULTRY *;F
GROUP TOTAL 42? .54
C S 2.5 LB BRLCLS TURKEY BRST SLI 342 MESQT SMK MSTB940SLB 4860003 43 43 98
GROUP TO 43 98...'.
FROZEN. 11
r:::
F 2 4 2502 KRSIMP MiJFFIN ASST BL /BAN /CHOC /CH I/W 073473021825 7813114 23.94 23 94 11 F 5LB ANTLZR ONION RING BEER BTR 5/$" 30423 0855 26.71 26 71
11 F S 5 LB YS IMP POTATO FRY 38 SKON PHANTM PLU SY003108 4356.465 31.62 6a.24
R7 P TOTAL 113 89 II. 11.11 CANNED DRY
C NM 36 CT ARS CANDY BAR MILKY WAY 4367363 27.74 27.74 11
C y �,�NL 48 CT NICKER CANDY BAR SNICKER 2 07 OZ 01202 4348 32.61 65.22 11
,,.r
D� 60.CT AYS CHIP VARIETY /FRITO LAY 31831 6586 26.98 26 98
D S 3" ARFARM COOKLE CHOC.:CHIP IND 23110 4443925 45.93 45 1 9 3 11 1-1 GR..OUP .TOTAL 16:5 I "I
PAPER DISPOSABLE
D �1,2200CT YSCO CUP PLAS PRTN TRANS 2OZ YS200SYS 7790239 46 22 46.22 1.
D NL 500Cfi YSCO FOIL SHEET 9X10.751N SILVER` °W69372 6938'500 12 98 25 96
REMIT Ta
P.O. BOX 7137
l 1 6 '25 16.3 309 INDIANAPOLIS IN SUB
R IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE 4206 -7137 TOTAL
E F ANVS HORTAGE AFTER T HIS H SIGNED ILL S RECEIV D MUST
TAX
NO. PC S CUST. n �I NO. PCs TOTAL
DRIVER'S DELVD. SIGN �r1J REC. INVOICE
SIGGN C E S
og T UTHp PERII E H D ABI t A E G C RI ION L T 5(C) q O FOHEOPERIISHALgILE7F�GRICULTIURALVOCOMMApDITIEOLD C TUB�E g C 3 T H 49 gAgEE77 UC7)�OT E p TOTAL
THESE R COMMOD ITIES RETAINS A TRUST CLAIM OVER THESE COMMODITIES, ALL INVENTORIES O FOOD OR OTHR PRODUCTS PAYABLE ON OR BEFORE
1 DERIVED FROM THESE COMMODITIES. AND A RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2
o FULL PAYMENT IS RECEIVED.
I A.- 4
CUSTOMERS ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
Good things 11 comefrom bELV ;DATE CUST;DMER Ni
BROOKSHIRE GOLF CLUB C
12120 BROOKSHIRE PKWY ®s c TR CK s QP 412940 205311138 7 2 11
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST ROUE
INDIANAPOLIS, IN 46268
317 846 7431 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: J HN TON, LEWI
EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60- 1.4 60 -250.4 AND 60 -741.4 ARE INCORPORATED HEREIN BY REFER[ =NCE.
s ITENt UNET EXTENDED T :11 If'TMPKlTcZ
l`2TY T PAC /SIZE ITEM DESCRIPTION CoQE U IT ,PRICE
a
D 4l..O.0CT YSCQ L PLAS CLR F/1.:5-2 5OZ PRTN YLSZFRSYS 7794795 6Q•19; 60 9 1. GRQUP TOTAL 13.2 37
SUPPLY EQUI.PMENT
D OU 5 l 16X19.." HEF... TQWEL BAR MOP RI BD TERRY 32` OZ 70'OBRT3'2 0265548 15.70!
EMOTE STOCK 2.....
PRODUCE
GROUP TOTAL
C S 112CT ACKER APPLE RED DEL FCY.FRESH 1344092 9.08 5.08 11,
C i 5 LB YS NAT LETTUCE GREEN LEAF GOURM SNGLS 5063722 28.35 28 35 11
C OU l' 5/) 5 LB YS NAT LE,TT,UCE. ROMAINE GOURM SNGLS 5063599 1. UT /5TflCK 1 1.11
C S r 5 LB YS iIMP ANION RED FRESH JUMBO 1;03949'4 1039494 8.76 8, 7 6 11
C C. 5 LB BRLIiMP SALAD CHICKEN 51071 25110717 ;41.08 82 1;6.
C ,,f 5 LB YS CLS SALAD TUNA W /CELERY PICKLE .71117':6804.9 6324249 41.08 41.08! 1
C S 2,5 LB YS TMP TOMATO'LSLICE.p 1 4 40451 6113765 :::38.9.9 <38 99. 11
I GROUP `DOTAL 208 �2
MIS <H RG S HGS ..FOR FUEL SURCHARGE 5 00 11
ORD S RY 79786 11 0
7137
REM1T TO
P.O. BOX
z 5.3 81 INDIANAPOLIS IN sue
q IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE 4 206 -7137 TOTAL 1116.05
E 2 6 33 21.6 390 FOR ANV SHORTAGE AFTER V HA SIGNED PIECES RECEIVED MUST TAX
v
NO. PCS CU NO. PCS TOTAL
oELVD.
DRIVER'S
SIGN H S p REC. INVOICE
I g F R R ZZ ISH pp AB gg L yy EE ggAEEGCCRICOUNL 5 1C QEO E I RIEgS ABLE TLTIURALVOCOMMOOETIESLD C SUB�9C 3 0 1 O S H g S S T9 E T U OR HE RS E p TOTAL 1116 0 5
I THESE COIv1MODITIES RE TAINS�A TRUST CLAIM OVER THESE COMMODITIES, ALL INVE RIES O FOOD OR �THER PRODUCTS PAYABLE ON OR BEFORE
I DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 6/29/12 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
$1,116.05
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1207 I 205311138 I 42- 390.40 I $1,116.05 i 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
Monday, June 04, 2012
Director, Brookshire o f 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))
05/31/12 205311138 Food $1,116.05
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