211496 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC CHECK AMOUNT: $8,476.00
` CARMEL, INDIANA 46032
PO BOX 660088
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 211496
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 2156561 4, 089 .44 FOOD & BEVERAGES
1095 4239040 2191437 220 . 20 FOOD & BEVERAGES
1095 4239040 2279530 1, 829 . 54 FOOD & BEVERAGES
1095 4239040 2348272 2, 336 . 82 FOOD & BEVERAGES
'
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO, DATE NO. NUMBER LOC . REP ORDERED
90569922 2156561 07/03/ 12 90569575 1054 0062� 07/02/12
Route: 2251 / 5 ORDER NUMBER: 569436
8ill Ship Remit
To : 1411 E. 116TH ST To: 1235 CENTRAL PARK DRIVE E To:
46032 46012 INDIANAPOLIS
317 643 3873 . 46266-0088
Att: DEPT # 00 800 428 2118
7�iPFrm 123O1 CUM8ERLAND RD FISHERS IN Ship W 07/03/12 �--�-- � Page 03 of 03
-rt7rms �
� Spcial
'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
TOTAL WGT SHIPPED: 2190. 03 PIECES ORDERED: 167 PIECES SHI PPED: 141 ITEMS SHIPPED: 44
PRODUCT TOTAL $ 4069. 44
Federal Ocqupationjaiety and Health Standards. Section 1910. 1200 on Hazard
Communication requires manufactureps and distributors to provide Material
Safety Data Sheets on not-food products defined to be hazardous. Products
such as cleaning products and pesticides are included in the scopp of the
Standard. In compliance with the law. MSDS are available to USloods, Inc.
customers and can be obtain;d bV contagting the Procurement Manager in out § TAXABLE AMOUNT $ . 00
district Wice or by advising your sales reppeseptative. A GEN SALES TAX % . 00
You may contact KEVIN BURTON at phone 0 (3710 585 - 6822.
This amount is au estimate at time of shipping prior to auV adjustments made at deliverV: s 4089. 44
pvmhaoo '
DescdpHo JUL 10 2012
Budget
Line D~s^
Purchaser """�_-__- �
Date_ _
`
\
ACCOUNT INV ICF INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
N0 NO. DATE NQ. NUMBER LOC . EP ORDERED
90569922 2156561 07/03/12 90569575 �� ~� 1054� 0062� 07/02/12
�I [, � / �~ ^�
Route: 2251 / 5 � '~ � �� ORDER NUMBER: 569436
8iIl Ship Remit �
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT' US Foods, Inc .
To: [o: To:
j 46012 4600-'.' INDIANAPOLIS IN
317 843 3373 46266-008a
Att: DEPT # 00 800 428 2118
0ipFrm� 123D1 CUMBERLAND RD FISHERS IN �hipD� O7/O3/12 O3
-rtTrms
: Spcial
'yt7rms: NET 30 DAYS Instr: JUL 0 9 2012
Qty qty Sales Product Descripton Pack Size Labe} C Weight Extended
rdered Shipped Unit Number D '
Vnzt Nice Price
DRY
r CS 0445098 TAPE, THRML CASH RGSTR WHT 50 RL MONOGRAM CS 85. 7800 85. 78
1 CS 0791616 CUP, FM 32 Z WHT 25/20 EA MONOGRAM CS 35. 4300 35. 43
I CS 0814541. CUP, FN 20 Z LIHT 25/20 EA MONOGRAM CS 21.8300 21.S3
I CS 1287747 SNACK BAR, CRL ASST 1W SS 3/16/1. 3 OZ VELLOGG'S CS 28. 2900 28. 29
1: CS 2255396 CONE, ICE CRM CAKE FLAT BOTH 28/45 EA JOY CONE CS 69. 6800 69. 68
I CS 2404325 GLOVE, POLY LG TXTD AMPDX 10/100 EA MONOGRAM P, CS 42, 1000 42. 10
1: CS 3256104 LID, CUP 12-24 Z BBL PLST 000 EA WINCUr-''. CS 16.9200 16.92
8 0 CS 4260238 SAUCE, CHS NACHO SHLF STABL 4/107 OZ ORTEGA
2 CS 5311600 CONE, ICE CRM CAKE 226 FLAT 36/20 EA JOY CONE CS 38. 3600 76. 72
1 i CS 5329289 MUSTARD, YLU SS 5. 5 OR SHLF 500/5. 500 OR MONARCH CIS i2, 7,�00 12. 73
1- CS 5429303 JUICE, ORNG 100% PET PLST BTL 24/10 OZ THIRSTER CS 20.2300 20. 23
i CS 5601927 CHIP, PTATO KTL JLP SS BAG 64/1075 OZ MISS VICK! CS 31. 2000 3- 20
i CS 6260665 COOKIE, FUDGE STRPE MINI SS 6012 OZ VEEBLEI'',.' CS 25. 6700 25. 6-7
i I CS 6818819 TRAYI PAPR FOOD 5 LB CLAY 2/250 EA MONOGRAM CS 44. 1.200 44. 1.2
2 2 CS 7009966 SAUCE, CHILI HOT DOG W/ BEEF 6/108 OZ CHEF NATE CS 62. 1200 124. 24
10 to CS 9463688 CHIP, TORTLA CORN YLW RND 6/2 L1 EL PASADO CS 19. 2500 192, 50
I I CS ?954371 LID, CUP 32 Z STRAW SLTD PLST 10/50 EA MONOGRAM CS 215500 21.5-'.�
REFRIGERATEO
READY TO EAT - Please Refer to Return PolicV
READY TO EAT - Please Refer to Return Folicti
2 CS 4800843 MILK, 2% REDUC FAT PLST REF 12/1 PT PRAIRIE FM CS 10.5500 21 . 10
2 2 CS 4800884 MILK, CHOC 1% LOW FAT PLST REF12/1 PT PRAIRIE FM CS 0. 5500 21 . 1f)
to 10 CS 4884151 ICE CREAM MIX, SOFT SRV VNL 4%2/2. 5 GA PRAIRIE FN CS 32. 1100 321 . 10
-READY TO EAT - Please Refer to Return Policy
I I CS 5006556 BANANA, GRN FRESH REF 10 Q PACKER CS 7. 7800 7. 78
1 0 CS 7197775 YOGURT, ASST STRWBNA & RSPBRY 12/6 OZ YOPLAIT
1.0 10 CS 7451354 ICE MILK NIX, SOFT SRV CHOC 4%2/2. 5 GA PRAIRIE FM CS 321100 321 . 10
READY TO EAT Please Refer to Return PoldcV
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. N8. DATE NQ. NUMBER LOC. REP, ORDERED
90569922 2156561 07/03/12 90569575 1054 0062 07/02/12
�oute� 2251 / 5 ORDER NUMBER: 569436
Bill Ship Remit �
CARMEL CLAY R—AT CARMEL CLAY PARKS&RECREAT Foods, Inc .
To: 1411 E. 116TH IT [o: 1235 CENTRAL PARK DRIVE E To�
CARMEL ^'"
46032 46032 INDIANAPOLIS IN
J -317 84 - 46266-0088
Att: IDEPT # 00 600 428 2118
FhipFrm: 12301 CUMBERLAND RD FISHERS IN Shipl7� O7/03/12 ------'----------
� rage 02 of 03
-r��rms ci^s/
`pt0m5: NET 30 DAYS Instr.
Qty Qty Sales Product Descripton Pack Size Label C Ueight Pricing Unit Ex^ended
irdered Shipped Unit Number D Unit Price Price
FROZEN
6 6. CS 0105700 BEEF, PTY GRND 80/20 4: 1 RND 00/4 CZ CTLMN SLCT CS 62. 0700 $ 372, 42
13 13 CS 2011278 PRETZELi KING SOFT BKD FZN 50/5 OZ SUPR FRTZI- CS 31.6700 411. 71
I i- CS 2014652 MUFFIN, BLBRY IW 24/4 OZ SARA LEE CS 21- 7000 21. 70
15 Is CS 2639250 ICE CREAN CUPj CKY DOUGH 12/2. 9 OZ ITTIBITZ CS 0. 5500 18"D 40
5 5 CS 2649796 ICE CREAM CUP, COTN CNDY 12/2. 9 OZ !TTISITZ CS 12, 5500
4 4 CS 3041423 CORN DOGo AM CH FZN 40/4 OZ STATE FAIR CS 33. 4100 133. 64
to - 10 CS 3330099 HOT DOG, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS &. 9700 299. 70
2 CS 5218862 ICE CREAN SANDWICH, VNL 24/6 OZ BLUE BUNNY CS 1?, !400 34.28
8 0 CS 5403548 ITALIAN ICE, LMN DDL CUP FZN 12/16 07 CHILi- CS 23. 2500 186. 00
4 4 CS 550?708 PIZZA, CHS 7" DEEP DISH FZN U/36/10. 22 OZ BOSCO"S CS 61. 7800 247. 12
4. 4 5241 - 18 Lim H---- 4" SLCD TFF BKO FZN10/12 EA HILLTOP HR CS 2-42900 t13 16
2 CS 5741228 BUN, HOT DOG 6n HINGE SLCD TFF12/12 EA HILLTOP HR ---------
2 2 CS 7175128 10E CREAM COME, VNL TFF 2/12/4. 6 OZ BB CHAMP CS 22. 9000 45. 80,
I CS 9763061 POPSICLE, ORNG CHRY GRAPE SO/02"/6/1 . 65 07 POPSICLE CS 143300 19. 37
*K PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 41 PIECES SHIPPED: 31 TTEMS SHIPPED: 20 974, 70
TOTAL REFRIGERATED PIECES ORDERED: 31 PIECES SHIPPED: 30 ITEMS SHIPPED: 13 840, 97
TOTAL FROZEN PIECES ORDERED: 95 PIECES SHIPPED: so ITEMS SHIPPED: 16 2273. 77
ACCOUNT INVOI INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
use NO. AT- NO. NUMBER F LOC. REP. ORDERED
9056992 1914 /03/12 9 569575. C 3 �Z 1054 0062 07/03/12
F DELIVERY RO 97=53 507
BILL
TO: CLAY PARKS&RECM_v `SHIP CARMEL CLAY PARKS&RECREAT REMI US Foods, Inc .
TO: 1411 E. 116TH ST To 1235 CENTRAL PARK DRIVE E
%30X 660088
CARMEL IN CARMEL IN
46032 46032 INDIANAPOLIS IN
ATT.. 317 643 3873 46266-0088
MICHELLE COMPTON DEPT #$ 00 800 428 2118
SHIPPED FROM:_ 12301 CUMBERLAND RD FISHERS IN SHIP DATE: 07/03/12 Page 01 of 01
FREIGHT TERMS: SPECIAL
PAGE WILL PICK V
PAYMENTTERMS: NET 30 DAYS INSTRUCTIONS:"
CITY. QTY. SALES PRODUCT p PRICING UNIT EXTENDED,
ORDERED SHIPPED `� UNIT NUMBER DESCRIPTION PACK SIZE LABEL E WEIGHT UNIT PRICE PRICE
DRY-
2 2- _ CS 6820039 TRAY, PLYST—NACHO 6X8X1-.75—CLR4/125 EA - PACTIV -- __ CS 110-.1000 _-- 220,-20
>f## INVOICE SUMMARY
TOTAL WGT SHIPPED: 20.00 PIECES ORDERED: 2 PIECES -SHIPPER:- 2 _
PRODUCT TOTAL $ 220.20 - -
TAXABLE AMOUNT- .$ .00
GEN SALES TAX Y, .00
Purchase PLEASE REMIT THIS AMOUNT BY 08/02/12 AMOUNT s _ 220,20
Description r(11(1oD'�1�►�?jCp/�
P.O.# ,1 Qp FG.L-.It X0)5-k— ` -239 �
_. ---_
Bu ge —- -
- Line Descr
_ Purchaser _
Date
_ Dale -
Approval - -
- - JUL 1 0 2012 --
�,:
_ _
The perishable agrlculWral commodities listed on this lnvolce are sold subject to the statutory trust authorized by section 50)of the Visit www.usfoods.com for a fast and easy way to order.
Perishable Agricultural Commodities Act, p U.S.C.499e(c)).The seller of these commodities retains a bust claim over these
COmmodibes,all Inventories of food or other products derived from these mmmodlUes,and any receivables or proceeds from thesale o1 X
these commodreesuntil full payment isreceived. CUSTOMERS SIGNATURE:
Interest shell same on all unpaid balances exceeding established credit terms at a rate equal calculated the lesser of a Im ap par month or
(b)the maximum ue Net the customer may IavA din contract to pay,end in all events a eqal to In accordance)P applicable law.
•1'
___..,. __
i
AC U N T INVOICE INVOICE CUSTOMER ORDER SALES SALES DATE
NO. NO ]}ATE NO LOC. REP ORDERED
9D569��22 2�7953D O7/O6/12 9O56�575 1O54 OO6p O7/O5/12
Route 5291 / 9 ORDER NUMBER:
� 571955
8iIl �_hip Remit
To:
BOX 660089
Att�
��ipFrm 12�O1 CUMBERLAND RD FISHERS IN ShipD. O7/O6/12 Page 02 of
�
s. Spcial EMTER OFF O� 111TH STREET! { {
NET 3D DAYS �nstr
�ty Qty Sales Product Descripton PaCk Size Label C Weight Pric�n `
g Uni� Extended
�dered Shipped Unit Number D Unit Prie Price
REFf,'7GERATED I IECER ORDERED- 17 PIECE'S" q-41PPED: ITEMS SHIPPED:'
INV]DiCE SUMMARY
FUEL
T0'T'i-'u_ WGT HfIbl FEf.): 61" . PT'E.. Et ORDERED, f3o PIECES SHIPPED: ITEMS SHIPPED: 2.;
J.
and I-an' be obtained bV Cv-t 1-
- -
Purchase ^
-` ~~~`^p~~' FRE CT
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'
Budget�^ -~~� /-7~7
purchaser- ' Date_~-
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^
ACC INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES BALES DATE
NQ NO, DATE NO NUMBER LOC . REP . ORDERED
90569922 2279530 07/06/12 90569575 1054 0062 07/05/12
- Route: 5291 / 9 ^ ~ - ORDER NUMBER:� 571955
Bill Ship Remit
To� 1411 E. 116TH ST T To:
BOX 660088
46032 46032 INDIANAPOLIS IN
317 841 3873 46266-00%
Att: MICHELLE COMPTON DEPT # 04) Q00 428 2118
?AipFWm: 12301 CUMBERLAND -� - Page 01 of 02
Q1 Rty Sales Prrif j IL4upipt n Pack Size Label C Ueight Pricing Unit Extended
Alred Shipped Unit An Price Price
DRY
1 1 CS 3256104 ./LID, CUP 12-24 Z BBL PLST 1000 EA WINCUP CS 16. 9200 16. 92
1 1 53111-600 ./CONE, 10E CRM CAKE 22S FLAT 36120 EA JOY COME CS 38.3600 38. 36
1 i CS 5601679 /CHIP. PTATO REG PLN SS BAD 64/1 , 5 OZ LAY "..-3 CS 30. 0900 30, 89
1 1 CS . 9954371 ,01D, CUP 32 Z STRAW SLTD PLET 10/50 EA MONOGRAM CS 21 . 5500 21. 5,5'
READY TO EAT - Please Refer to Return Pol '
BEADY TO EAT - Please Refer to Return Policy
CS 6164001 J%YRUPe FONTM GRAPE ICE CAP RTU4/1 GA LYONS NAG CS 40.5600 40. 56
8 8 CS 6483952 ,/BEEF, PTY GRND 80/20 4: 1 RMD 56/4 OZ CTLMN BLCT CS 43. 9300 351. 44
15 is CS 2639235 QCE CREAM CUP, CKIES I CRM 12/2. 9 OZ ITTIBITZ CS 12. 5500 188, 25
10 io CS 2639250 VICE CREAM CUPo CkY DOUGH 12/2. 9 OZ ITTIBITZ CS IZZ00 125. 50
5 5 CS 3330099 4HOT 000, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS 29. 9700 149. 85
I CS 9763061 VPOPSICL& ORNG CHRY GRAPE SG/F!2/6/1. 65 OZ POPSICLE CS 0. 3300 19. 33
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ACCOUNT INVOICE INVOICE CU8IOMER PURCHASE ORDER SALES SALES 0 A T E
NO [,',ATE°+/ E v0. NU IlUE R LOC � REP ORDERED
90569922 234827P 07/10/12 90569575 �� 1054 0062� 07/09/12
Route: 2251 4 ORDER NUM8ER� 574515
BiI3 Ship Remit �
CLAY PARKS&RECRE To: To: To: ~� ' ~~~ �' ^''`
1 BOX 660088
CARMEL IN CARMEL IN
46032 46012 INDIANAPOLIS M
Att: - - -- -00 800 428 2118
7hipFrmT 121 CUMBERLAND RD FIBHERS IN S�jPD� O7/�O�12 -- � --
3O Page 01 of 02
7rtTrms: spCial ENTER OFF OF 111TH STREET ! ! '
TtTrms: NET 30 DAYS Instm
Qtv QtV Sales Product Descrwton Mack Size Label C weight Prilip Unit Extended
DRY
1 CS 0791616 ,00 FN 32 Z WHT 25/20 EA MOMOGRAN CS 35. 4300 $ 35. 43
1 CS OS14236 JAP, FM 16 Z WHT 20/25 EA MONOGRAM CS 17- 6100 17. 61
I CS Oet4541 WCUP, FM 20 Z WHT - 25/20 EA, MONOGRAM CS 21. 8300 21. 83
1 CS 225531�6, VC*QNE 10E. CRM CAKE FLAT BOTM 28/45 EA joy COME CS 646800 )9
42, 000 42
0000 EA MONOGRAM B CS
2 CS 325610411kID, CUP 12-24 Z BBL PLST 1000 EA wlmcul'-, CS 16, 9200 33. 84
1 CS 3708773 PDON, TEA .MW UHT POLYP BULK 1000 EA MONOGRAM CS 14. 9200 14.92
4 CS 4260238 SAUCE, CHS MACHO SHLF STABL 4/107 OZ ORTEG-'i
:1 CS 4329397 -'RETCHUP, TMTO FCY. SS FOIL PMT 500/9 OR MONARCH CS 14, 9600 14. 96
1 1 CS 5311600 ,(COME, ICE CRM CAKE 22S FLAT 36120 EA jOY COME CS 38. 3600 38, 0.,
I 6810019-ITRil-0 F-AFIR FOOD 5 LB CLAY 2/250 EA MONOGRAM CS 4i 4000 44
n"PRIGERPTED
READY TO. EAT - Please Refer to Return Polic
READY TO EAT - Please Refer to Return Polic
READY TO EAT - Please Refer to Return Policy
1 EA 3006452 ,/SALAD, TUNA ALBCR TFF REF 5 LB PIERCE B EA 26.9600 2636
READY TO EAT - Please Refer to Return Policy .
I CS 40000431MILK, 21 REDUC FAT PLS1 REF 12/1 PT PRAIRIE FN CS 16,5300 1005 -
PRAIRIE FN CS 10. 000 10- 55
6 CS 4884151 1ICE CREAM MIX, SOFT SRV VNL 02/2. 5 GA PRAIRIE FN CS 32. 1100
54) CS 7. 7800
1 CS 5332242 ., mum, rCPRG SIN , 1 /4v CLND 4/5 LB CROSS VALY B CS 17. 1!00 17. 11
READY TO EAT - Please Refer to Return Polic
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
7/3/12 2156561 Concessions 31048 $ 4,089.44
7/3/12 2191437 Concessions 31048 $ 220.20
7/6/12 2279530 Concessions 31052 $ 1,829.54
7/10/12 2348272 Concessions 31065 2,336.82
Total $ 8,476.00
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
120_
Clerk-Treasurer
Voucher No. Warrant No.
353824 U S FoodService, Inc. Allowed 20
Box 660088
Indianapolis, IN 46266-0088
In Sum of$
$ 8,476.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1095-1 2156561 4239040_ $ 4,089.44 1 hereby certify that the attached invoice(s), or
1095-1 2191437 4239040 $ 220.20 bill(s) is (are)true and correct and that the
1095-1 2279530 4239040 $ 1,829.54 materials or services itemized thereon for
1095-1 2348272 4239040 $ 2,336.82_ which charge is made were ordered and
received except
26-Jul 2012
P�dli&00
Signature
$ 8,476.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund