HomeMy WebLinkAbout211961 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
0 ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $2,205.27
CARMEL, INDIANA 46032 PO BOX 7137
s� INDIANAPOLIS IN 46206-7137 CHECK NUMBER: 211961
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 208021316 1, 096 . 50 FOOD & BEVERAGES
1207 4239040 208091149 1, 108 . 77 FOOD & BEVERAGES
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CUSTOMER' IN ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
come fr DELV,:i qTc cusroMER
BROOKSHIRE GOLF CLUB...
12120 BROOKSHIRE PKWY rRCKsoP 1412940 208021316 4 1
® SYSCO INDIANAPOLIS, LLC 1+
CARMEL IN 46033 4000 W 62ND ST RouE
INDIANAPOLIS, IN 46268
317-846-7431 I; DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL �'
1 CIVIC SQUARE I DRIVER: JOHNSTON, LEWI
CARMEL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CL'AU SES OF 41 CFR 60-1.4, 60-250 4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE
QTY ° PAC SIZE ITEM RESCRIPTION. q E PRICE EXTENDED PRICE , .X
c nonF: Ty
DAIRY
C S... NL 5 LB , BRLCLS CHEESE AMER_ YEL ,120 SL 28131, 6697114 17.80 35.60
S 1216 OZ HLFCLS TOPPING WHPD IN BAG 52960. 2389534 43.55 43 55
GROUP TOTAL* * 79.15
** MEATS„ ***
. ............ .
S 605.3302 AB BEEF PATTY GRND STKBRGR FRZN 99763151 6703049 6.7:88.; 135. 76
F S 110 LB , BRLCLS FRANK ALL-MEAT 5X1 6 IN 37736-070. 1137736 25.32 126 60
GROUP TOTAL'**** 262. 6
** POULTRY ***
S 42.5 LB, BRLCLS TURKEY BRST SLI, 3L4Z MESQT SMK MSTB940SLB 4860003 43.98 43.98
T 4 98
GROUP TO AL****
3
** FROZEN ***
S 5 LB YS IMP POTATO FRY 368 SKON PHANTM PLU SY003108 4356465 31.6,2 31.62
GRO P TOTAL**** 31.
** CANNED .& DRY ***
vec S NL 36 CT ARS CANDY BAR MILKY WAY 4367363 27.74 27.74
� c NL 24 CT ERSHEY CANDY BAR PAY DAY 80723 7030414 16.59 16.59
IS NL 48 CT NICKER CANDY BAR SNICKER 2.07 OZ 01202 4348389 32.61 32.61
.... .........
IS NL 48 CT &M CANDY M&M PEANUT 1.74 OZ 4380788 31.82 31.82
C S NL 36 CT EESES CANDY PEANUT BUTTER CUP 44000115197.769 22.61 22.61 .....
VC NL 36 CT &M CANDY SKITTLE FRUIT CHEW 2.172 117009251 24.714 24.74' "
D S 160 CT AYS CHIP VARIETY SYSCO FRITO LAY 31831j$586721 26.98 53.96
S 1223 OZ RIZONA DRINK TEA ARNOLD PALMER LITE 1. 0554968 14.94 119.52
D..... S 135 LB YS REL SHORTENING FRY LIQ CREAMY ZTF 99947-COMi' 4119509 29.98 89.94
D aa... S °"I01 LB BRLCLS SNACK 'MIX SPCY CREOLE 91069 9960329 33.97 67.94
- REMIT TO
P.0.1-BOX 7137
2 2 8 33 20.6 512 INDIANAPOLIS IN SUB
R IMPORTANT: PERISHABLE PRODSUCTS ARE NOT ELIGIBLE FOR RETURN gAFTE 46206-7137 TOTAL
v FOR VANY SHORTAGE AFTER YOUI HAOVIE ESIGNED IPIECEOST RECEIVED MUSTS TAX
v
NO, PCS OUST. N0, PCS TOTAL
DRIVER'S DELVD. SIGN REC. NVOICE
� SIGN �J C M p p �S T
TTH pPER1 F,�A LyE gAEGCRIIONL T5IC)q OF0,M IDFIRIESHAgILETEAGRICITLTURALVOCOMMApDITIESL ACTUB1 gE30(70U�JSCE 4g99AEETlJC)�OR HET RS ESLT�ER p TOTAL
TH SE C M DITIES RETAINS A TRUST FC LAIM OVER THESE COMMODITIES, ALL INVENTORIES OF'FOOD OR O'T HER PRODUCTS PAYABLE ON OR BEFORE ONT. ON PAGE 2
1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM 7HE SALE OF THESE COMMODITIES UNTIL
o FULL PAYMENT IS RECEIVED.
'I
Good things
CUSTOMER'S.1 ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
SiiOELv,"OATE CUSTOMER.;,12120 BROOKSHIRE
BROO GOLF CLUB+++ TRCK.S. OP 412940 208021316 4 2
12120 BROOKSHIRE PKWY �0 I NDI ANAPOLI S, LLC nnq
CARMEL IN 46033 4000 W 62ND ST ROUTE:..:. PuRrHaq
„
INDIANAPOLIS, IN 46268 „'.,..,
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL '
1 CIVIC SQUARE DRIVER: JOHNSTON, LEWI
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
QTY N. PAC P:::: S12,E::. ” M DESCRIPTION F E PRICE EXTENDED A
T. ITE 0 �E. PRICE x Ty
GROUP TOTAL 487.4F7
** PAPER & DISPOSABLE ***'
�D .S 1.0.0 CT YS.::'CLS:'::GLOVE::LATEX .FDSVC PWDRFREE MED, 304750:022..: 347$41, ::'39::96 39:'95
A*SCS 1 10.0 CT YS CLS GLOVE POLY CAST DISP MED 303363112 8348245 42.60 42.60
*:::CHEMICAL *.;**
GROUP TOTAL**** 82.56
D I B 10OCT ECOLAB, TEST STRIP CHLORINE 20302-01-11 4592689 7.99 7_.99
D
5::;:.. : 15'.RL COLAB,:.:TEST.':S.TRIP UAT " 2.0304-03-11 2940856;'::.;;'7.99 7.99
** PRODUCE ***
GR8UP TOTAL**** 15.98
S 12C7i: ACKER:::. APPLE.RED DEL FCY:FRESH 1344092 7.97 7.9.7
C ° 'S 25 LB '' YS NAT LETTUCE ROMAINE GOURM SNGLS 5063599 29.49 29.49
S 5-FlB SYS IMP:.::ONION .RED FRESH JUMBO 103.9494 039494 9::84;`. - 9:84,:: '
C ': ` ':5.:.. 5'::hB BRLIMP SALAD CHICKEN 51071 2510717 4T,.08 . 41.08
C S 2 S ;LB YS :LMP:..;TOMATO SLICED 1/.4'."'>:: 40451 ,6113765 ,':' 3$:.99 3' 99
GROUP `TOTAL**** l 127.
MIS( CHARGES HGS FOR FUEL SURCHARGE 5.00
j.
wo
ORDER SUMMARY 36442
o:
I REMIT. TO
P.O. BOX 7137
z IS 9 4.9 62 INDIANAPOLIS IN SUB
IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE 4206-7137 TOTAL 1135.49
R DELIVERY. PLEASE CHECK THIS INVOICE. WE WILL NOT BE RESPONSIBLE
3 8 42 25.5 574 FOR ANY SHORTAGE AFTER YOU HAVE SIGNED PIECES RECEIVED MUST TAX
NO. PCS CUST. NO. PCs TOTAL
DRIVER'S DELVD. SIGN REC. INVOICE
SIGN E q E E G o S g EgCg U C gE g TOTAL 1135.49
o AUTHpRRZZI SEEHDA BggLE SAEEGCCRII,NL T51C7 OCO HMEODIRISHAgVERDTR SE TCOMMOD TI ES,DALEOINDAVETMiORIE��OF sPOOD90R�C��OR R PROD UC? PAYABLE ON OR BEFORE TRIJ I THESE COMMODITIES RECOMM COMMODITIES, A CLAIM $/31/12 LAST PAGE
DERIVED FROM THESE COMMODITIES. AN❑ ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL
o FULL PAYMENT IS RECEIVED.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF $
4000 W 62nd Street
Indianapolis, IN 46268
$1,096.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
1207 I 208021316 I 42-390.40 I $1,096.50 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
Friday, August 03, 2012
Director, Brookshir olf 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))
08/02/12 208021316 Food $1,096.50
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 ;DELV, DATE CUSTOMER
BROOKSHIRE GOLF CLUB+++ l
12120 BROOKSHIRE PKWY TR cK s oP 412940 208091149 4 2
®� 0 INDIANAPOLIS LLC
CARMEL IN 46033 4000 W 62ND ST Rou„.,,,,,;, OK-TYSON...
INDIANAPOLIS, IN 46268 4448 TERMS :PA : o SERVICE CHARGE.
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
CITY OF CARMEL AA: SN139
1 CIVIC SQUARE DRIVER: JOHNSTON, LEWI
EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR 60-1 4, 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.
ITEM UNIT” .
ExPCEn
A:QTY PAC SIZE' ITEM. RIE onp Ty
T.D ,d* ICS :4 FULL 3YS CLS PAN .FOIL STM TBL FULL DP 3-3/8 Y605OXHSYS 7293283 52.13 52.13
D:A0.4 S:> NL 5:00CT 3ERENE STRAW::PLAS .WRPD JMBO. STRP 7.75YSTWJ77SSER24 019151.6 1:.99:. 15.96.
D NL 500CT 3ROWN WRAP PAPER DRY WAX 12X10.75 2212 0894432 6.99 13.98
GROUP TOTAL****
** SUPPLY & .EQUIPMENT:::*:*:*::.
D ► S: 2 4HR YSCO FUEL CANNED HOT SPOT STERNO ST05016S 5420419 63.66 63.66
** PRODUCE
GROUP TOTAL**** 63,66
C I CS 15' LB 3YS IMP ONION RED FRESH JUMBO d:p 1039494 1039494 9.84 9.84
C::'::: S 5...LB,::;: BRLIMP SALAD: CHICKEN 5.1:071 2510717 41,:08:: 41:.0.8
C I CS 5 LB 3YS CLS SALAD TUNA W/CELERY & PICKLE j0011117.68049 6724249 41.08 41.08
C " S::::,: 2..5. LB YS IMP TOMATO:.::SL.IC .
.ED .1 4 40451 6113765: ..38.99 8.'99.. .
GROUP TOTAL**** 13.99
MIS CHARGES CHGS FOR FUEL SURCHARGE 5.00
ORDER" SUMMARY 418 4 2
REMIT To;
P.O. BOX 7137
2 6 12 5.1 82 INDIANAPOLIS IN SUB
q IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN gAFTE 4206-7137 TOTAL 1108.77
E 2 10 35 20.1 363 FDORVANV SHORTAGE RAFTER YIOU HAOVE ESIGNEO IPECEOST RECEIVED MUSTS v TAX
NO. PCS CUST. O. PCs TOTAL
DRIVER'S DELVD. SIGN EC.
i SIGN 7EpE ZED gg yE SqE CR )q 7 ME g E Gp p pg Eg U C E E gEL E p INVOICE
THESE RCOMMOLD ITIESTIROENTA-(ICI
Ao TRUSTO�R�M AOVE RATHIE ULTCOMMODIMIE S,D,TIE D FOR E�I OFSF OOD OR�C��THER PROLD LICTS PAYABLE ON OR BEFORE( TOTAL 1108.77
I DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLEES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 9/07/12 LAST PAGE
o FULL PA MENT IS RECEIVED.
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
S# NDIANAPOLIS,e from .. DELV,'DATE :''CUSTOMER .:
BROOKSHIRE GOLF CLUB...
12120 BROOKSHIRE PKWY LLC TR CK SOP 412940 208091149 4 1
CARMEL IN 46033 4000 W 62ND ST RouE =TYSON
INDIANAPOLIS, IN 46268 1 4448 TFRINMq -
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
i
CITY OF CARMEL MA N
1 CIVIC SQUARE DRIVER: JOHNSTON, LEWI
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
ITEM UNIT EXTENDED
QTY' . PAC SIZE ITEM DES.CRIPTI,ON;, CODE PRICE.:.., PRICE...: X,
T .;.
DAIRY
C .l) I S D NLY 5 LB BBRLCLS CHEESE AMER YEL 120 SLI 28131 6697114 17.80 17.80
** MEATS ***
GROUP TOTAL**** 17.80.
S 6 5,330Z AB BEEF PATTY GRND STKBRGR FRZN 99763151 6703049. 67.88 67.,88
5,
110 LB , HNSVLE „B,RATWURST, 5Xl. PRC,K SKLS 3188 2199198 33.97 101.91
F S 110 LB BRLCLS FRANK ALL-MEAT 5X1 6 IN 37736-070 1137736 25.32 101,2
C S 42.5 LB BRLCLS HAM SLICED HNY WTR ADD FRESH Q HHN850SLB 8286429 44.26 4.2
..
F I C.S 276. OZ hDVANCE PORK FRITTER BRD RAW 6606 2205383 39.98 .98
** FROZEN ***
GROUP TOTAL**** 355.3
F` S 244.250Z KRS,IMP MUFFIN ASST BL/BAN/CHOC/CH I/W 073473021825 7813114 23.94 23.94
F 1 CS* 42.5LB rANTLZR ONION RING, BEER BTR 5/8" 30423 0855296 26.71 26.71
Fo!D I CS 65 LB SYS IMP POTATO FRY 3/8 SKON PHANTM PLU SY003108 4356465 31.62 31.62
GRO P TOTAL**** $:2.27 .;...
** CANNED & DRY ***
C o IS DNLY24 CT HERSHEY CANDY BAR PAY DAY 80723 7030414 16.59 16.59
C c0 NL 48 CT SNICKER CANDY BAR SNICKER 2.07 OZ 01202 4348389 32.61 32.16 1
D aV I CS 1201.4 OZ PLANTER CRACKER PEANUT BTR TOAST ROUND 7513 70.2.9.192 29.99 29.99
D S 112 OZ FRENCHS MUSTARD' YELLOW CLS SQUEEZE '4150075677 4736070 21.94 21.94
D S DNL 40 OZ AWRYS SALT SEASONED 2150080612 5130422 9.98 9.98
D S 101 u BRLCLS SNACK MIX SPICY CREOLE 91069 9960329 33.97 67.94 ...
GROUP TOTAL**** 179.05
** PAPER & DISPOSABLE ***
D 5 2 200 CT WHEART` CUP PAPER WTR CONICAL 4 OZ 4R-2050 9289711 96.31 192:: 62
o `
REMIT To
P.O. BOX 7137
1S 4 23 15.0 281 INDIANAPOLIS IN SUB
q IMPORTANT PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE 4206-7137 TOTAL
E FDEL I ANY SHORTAGE RAFTER THIS HAOVE ESIGNED.WILL S RECEE EF70 MUSTS
TAX
NO. PCs CUST. M PCs TOTAL
DRIVER'S DELVE. SIGN RFC.
i SIGNS E 3 INVOICE
gTUTH RRZIED ggLyE gAEGCF CU TUR LOEOMi MEODIRISHAgILETEAGRICUT LTURALV�OMMODIT SEOL ACCS�UB�1 3C 017 S 479 EET UC O RYH ETRS EESLLT ER O TOTAL
THESE COMMODITIES RETAINA TRUST CLAIM OVER THESE COMMODITIES ALL INVEN70IES O O ORTHER PRODUCTS PAYABLE ON OR BEFORE
❑ERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2
o FULL PAYMENT IS RECEIVED. r--
,+n
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sysco Indianapolis LLC
IN SUM OF $
4000 W 62nd Street
Indianapolis, IN 46268
$1,108.77
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 208091149 I 42-390.40 I $1,108.77 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
Monday, August 13, 2012
r
r
Director, BrookshiraGolf 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))
08/09/12 208091149 Food $1,108.77
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