The URL can be used to link to this page

Home My WebLink About211977 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1 ONE CIVIC SQUARE U S FOODSERVICE,INC O CARMEL, INDIANA 46032 CHECK AMOUNT: $22,415.91 PO BOX 660088 INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 211977 CHECK DATE: 8/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1095 4239040 2191433 405 . 76 FOOD & BEVERAGES 1095 4239040 2446900 125 . 90 FOOD & BEVERAGES 1095 4239040 2477581 5, 269 .41 FOOD & BEVERAGES 1095 4239040 2548606 3 , 505 . 83 FOOD & BEVERAGES 1095 4239040 2612660 556 . 39 FOOD & BEVERAGES 1095 4239040 2666613 2 , 911 . 14 FOOD & BEVERAGES 1095 4239040 2759763 2, 812 . 95 FOOD & BEVERAGES 1095 4239040 2868221 3 , 591 . 27 FOOD & BEVERAGES 1095 4239040 2944298 3 , 237 .26 FOOD & BEVERAGES ACCOUNT INVOICE INVOICE CUSTOMER 4 PURCHASE ORDER SALES SALES DATE NO, NO. DATE NO. NUMBER LOC. REP. ORDERED use 905699 469.0 /12/12 90569575 FOODS — - . ' 'm ( 3 / � '(e 1054 0062 07/12/12 9365 1 ---- ---- ORDER NUMBER- 577590 BILL CARMEL CLAY PARKS&RECREAT SHIP CARMEL CLAY PARKS&RECREAT REMV US Foods, Inc nc I s, ' TO: 1411 E. 116TH ST TO: 1835 CENTRAL PARK 'DRIVE 'E T , ' nc . BOX 660088 CARMEL IN CARMEL IN 46032 46032 INDIANAPOLIS IN 317 843 3873 46266-0088 ATT• MICHELLE COMPTON DEPT # 2118 00 800 428 2118 111!!�PPED FRO-M: 1,230 J.- CUMBERLAND_ RD F.ISHERS -I.N . .;SHIP DATE: 07/13/12 Page 01 of 01 FREIGHT TERMS: SPECIAL Michelle will PT_�� wit1hin the hour . PAYMENTTERms: NET :30 DAYS INSTRUCTIONS: C QTY. QTY. SALES PRODUCT DESCRIPTION PACK SIZE LABEL 0 WEIGHT PRICING UNIT EXTENDED ORDERED SHIPPED ✓ UNIT NUMBER D UNIT PRICE PRICE E --DWY- 1_ CS_- 5597968-, -CH I P CORN -OR-1 G-IFF -SS-BAG- 61/2-OZ- -- F R I TOS_ __CS 30-8900 _t _30-89 --FROZEN---- _3 -CS 2011278- - PRETZEL,--KING SOFT BRD__FZN 50/5 _OZ SUPR PRTZL, CS 31-6700_ _95.-01-__. --_-----. __._ - -----.-____._._.-._--.__-_..."...----..***----.INVUICE-..SUMMARY- , TOTAL WOT SHIPPED:. 56.75 PIECES 'ORDERED:. 4 PIECES SHIPPED: 4. _PRODUCT TOTAL. 125-901 TAXABLE AMOUNT GEN SALES. TAX_ _00- PLEASE -REMIT -THIS- AMOUNT BY_ 08/11/12 AMOUNT Z12 P-Lir6hass De cription- P.0� # -P, rF G.L.# Budget Une Des JUL 3-12012 Purchase �.=_Date Date--.;--. '-Approval- -7 The perishable agricultural commodrfies listed on this invoice are sold subject to the statutory tnust ad by.....n "the Visit WWW.UsfoodS.Com for a fast and easy way to order. Perishable Agricultural Commodities Act,1930(7 U S.C.499e1c))The seller of these COMMOditleS retains must claim over ve'r.se X commodities,all invent)nes of food or other products derived from these commodrues,and any receivables or proceeds from the sale at these commodues,until full payment is received. CUSTOMERS SIGNATURE: Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a)1 I,%par month or b)the maximum rate that the customer may lawfully contract to pay,and in all events calculated in accordance with applicable law. ACCOUNT INV ICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO. #O . DATE N8. NUMBER LOC . REP. ORDERED 90569922 2477581 07/13/12 90569575 1054 0062 07/12/12 Route: 5191 / 8 ORDER NUMBER:� 5�812578124N�iIl Ship Remit T | o: 1235 CENTRAL PARK DRIVE E To: BOX I 66008e 46012 46032 INDIANAPOLIS 1N 317 843 3873 46E66-008a AW MICHELLE � � L_- �� IDEPT # 00 800 42B 211e WpFrm. 12301 CUMBERLAND RD FISHERS IN Ship& 07/13/12 Page 03 OP 03 -rtTrms: Spcial ENTER OFF OF 111TH STREET } ! ! /ytTrms: NET 30 DAYS Jnstr: Qty � Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended rdered Shipped Unit Number D Unit Price Price **� INVDICE SUMMARY *** TOTAL UST SHIPPED: 1951.39 PIECES 0KDER[W 198 PIECES SHIPPED: 198 ITEMS SHIPPED: 53 � * PRODUCT TOTAL $ 5301, 52 * Federal Occupation Safety and Health Standards. Section 1910. 1200 on Hazard * * Communication requires manufacturers and distributors to provide Material * * Safety Data Sheets on non-food products defined to be hazardous� Products * * such as cleaning products and pesticides are included in the scope of the * * Standard. In compliance -with the law, MSDS are available to US Foods, Inc. * * customers and can be obtained by contacting the Procurement Manager in our * TAXABLE AMOUNT $ O0 * district office or by advising your sales ,epresentative * GEN SALES TAX � % 00 * You may contact KEVIA BURTON at phone # (371) 58� - 6822� * * * This amount is an estimate at time of shipping prior to any adjustments made at delivery: $ 5301. 52 \ �� ........ ��_��_��_��_�� Purchase DescripUon Bud t BY: Line escr ' Approval Date______ ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO NO. DATE NO NUM8ER LOC REP ORDERED 90569922 2477581 O7/13/ i � � � 2 90569575�5 105 0062 07/12/ 12 Route: 5191 / 8 ORDER NUMBER: 578126 8ilI Sbip Remit CARMEL CLAY R_ . ' / o : To: 1235 CENTRAL PARK DRIVE E To: IN CARMEL IN - % 46052 46032 317 843 3873 46266-0088 Att: { ! L-1.1_--__- _____-�__.-......... _- _1 ThipFrw 12301 CUMBERLAND RD FISHERS IN GhipD: 07/13/12 Page DE of 03 -rtTrm s. Spcia{ ENTER OFF OF 111TH STREET ! { ! 'ytTrms: NET 30 DAYS Instr 0ty Qty Sales Product ' Descripton Pack Size Label C Weight Pricing Unit Extended /rdered Shipped Unit Number, " Unit Price Price .�� / CS 4884151 ICE CREAM MIX, SOFT -SRV VNL 4%2/2. 5 GA PRAIRIE F11 CS (ITTI)READY TO EAT - Please Refer to Return Policy - -- 1 1 `p CS 5OO6556 BANANA, QRN FRESH REF 10 LB PACKOR' CS 0 1 �'��S 5332242 LETTUCE. ICBRG SHRD 114" CLND 4/5 LB CROSS VALY B CS 1' � �""S ' '" ' � .zv �� READY TO EAT - Please Refer to Return Policy � - � 6 6 S 6483952 BEEF, PTY GRWD 80/20 4: 1 RND . 56/4 OZ CTLMN SLCT CG 43.9300 2 2 ^��S 7197775 YOGURT, ASST STRWBNA & RSPBRY �12/6 OZ YDPLAIT CS 10� 3400 ^~~ ~~ 3 3 ^^ CS 7451354 ICE MILK MIX, SOFT SRV CHOC 4%2/2. 5 GA FM CS 32, 1100 ^ ~~ READY TO EAT - Please Refer to Return Policy` -� -- FROZEN 10 PRETZEL, KING SOFT BKD FZN 5015 OZ SUPR PRTZL CS 31. 6700 1 1 MUFFIN, BLBRY ZW 24/4 OZ SARA LEE CS 21 � 7OOO ~^~ '` 15 ICE CREAM CUP, CKIES & CRM 12/2. 9 OZ ITTIDITZ CS 12.5500 �^ ' `' 15 5 O ICE CREAM CUP, CKY DOUGH 12/2. 9 OZ ITTIBITZ CS 12'55OO ^°° �^ 15 8 ICE CREAM CUP, BANA SPLT 12/2. 9 OZ ITTI8ITZ CS 12' 5500 ^"= �" 15 -- 15 �^ 2649796 ICE CREAM CUP, COTN CNDY 12/2. 9 OZ ITTIBITZ CS 12'550O ^`'~ �^ 6 6 v' 3041423 CORN DOG, AM CN FZN 48/4 OZ STATE [AIR CS 33� 41O0 ^~~ �^ 20 2O 3330099 HOT DOG, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS 29.' 97OO �"" `" 2 2 CS 5218862 ICE CREAM SANDWICH, VNL 24/6 OZ BLUE BUNNY CS 17. 1400 =' 0~ 5 5 CS 5403548 ITALIAN ME, LMN 0BL CUP FZN 12/16 OZ CHILL CS 23. 2500 3 3 �' CS 5509708 PIZZA, CHS 7'' DEEP DISH FZN W/36/10. 22 OZ BO8CO'G CS 61 7800 185. 34~ ~~ 4 4v~ CS 5741178 BUN, HMBGR 4" SLCD TFF BKD FZN10/12 EA HILLTOP HR CS 28� 2900 6 6 S 5741228 BUN, HOT DUO 6" HINGE SLCD TFF12/12 EA HILLTOP Hg CS 31 � 2400 ^^� ^~ 2 2 ' S 7175128 _ICE CREAM CON�, VNL TFF 2/12/4. 6 OZ BB CHAMP CS 22� 9000 ^"' �� 2 2 w-CS 8187999 ICE CREAM BAR, CHDC TACO & VNL24/4 OZ KLDNDIXE CS 25� 55O0 -~ ~` ^^ �" 2 2 ~-�S 9763061 POPSICLE, ORNG CHRY GRAPE SG/F1216`/1. 65 OZ POPSICLE CS 19. 3300+' m* PRODUCT CLASS RECAP ** ' � TOTAL DRY PIECES ORD D: 51 PIECES SHIPPED: 51 ITEMS SHIPPED: 25 TOTAL REFRIGERATED PIECES ORDERED: 24, PIECES SHIPPED: 24 ITEMS SHIPPED� 12 ^'�� ^° TOTAL FROZEN PIECES ORDERED: 123 PIECES SHIPPED: 123 ITEMS SHIPPED: 16 ~~- °~ _ ............__-_____ _ _ ....... _�............. _______ _...... ___ ACCOUNT 3 r j , : i::: INVOICE CUSTOMER ^ l t i •s NO, NI^ DATE j\tt.YJ l LL: E:3-F r E.�r.....,.. Il - � S# �)L°•"?tt f�-J,r�•t Y t�¢�€r+".r�NxP , a " 7a" 24775 81 07r13i 12 905691 75 1 °t al.. Route: 5191 NUMBERi Bill ;;i_f::t'•;` c .tt t:i�,•_.•.:•`.Y. -,.. • CENTRAL _». L C - 1,1 ~L. r; C? % ;L CLAY rAtK ' R _ „ E : 1 US Foods, . ic z . i - : 1 °o; $ 2 �; : - ;K DRIVE s 1 Box 660088 46032 4603E_' INDIANAPOLIS 11:04 317 S43 3S73 46266-0088 ...:..,i -n.. 1 t A t O MICHELLE C O E4 P E>.f Ey l i ..r ,,; J „ ' DEPT CUMBERLAND ...... .............. ' i jr Ym I�:0� F { F1 H R S E N `. �a0/ E1 1r P PtTrms: spCial ENTER OFF OF 111TH STREET ! ! ) kytTrms: NET 30 DAYS Instr: v Qty Sales Product Desc't'iptol., Pack Size Label E,. we1Jtit Pr1C3nC_9 Unit Extended f'tiered t!E'}�.pped 1�i11.t Number 0 Unit- Price pp ice z _ DRY i 35. 43 j •t / f`t•' }C}i .L CUP, l:n: .7 r) q Y' ..1[., } i a >v ,✓ :.:r:r. 'r,.,L< +• #.-r t{U•16 r ? - :_ � � } €:, �, E"Ea-}• C t` ; C 1-7 t'f } 1. 1: V Cf3 00.14236 ?::UP E�N 16 t_' (��P•T '�'%:/25 EA ?'lE:f?';i:lt�E"tr�-M CS 174100 :L£, 61 .e c #.•-a' 5 1-'S, -`t +fie•/2 €•r' r':,+ I CUP, �:� �ejE�� ,.•.Tr ,:^CI �.i=1 _ ;E sE''4.1f.Tta,e1, {_ j ;^� r I 1 1: �Cr�": �z,.��•..?�i ,i,.>E-', t '( �.;J _. •� }�y } 3 � s=�.�, ._1.. .:✓(:�� :).1.��' t 'f •� t. ,-, .,,.877.c7 �^4Y� i_•Kt ''{{''fAR {{ :'�1SS IW SS ,.'./16/1. 3 E,�.e`.. KEL_L_+.s...St,'S CS .fir. "}�„?+) ,rS 9 1. S _i..�f }I SMACK k.`!'I?''al M-1�E_ ASST }T• y1 t } !� ,J. '".'',;J,:i`6 CONE-., 4_L.E::. t�E•M CAKE FLAT BOTH ,'`8/`45 EA JOY r�•INE CS 69. 6800 1,;} 36 2 2404 325 OLOVE=, POLY Q T:XTD f3ii;BDX W/100 EA MONOGRAM M i CS 42. 1000 84. 20 11. 1. :•_ 3256104 1_.i:E;, CUP 12-24 i BBL E=°!;:,3` 1000 E.r, &EINC}..t C'S 16.9200 16,92 1 3708674 FORK, MW i,Pj..E7. 1's•)i...'YP BULK F'#..;:7 1000 EA MONOGRAM CS Q. 5000 15. 0 3700773 :rSCN, TEA MW WHPOLYP BULK 3 �00 E A ' 7hC? tFN C S 1 i r�0 29 01, t 1 a ✓ 40042S9 . i.-€!'yf7';, :Cas•.,t. :E''i{:'/;R 2. 07 0Z 48 EA Sr?IE;Kr,:.i',:,1 EA 34. 2700 34. 2-/ C. ss '� 4tea a '23 0 MACHO ti_ J: t._ ..fz,�1. ,}� .SFl�.�Z��.< i.,Ei��r 1`�c,i}.�Y'E�_i ,Ca,_.E- {:3f�Cii_ %•E.�;.0}7 E.)Z �.�i'+�T}'.ij'r"•l 3�;.�'•✓` 50. 7200 -`:j(,`? 'r is i 2 .�; 4.;,l... 'rt__ p^ .ire,�_. 117} i t� SS 5 r° r, r+--r--'•r r-. ' . t,N:i ,.S.r_')r,�? % i",£:.1.#_�.'y+.J, }Fri�,� S�f.rY il ) iT��}_ F,F'.,} .ti�}i �+ i,S 1 i4, 9600 ,t;� ' .)J''. L?T•. :'!i.)}'9 f-i„ 1', jv:7 i.' '7:r, I 1. S 5•�##.tF•00 '�C�E`E, :ECE f"r-M C..r•'KE 22 AT ""`,�2 F'A: JOY ;�.'rjN S :3E�.�?,�r0 0. 36 1, 1- i a .'�L{a!; .;ctr ,l`EEJ.�I`i�ii�:s•?: ¢'E_�d c::3 u7 :a iEn <i.aL.�� ,.>fJ0f ,� ;afJC3 #.r.; }3i�?�;r�t1y;',':ai C, 12, 7300 12. 73 (� 1 T /-tee 5 `�, 5 ,� c' C S T C 64/1, 75 I 1 1/ �_ ) :f 1 CHIP, `I'?✓s:rL�y. f°�•_,E;7 i EE} °`t,l_� L`1 3sil `,i:'T's}"i } S :3gar.�_> V(l 30.89 f _', .; � , Q-97968 F +t-,^, r CRIB- T .,^, {,•r-tea, t V t :� 01679 (.CHI"a i.._;',j.s {!•'t Ea ,�=t' BAG i " % r t.31 E'l:l�i. E.�`"7` 30. ti900 ';� •113 ✓ ? .., �.:;E°IF', f`,=._t!{r r<°E��:� ,'€...E+E ,.��_, :.:=;ALE 64/1. 5 C.1,:, (_.;'t', -'' _ ?�S 30. 8900 -� � 1. ,.i ., ,,1 t)•!;' E�;;.)4.E{,:��• j�tli TE�i :EiE.#Tr, 1. :s:a •$.:),`1. E:i:l:. ?'EE�•TTi�i , r 28. 6200 . : 20. 82 L I S 6329213 RELISH, _t1 __ 4 ' ' L� EY E 200/9 OR ' _ R_ i ;om 14. 0400 E4. 0 4 1 6429302 J I :, z R`Dt L rh ` 27Z PET _S T �: ts G: THIRSTER 24. 1300 "T. .0 ✓L : 6820039 Tk( : 'is t, 3rCt1 4XB, s . 7: =.R - Vii " i; € L; CS 1E0. 105: ;ar. � } ! 1 EA !E 8036 576 CANDY, 1'E'M PNT 1. 74 ?..tZ '"E?:i EA N A N EA 34. 1.t�0 :4. '` � 1 1, 1.,S ci-TS5''0 �}sasE°'#x..11'•: L?1SPR .[:}-F O W 02:, 50 .Wbt,-•-�' 7 P r 57. 9300 - a 1.Cs 1.G' V i L,1,:,F'rs:r.) i_.t"�.R�}';' S.:r:`E...,$ w�.lSi'.E�E YEw.€.i E'C,"i_, 6/2�_E,.E E=. E"':i=::if`%E.;rl t'; r_. -,--� j_r0 a 1 1 A CS 9954371 LID; CUP 32 Z STRAW SL.•TL'} i°'E_9T 10,•'50 EA l'J(3Ni.'1=RAM S 21. 5500 21. 55 REFRIGERATED 2 2 0634269 i'10E1`FMU�S: RS i D RED !'`t'R E'7ONDh$R 1 12/4, 56 Z_Ef -E.~3AORn CS 23. 7500 WAN ,�f "c.�1ti�-! TE:1 L:.4a^r E''.Lt_,s.,_. 4 �iz-,_ t� E�.r�'L;1i`iY Policy 1q ._. 2 CS 0�)543C:1. }"E}_Ii`EE°EUS, GE•t`E, C €�SYt+ I'•ii1€•$LFi±'�{'t.ai ?'Sti^E•' 12/4.56 OZ uk�L't'.A - CS 23. 7500 47. 50 READY-TO tit ._ 'a} �, r,e ..r t Return n t'fS�.i,7«f.:ts ,: EAT "''1 4 i3 a-:. '}'.4P'�1'::, 4..t s°„_C.'_€ s ' •i q ,t_ 2nd. c'7' SALAD, }-a v ice':'+ •", ,r-; .L �. -✓ �._•_, ,_:r':,t�'�,.�w >..:E..]'}' ' •,,, � PIERCE '� ti� �d i.S i'7 �'� ^, ., .i.E^} EAT _„ Please Refer ,x o Return Policy ,... //y4 _ .L _. ... %.t ii€�i q`� y,.... .. 6 ,, 5, ),., ,� `•� �1.t. 1f C1VG+ .,.:<.a. Cr i.1'l G r AEr.A , T'',?"'A AL,e?CR 1°E=•- REF LB PIERCE B E A 26.9600 ` 6, jF) ?��:Ar�'t' qta .._r-€# .... r.i,(�'e;l4i4? rte:�rY'' -Ls� Fir-C•Y.#i'•i's E"'uS.:L,'.:i•` � {1{ "}. 1. ✓ CS ;€E:it?+:E343 MILK, �:Z E'S:C.�)Li(,:; FAT PLST• ry3_-FL� 'k2/1. PT' 1="'t-�€;IRIE.:. FN CS :i.0.'�`s€ 0 1, ✓C 'dci�}CeO4 MILK, C;l°;E�s_': 1.1 LOW FAT PPS T RE:f"1:?J/1 ':- T E:fE'l?�•f`IRIE 1:M CS t.0. ��,500 10, 315 .._..-.._...W._.i __.... _.__..,.__._..^___._..__.._.._. ..._._ ._..._.__._.._,._.__._.._....,_..,.._._._.....,_._,._....,.......__..__ ,.__._...__ ._ _..__._........__...,...,._..._,_...___.._....._ .,..._�_.__......_..._....._._,.._,.__...-.._._...�_ __,_..._..,......_,_,._.__..__.,.w. ,....._.. ._._,.....__._........__,_._.__ __ .._. _.._.,,..._. ,._.......... ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES NO- NO. DATE JNO. NUMBER LOC. REP . ORDERED 9O569922 254B6O6 07/17/12 10569575 1054 0062 07/16/12 Route: 2251 / 5 ORDER NUMBER: 580300 8ill Ship Remit CARMEL CLAY PARKS&RECREAT CARMEL CLAY RARKS&RECREAT -us Foods, Inc . To: 1411 E. 116TH ST TO: 1235 CENTRAL PARK DRIVE E To: CARMEL IAN CARMEL IN 46032 46032 INDIANAPOLIS iN 317 843 3873 46266-0088 Att: DEPT # 00 800 428 2118 TipFrm.' 12301 CUMBERLAND RD FISHERS IN Ship& 07/17/12 Page 02 of 02 -rt Ttms., spcial ,yt7irms/ 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 3 3 CS 1157387 ICE CREAM BAR, DREAM STICK VNL2/A/3 OZ BLUE BUNNY CS 18.8800 56.64 12 12 CS 2011278 PRETZEL, KING SOFT DKD FZN 50/5 ,OZ SUPR PRTZL CS 31. 6700 380.04 10 10 CS 2639235 ICE CREAM CUP, CKIES & CRM 12/2. 9 OZ ITTIBITZ CS 12. 5500 125. 50 10 10 CS 2639250 ICE CREAM CUP, CKY DOUGH 12/2.9 OZ ITTIBITZ CS 12.5500 125-50 10 10 CS 2649796 ICE CREAM CUP, COTN CNDY 12/2. 9 OZ ITTIBITZ CS 120500 125-50 2 2 CS 3041423 CORN DOG, AN CM FZN 48/4 OZ STATE FAIR CS 33. 4100 66.82 2 2 CS 3330099 HOT DOG, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS 2919700 59. 94 3 3 CS 5218062 ICE CREAN SANDWICH, VNL 24/6 OZ BLUE BUNNY CS 17. 1400 51. 42 5 5 CS 5403548 ITALIAN IC& LMN DBL CUP FZN 12/16 OZ CHILL CS 23,2500 116. 25 2 2 CS 5509708 PIZZA, CHS 7" DEEP DISH FZN U/36/10. 22 OZ BOSCO'S CS 61. 700 123.56 5 5 CS 5741228 BUN, HOT DOG 6n HINGE SLCD TFF12/12 EA HILLTOP HR CS 310400 156.20 1 4 CS 7175128 ICE CREAM CONE, VNL TFF 2/12/4.6 OZ BB CHAMP CS 22, 9000 91, 60 PRODUCT CLASS RECAP IOTAL DRY PIECES ORDERED: 42 PIECES SHIPPED: 42 Ili HIPPED: 20 1432.04- TOTAL REFRIGERATED PIECES ORDERED: 16 IIECES SHIPPED: 16 - 1 j HIPPED: (8 464)33 TOTAL FROZEN PIECES ORDERED: 73 PIECES SHIPPED: IT S SHIPPED: 14 1609.46 INVOICE SUMMARY TOTAL WGT SHIPPED: 1508.82 PIECES ORDERED: 131 PIECESJOY& ED: 42 Rim goo PRODUCT 3 83 * Federal Ocqupation.SafetV and Health Standards. Section 1910. 1200 qq�Qt Or yoke * Communication re uires manufacturers and distributors to provide Matkp,14 Id * Safety Data Sheets on non-food products defined to be hazardous. Pri A j JUL 1 2019 * such as cleaning products and pesticides are included in the scope of * Standard. In compliance with the law. MSDS are available to US Fooddy * customers and can be obtainqj by contacting ,1he Procurement Manager in TAXABLE AMOUNT $ -1,_100- v1sing .vour sales representative. _ __ ::--D * You may contact KEVI BURTON at phone 0 (371) 585 -, 6822. > This amount is an estimate at time shipping prior to any adjustmentj made at delivery: 3505. 83' r� ' `= ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO. NO. DATE NO. NUMBER LOC . REP . ORDERED 9Q569922 25486O6 O7/17/12 9O569575 / '� � �/ / 1054 0062 07/16/12 ��/�� \ k | Route: 2251 / 5 ORDER NUMBER: 580300 Ship Remit To: 1411 E. i16TH ST To: 1235 CENTRAL PARK DRIVE E To: CARMEL IN CARMEL IN BOX 660088 46032 . 46032 INDIANAPOLIS IN 317 843 3873 46266-0089 Att: EEPT # 00 600 428 2118 7hipFrm: 12301 CUMBERLAND RD FISHERS IN Shjp& 07/17/12 Page 01 of 02 �rt�r'ns spciaI vyffrms: 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 JRY 1 CS 0791616 CUP, FN 32 Z WHT 25/20 EA MONOGRAM CS 3S.4300 35�43 I' CS 0814236 CUP, FM 16 Z WHT 20/25 EA MONOGRAM CS 17. 6100 17. 61 1 �wo I CS 0814541 CUPv FM 20 Z WHT 25/20 EA NOMOGRAM CS 21.8300 21.83 1 1 CS 2404325 GLOVE, POLY LO TXTD AMBDX 10/100 EA MONOGRAM B CS 42. 1000 42, 10 3 1"j CS 4329397 JETCHUP, TMTO FCY SS FOIL PKT 500/9 GR MONARCH CS 14. 9600 44. 88 2 CS 5329289 MUSTARD, YLW SS 5.5 GR SHLF 500/S.500 GR MONARCH CS 12. 7300 25. 46 i A 5521,19 PEPPER, JLP SLCD PLST SHLF I GA EL PASADO B EA 11. 7700 11. 77 1 CS 5597604 CHIP, CHS CNCHY PLN SS BAG 64/2 OZ CHEE-TOS CS 30.8900 30.89 2 CS 5597851 CHIP, TORTLA MACHO CHS TRGLE 64/1.75 OZ DORITOG CS 30, 8900 078 2 .12 CS SS97968 CHIP, CORN ORIG TFF SS BAO 64/2 OZ FRITOS CS 30.8100 61. 78 CS 5601927 CHIP, PTATO KTL JLP SS BAG 64/1. 375 OZ MIS9 VICKI CS 31. 2000 31. 20 1 CS 5605431 CHIP, MULTORN GRDN SALSA 56 64/1.5 QZ SUN CHIPS CS 30.8900 30. 89 I CS Q0502 CHIP, MULTGRN CHEDR SS BAG 64/1. 5 OZ SUN CHIPS CS 30. 8900 30. 89 818793 TRAY, R&R-FUDD 3 LB CLAY 2/250 EA MONOGRAM --USS 31. '7100- 2 X2 CS 7009988 SAUCE, CHILI HOT DOG W/ BEEF 6/108 OZ CHEF MATE CS 62. 1200 124. 24 1 -WA. I CS 9328311 URAP FOIL 12XI0. 75 INFLD POP 12/200 EA MONOGRAM B CS 85. 0600 85. 06 1 2950 1 CS 9954371 LID, CUP 32 Z STRAW SLTD PLST 10/50 EA MONOGRAM CS 21.5500 21.55 v REFRIGERATED CS 0654269 HUNMUS, RSTD RED PPR _NONDARY 12/4. 56 OZ SABRA CS 23. 7500 47.50 READY TO EAT - Please Refer to Return Poliv/ READY TO EAT - Please Refer to Return Polic I L/ I EA j000452 . SALAD, TUNA ALBCR TFF REF 5 LB KIERCE B EA 26. 9600 2606 READY To EAT - Please Refer to Return Polict, I py-1 CS 4800843 MILO 2% REDUC FAT PLST REF 12/1 PT RAIRTE FM CS 10- 5500 10. 55 1 CS 4800884 MILK, CHOC 1% LOW FAT PLST REF12/1 PT PRAIRIE FM CS 10.5500 10.515. 4 CS 4884151 ICE CREAN MIX, SOFT SRV VNL 4%2/2.5 GA PRAIRIE FM CS 321100 128. 44 READY TO EAT - Please Refer to Return Polic READY TO EAT - Please Refer to Return Polic 4 4 CS 6483952 BEEF, PTY GRND 80/20 4: 1 RND 56/4 OZ FTLMN SLUT CS 43. 9300 175. 72 �CCOUNT INVOIC� INVOICE C\]STOMER PURCHASE ORDER SALES SALES DATE NO WO DATE NO NUMBER LOC . REP- 90569922 2759763 07/24/12 90569575 1054 0062 07/23/12 Route: 2251 / ORDER NUMBER:� 586434 8ilBill, Ship Remit To: To: To: ~~ ' --- -' - ''- I BOX 66008B 46032 46032 INDIANAPOLIS IN Att� � ' 46266-0088 ^ � � lhipFrm: 12301 CUMBERLAND RD FISHERS IN Ship17: 07/24/12 �Page 02 of O2 -rtTr,ns ' spcial ENTER OFF OF 111TH STREET! ! ! `yt&ms: 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 � ...... �'�� 1 1 CS 6153027 BROWNIE, CHOC 2. 5 Z UNSL DKD 40/2. 5 OZ OREO CS 41. 5500 41. 5'S 2 2 8187999 ICE CREAM BAR, CHOC TACO & VNL2414 OZ KLONDIKE CS 25.5500 51. 10 ** PRODUCT CLASS RECAP ** TOTAL DRY PIECES ORDERED: 34 PIECES SHIPPED: 34 ITEMS SHIPPED: 15 1430. 13 TOTAL REFRIGERATED PIECES ORDERED: 7 PIECES SHIPPED: 7 ITEMS SHIPPED� 5 197�62 TOTAL FROZEN PIECES ORDERED: 46 PIECES SHIPPED: 46 ITEMS SHIPPEB� 13 1185� 2O ' *�* INVOICE SUMMARY *** TOTAL WGT SHIPPEDi 107328 PIECES ORDERED: 87 PIECES SHIPPED: 87 ITEMS SHIPPED: 33 * * PRODUCT TOTAL $ 2812. 95 * Federal Occupation Safety and Health Standards. Section 1910. 1200 on Hazard * * Communication requires manufasturers and distributors to provide Material � * Safety Data Sheets on non-food products defined to be hazardous. Products * * such as cleaning products and'� pesticides are included in the scope of the * * Standard. In compliance with the law, ~ MSDS are available to US Foods, Inc.* * customers and can be obtained by contatting the ProcureAnt Manager in our * TAXABLE AMOUNT S . 00 * district office or by advising your sales representative� * 8EN SALES TAX % O0 * You may contact KEVIN BURTON at phone # (371) 58� - 6822� * � * * This amount is an estimate at time of shipping prioP to any adjustments made at delivery: $ 2812. 95 } ��. Purchase ^ CEIVED Description P.O.# G1 0155v /�r�' ~~ �____' Purchaser --- Date_ Approval Date- ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO j140 DATE NO. NUMBER LO C. REP . ORDERED 9O56��922 2759763 07/24/12 90569575 /n �� 1O54 0062 07/23/12 � `� � Route: 2251 ' ' ORDER NUMBER: 586434 Ship Remit � To., 1411 E 116T To: 1235 CENTRAL PARK DRIVE To: US Foods, Inc , CARMEL IN ICARMEL IN 41032 146032 INDIANAPOLIS IN 17 843 3873 46266-0008 Att: } MICHELLE COM � � _] ThipFlw 12301 CUMBERLAND RD FISHERS IN ShQD: 07/24/12 Page 01 of 02 - r tT rms. Spcial ENTER OFF OF 111TH STREET ! ! ! `yt7rms: NET 38 DAYS Instr. Qty Pty Sales Product Descriptor, Pack Size Label C Weight Pricing Unit Extended rdered Shipped Unit Number D Unit Price Price 1 I CS 0791616 AP. FM 32 Z WHT 25/20 EA MONOGRAM CS 35. 4300 $ 35. 43 1 1 CS 1695212 TRAY, PAPR BORD FOOD 5 LB POLY2/250 EA MONOGRAM CS 44. 1200 44� 12 1 1 CS 2404325 GLOVE, POLY LG TXTD AMBDX 10/100 EA MONOGRAM B CS 42� 1OOO 42� 1O 1 1 CS 3708773 'DUN, TEA MW WHT POLYP BULK 1000 EA MONOGRAM CS 15.0700 15.07 1 1qp CS 4180923 OAIE, QNL CREME SNDWH SNCWL 48/1. 7 OZ SNACKWELLS CS 26� 23OO 26� 23 CS 4260238 UCE^ CHS NACHO SHLF STADL 4/107 OZ ORTEGA CS 50� 72O0 507� 2O 1 1 CB 4573788 ACK MIX, STUDY YOGRT SS 60/1 , 2 OZ CHEX CS 28�5O0O 28� 50 ~ 1 1 CS 56O5431 rHIP, MULTGRN 8RDN SALSA SS 64/1.5 OZ SUN CHIPS CS 30� 890O 3O� 89 � 1 CS 5704077 YiOGKIE, NOTTR BUTR 1 Z SS 48/1 OZ NUTTR BDTR CS 28�82OO 28� 82 2 2 CS 6820039 TRAY' PLYST NACHO 6X8X1. 75 CLR4/125 EA PACTIV CS 110� 1000 220. 20 3 3 CS 7009988 SAUCE, CHILI HOT DOG W/ BEEF 6/108 OZ CHEF MATE CS 62� 12OO 186�36 1 1 CS 8355927 OOPKIN, DISPR INFLD WHT 6. 5X1024/250 EA EASYNAP CS 57� 9300 57� 93 1 1 CS 9187956 ��OOAIE^ DEVIL FOOD FT/FR CH/FR48/1. 1 OZ SNACKWELLS CS 272900 27�89 8 3688 CHIP, TORTLA CORN YLW RND 6/2 LB EL PASADO � 1 4..1 9954371 LID, CUP 32 Z STRAW SLTD PLST 10/50 EA MONOGRAM B�FRIGERATED - --------- 1 1 CG 0654269 ^NUMMUS, RSTD RED PPR NONDARY 12/4, 56 OZ SABRA CS 23. 7500 23, 755 READY TO EAT - Please Refer to Return Polic; � 1 1 CS 0654301 SUMMUS, GRLC RSTD NONDARY REF 12/4. 56 OZ SABRA CS 23. 7500 23. 75 DY TO EAT - Please Refer to Return Policy 1 t CS 4800884 K, CHDC 1% LOW FAT PLST REF12/1 PT PRAIRIE FM CS 10. 5500 10 55 1 1 CS 5006556 VANANA, SRN FRESH REF 10 LB PACKER CS 7� 78O0 7� 78 3 3 CS 6483952 BEEF, PTY GRND 80/20 4: 1 RND 56/4 OZ CTLMN SLCT CS 43. 9300 131� 79 FROZEN 1D >qt CS 2011278 'DRETZEL, KING SOFT BKD FZN 50/5 OZ SUPR PKTZL CS 31. 6700 316. 70 1 1 CS 2014652 "NUFFIN, DLBRY IW 24/4 OZ SARA LEE CS 21 � 7O0O 21, 70 4 4 CS 2639235 ICE CREAN CUP' CKIES & CRM 12/2.9 OZ ITTIBITZ CS 12.5300 50� 20 4 4 CS 2639250 ICE CREAM CUP, CKY DOUGH 12/2. 9 OZ ITTIBITZ CS 12. 5500 5O� 2O 4 4 CS. 2639268 ICE CREAM CUP' BANA SPLT 12/2. 9 OZ ITTIBITZ CS 12� 55O0 50. 20 .4 1 CS 2649796 ICE CREAM CUP, COTN CNDY 12/2. 9 OZ ITTIBITZ CS 12� 550O 50. 20 3 �� CS 3041423 CORN DQG, AM CM FZN 48/4 OZ STATE FAIR CS 33� 41O0 100 23 | ^,. � U510 WILL CALL INVOICE Page 1 of 1 ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED 90569922 2191433 07/03/2012 90569575 1054 62 07/03/2012 FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS 569951 NET 30 DAYS 9713 PAGE WILL PICK UP BILL TO SHIP TO REMIT TO CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc. 1411 E. 116TH ST 1235 CENTRAL PARK DRIVE E BOX 660088 CARMEL, IN 46032 CARMEL,IN 46032 INDIANAPOLIS, IN 46266-0088 ATTN:MICHELLE COMPTON Dept.:0 (800)428-2118 (000)000-0000 (317)843-3873 SHIPPED FROM: 12301 CUMBERLAND RD,FISHERS,IN DRIVER NAME: ROUTE NUMBER: 9713 SHIPPED DATE: 07/03/2012 DRIVER ID: STOP NUMBER: 1 INVOICE LINE DETAILS QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED ORD SHP UNIT NUMBER UNIT PRICE PRICE DRY 8 8 CS 4260238 SAUCE,CHS NACHO SHLF STABL ORTEGA 4/107 OZ CS 1 $50.7200 $405.76 INVOICE SUMMARY Product Total $405.76 Sales Tax Rate: 0.00 $0.00 PLEASE REMIT THIS AMOUNT BY 08/02/2012 $405.76 CUSTOMER ACCEPTANCE Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a)1-1/2%per month or(b)the maximum rate that the customer may lawfully contract to pay,and in all events calculated in accordance with applicable law. Promotional allowances,cash discounts,prompt pay discounts,growth programs and all other incentives are retained by U.S.Foodservice®and do not reduce Product Price.Product Price is defined as the supplier,packer,or any vendor delivered cost or f.o.b unit price plus standard freight less off-invoice discounts or off-invoice allowances(i.e.,manufacturer generated discounts or allowances on particular items for set periods of time and which are specifically reflected on the invoice). We appreciate your business.Please visit our website www.usfood.com for a fast and easy way to order. Or contact customer service at: (877)583-9659 Purchase ^ Description �t�l PO�1i1//Jl1.d� J U L 2 5 2012 P.O.# P�orrrFF G.L.# Z-0�1✓ ' �Z�aSS- by; Budaet � Line besc Purchaser Date Page 1 of 1 Approval _Date ACCOUNT I N VO E INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO. NO' - NO. NUMBER LOC. REP. ORDERED use 905699F(--2 f261266�0 7/18/12 '0569575 1054 0062 07/16/12 'DELIVERY ROUTE: 9648- -/ 1 ORDER I' MISER 582646 FOM - 'DELIVERY ROUTE. C; BILL CARMEL CLAY PARKS&RECREAT SHIP CARMEL CLAY PARKS&RECREAT REMIT/ US Foods, Inc TO: 1411 E. 116TH ST TO: 1235 CENTRAL PARK DRIVE E TO: BOX 660088 CARMEL IN CARMEL IN 46032 46032 INDIANAPOLIS IN 317 843 3873 46266-0068 ATT. -MICHELLE COMPTON DEPT # 00 800 428 2118) SHIPOEEFRO- C-UMBERLAND,--,RD --IN -;SHIPDATE:. 07/18/12 Page 01 of 01 FREIGHT TERMS: SPECIAL CUSTOMER PICK U P PAYMENTTERMS: NET 30 DAYS INSTRUCTIONS: QTY. QTY. SALES PRODUCT C DESCRIPTION PACK SIZE LABEL 0 WEIGHT PRICING UNIT EXTENDED ORDERED SHIPPED UNIT NUMBER D UNIT PRICE PRICE E _CS 38_3600___$_______ 38_36 - I CS., 5311640 -CONE,_ICE-Ckff, CAKE___"�s. -F-LAT - _36/_2_0,-" E_A jOY'_C0WE_' _ cs-, 108900 34.�89 1 CS_ --HIP,..JORTLA N 64/1.75 OZ ,ACHQ_CHS TRGLE DORITOS _A_ CS_ 5601679 CHIP, , PTATO REG PLAT SS___ 0 - 5 OZ CS- -30._8900 1 --30- 89 -,- I _ _CS 6820039 TRAY, PLYST NACHO 6XBXI.75 CLR4/125 EA PACTIV _CS 110000 , 11Q.I4 REFRIGERATED_ 1, CS 4884151 ICE CREAM MIX, SOFT __P,RA,WE FMI-' 32-.4 IaO 32:11__ -READY TO EAT - Please Refer to Return Polic __146ijS4 __.ICE_,A!LK -Mlxo ,-SOFT-SRV CHO-C, 4%2/2'V5___GA �R41RIE-TM,-- _CS__ 32'._11W - ,,, ---READY-. TO,--EAT -, Please Refer to Return P licy FROZEN STATEFAIR 33'4100 * 33'-41 -1 CS -3041423 CORN DOG, AM- Ch! FZN_ 48/4 OZ:-- 0 Z CS 161- 2 CS , 5509708 P I ZZAv-CHS -7_1'_ -DEEP, DISH FZN W/36/16.22 BOSCO'S 61.7800 .1% 4 4 CS 5741228 -BUN, HOT DOG 6" HINGE SLCD,-- TFF12/12 -.5A - HILLTOP HR _CS 31-.2400--- 1-74-. 96 INVOICE-' SUIIMARY ' 4f�4 TOTAL WGT_ SHIPPED.: 244.81 . PIECES- ORDIERED:. 13 PIECES SHIPPED'. 556',39 PRODUCT TOTAL ;,,,,,P6rchase ..Description iption TAXABLE AMOUNT 00� GEN- _SALES TAX 00--- P.O-# 20 111 Po(t) (31, BUC1QPt --Line Uescr- Purchaser Date PL EASE.,REMIT--THIS AMOUNT.-_BY_ -08/17/12 AMOUNT _W, Approval Date.. The perishable agricultural commodities,listed On this invoice Id uthonted by section 5O of the Visit www.usfoods.com for a fast and easy way to order., are sold'2r to o.'statutory �t r�e ta i Ott a trust c I a i in over the s is Perishable Agricultural rommodnes Act,1930(7 U.S C.499e(c)).TO seller of these commodities,all inventories of food or other products derived from these commodities,and any receivables or proceeds from thesale of these commodities until full payment is received. CUSTOMERS SIGNATURE: Interest shall accrue on all unpaid balances exceeding established credit tens at a rate equal to the lesser of(a)1!h%per month or wfu (b)the maximum rate that the customer may Is idly contract to pay,.and in all events calculated in accordance with applicable law. ACCOUNT INV ICE INVOIC3.- CUSTOMER PURCHASE ORDER SALES SALES DATE NO. NO. . DATE NQ. NUMBER LOC— REP . ORDERED 90569'7'22 26666i-} ' 0_7/20/12 90569575 101 54 0 0 62 O7/19/12 Route: 5191 / 8 ORDER NU111BER: ` 5843 9 Bill Ship Remit To: Tu: To: BOX 66008R 46032 46032 INDIANAPOLIS I[N 317 043 3873 46266-0083 At t: �hipFrm. 123O1 CUMBERLAND RD FISH�RS IN 5h y�D. O7/2O/12 Page O2 of O2 -rt Spcia2 `yt7-'ms: NET 30 DAYS Instr'' Gty Aty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended lrdered Shipped Unit Number D Unit Price Price CS 46 25300 139. 50 1. CS 5509708 '1*7 7" DEEP DISH FZN W/36,/10. 12`2 07 BOSC01*6 r Z It CIAOC TACO VNI.24/4 02 PRODUCT UASS RECAP TOTAL DRY PIECES ORDERED: 31 PIECES SHUPPED: 30 ITEMS SHIPPED: le 1128. 25 TOTAL. REFRIGERATED PIEU."S ORDERED: 23 SHIPPED: 23 ITENS SHIPPED: 81 610. 82 T OTAL. FROZEN ORDERED: 55 PIECES EGHIPPED: 55 ITEMS SHIPPED: 13 1172. 0 7 IMVOICE SUMMARY TOT,�'iL WGT SHIPPED: 1580. 91 P1E*[XS ORDERED: 109 PIECES SHIPPED: IN ITEMS SHIPPED: 39 PRODUCT TOTAL 2911. 14 * F-ede. ral Occu-pation Safety and Healtl--, Standards. Seclion 1910. 1200 on Hazard * Safety Data Sheet-S 01-1 nOn'-f-God"products. dePined to be 1--jazaretotis. Products -*t s a, aT'LA incluided in the scape of the. Standard. In compliance with the law. PISDS are available -to US Faods inc P.O.# P, rF . is an estimate at time of shipping prior to anV adpstments made at delivc-T,V: 121911 , 14 Budoet Purchaser Date_____ Approval oute___-_ ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO. NO. DATE NO, NUMBER LOC . REP , ORDERED 90569922 2666611 07/20/12 90569575 ��0,7 1054 0062 07/19/12 ' ��\ �] /- Route: 5191 / 0 ' ORDER NUMBER: 584109 Bill Ship Remit CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc . To: 1411 E. 116TH ST To: 1235 CENTRAL PARK DRIVE E To: BOX 660088 317 e43 3873 46266-0008 ' 46022 46032 INDIANAPOLIS :1 N1, Att: DEPT # 00 600 428 2118 lhipFrw 12301 CUMBERLAND RD FISHERS IN Shjp& 07/20/12 Page 01 of 02 ' -rtTrms spcja2 'ytTrms: NET- 30 DAYS Instr: �- Qty oty Sales Product Descripton Pack Size Label C Weight Pricing Unit Exteided rdered Shipped Unit Number D Unit Price Price DRY I CS 0791616 CUP, FN 32 Z WHT 25/20 EA MO1qO(3RAM CS 35. 4300 33. 43 1 CS 0814236 CUP, FM 16 7 WHT 20/25 EA MONOGRAM CS 17. 6100 17. 61 CS 2404325 LY LG TXTD AMBDX 10/100 EA MONOGRAM B CS 423000 42. 10, CS 3708773 NW WHT POLYP BULK 1000 EA MONOGRAM 2 CS 4329397 KETCHUP) TNTO FCY SS FOIL PKT 500/9 GR MONARCH CS 144600 29. 92 1 CS 5311600 CONE, ICE CRM CAKE 22S FLAT 36/20 EA JOY CONE CS 38.3600 $8. 36 i CS 5329289 MUSTARD, YLW SS 5. 5 GR SHLF 500/5. 500 GR MONARCH CS 12. 7300 12. 73 I CS 5597604 CHIP, CHS CNCHY PLN SS BAG 64/2 OZ CHEE-TOS CS 30. 8900 30. 89 I CS 3597851 CHIP, TORTLA NACHO CHS TROLE 64/1. 75 OZ DORITOS CS 30.8900 30.89 CS 5597968 CRIP, CORN ORIG TFF SS BAG 64/2 OZ FRITOS CS 30, 8900 61. 78, 3 7- CHILI HOT DOG U/ BEEF 6/108 OZ CHEF MATE A EA 8053126 CANDY, RESES PNT BUTR CUP 36 EA REESE'S, EA 25.9200 25.92 1: CS 8301913 FRUIT MIX, BIT IN JCE TFF BWL 36/4 07 DOLE CS 22, 0900 22.09 4 CS 9463608 CHIP, TORTLA CORN YLU RND 612 LB EL PASADO CS 19, 7300 78. 92 REFRIGERATED READY TO EAT Please Refer to Return Palicu i CS 0654301 HUVINUSj OfZA-C NONDARY REF 12/4. 56 OZ IABRA CS 23, 7500 23. 75 READY TO EAT Please Refer to Return Policw i CS 4800843 MILK, 2% REDUC FAT PLST REF 12/1 PT PRAIRIE Fri CS 10.5soo 10- 55 I CS 4800884 MILK, CHOG 1% LOW FAT PLST REF12/1 PT PRAIRIC FM CS 10,5500 10. 55 8 CS 4884151 ICE CREAN MIX, SOFT SRV VNL 4%2/2.5 GA PRAIRIE Fri CS 3Z1100 2S6.88 READY TO EAT - Please Refer to Return Polic i CS 5006556 BANANAi OR111 FRESH REF 10 LB NXER CS 77800 778 8 8 CS 7451354 ICE MILK MIX, SOFT SRV CHOC 4%2/2. 5 GA PRAIRIE FM CS 32. 1100 256.88 READY TO EAT - Please Refer to Return PolicV — FROZEN 4 CS 2011278 PRETZEK RINO SOFT PKD FZN 50/5 OZ SUPP PRAL cs 31, 6700 126. 68 i CS 2014652 MUFFIN, A% 24/4 GZ SARA LAZE C,s 21. 7000 21. 70 ACCOUNT TNVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATTE NO). fk1c). DATE NO. NUMBER LOC . REP , ORDERED 90569922 59692PI 07127/12 90569575 1054 0062 07/26/12 Route: 5291 r 110 ORDER NUNBER: 590256 Shi Rernit CARMEL CLAY PARKS&RECREATI I il _(",-A*F�'i--i"E7 I -,*-C.�",�-_-,�,-,-�l----rl-,I-tl*"F",�X".".T..,,-,"-I.r-�I."�--,,,-"—F,�.* 'I_'1-'4'._1F uS Foods, inc , To: 1411 E. 116TH 21' To: 1235 CENTRAL PARK DRIVE E Tn: - BOX 660088 CARMEL 1N CARMEI.,- 11,11 46032 4 6 0 32, INDIANAPOLIS I IN[ -217 W3 7873 46266 Att: MICHELLE COMPTO1,4 DEPT # OCI 800 428 2118 WpFrm: 12301 CUMBERLAND RD F 1 SHER S IN Ship& 07/27/12 Page 03 of 0--K WTrms. spcial ENTER OFF OF 111TH STREET ! ! ! TtTrms: AET 30 DAW::.`.; instr: Qtv Qty Sales Product Descripton Pack Size Label C Weight Pr cing Unit Extended indered Shipped Unit Number 1) Nit Price Price ............. ................. 0010E SUMMARY TOTAL WGT SHIPPED: 1812. 03 PIECES ORDERED: 135 PIECES SHIPPED: 132 ITEMS SHIPPED: 52 PRODUCT TOTAL 3591.27 * Federal Opupation ,SafetV and Health Standards, Section 1910. 1200 an Hazard * Communication requires manufacturers and distributors to pp{ vi de Material, A "afetv Data Sheets on non-food nroducts defined to he hazardous. Products X such an cleaning products app p6sticides are included in the scopR of the * Standaid. In MplianCe With the law. MSD8 are available to US roads, Inc. v customers and can be ob• ainqd bV coptacting the Procurement Manager in our TAXABLE AMOUNT 1 . 00 * district office or by advising vour sales representative. § GEN SALES TAX % - 00 A You may contact KEVIN SURTO• at phone N 1371 ) 585 - 6822. This amount is an estimate at time of shipping prior to any adjustments made at delivery: 3591. 2-,'' .......... ................ ...... .............. .......... Purchase Description P.O.# 3t1I3 P G.L.# lyeb s Purchaser—_Dete Approval Date- ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NQ. IN1O, DATE WO. NUMBER LOC . REP ORDERED 90569922 286B221 07/27/12 90569575 8 = 3 � 1054 0062 07/26112 Route: 5291 O � ORDER NUMBER:� 590256 8ill Ship Remit uS Foods, Inc . CARMEL To� CLAY ' A"'`S&' E^'`EA ' � To: 1235 CENTRAL PARK DRIVE E To: BOX 660083 46032 46032 INDIANAPOLIS IN 317 843 387'.".;j 46266-0088 Att: i MIC | | 7hipFrm�' 123O1 CUM�ERLAND RD FISHERS IN ShipD� f 03 O�/27/1� - --------o � rage o/ r -r�Trms � � spciaJ EMTER OFF OF 111TH STREET ! ! � 'ytTrms: NET 30 DAYS Instm Qty Qty Sales Product Descriptor, Pack Size Label C Weight Pricing Unit Extended >rdered Shipped Unit Number D Unit Price Price DRY 1 CS 0445098 TAPE, THRML CASH RGSTR WHT 50 RL MONOGRAM CS 35. ?900 $ was 1 Q9 6614236 CUP? FN 16 7 UHT 20/25 EA NONOGRAN CS 17. 6100 17.61 1 CS 0814541 CUP, FN 20 Z WHT 25/20 EA MONOGRAM CS 21. 8300 21. 83 1 CS 1052331 TRAY, PAPR FOOD 5 LB POLY 2/250 EA KANT LEEV CS 23. 7300 2 3. 1 CS 7404325 611YE, POLY LG TXTD ANDOX 10/100 EA MONOGRAM CS 42. 1000 42. 1,D 1 CS 3256104 L10 QP 12-24 Z BBL PLST 1000 EA WINCUP CS 16. 9200 16. 92 1 CS 3708674 FORK, NU WHT POLYP BULK PLST 1000 EA MONOGRAM CS 150000 13. 50 1 EA 4053336 CAHUY, BAR MILK CHOC 36/1. 552 HERSHEY EA 26. 8000 26. 88 2 CS 4260238 SAUCE, CHS MACHO SHLF STARL 4/107 0Z ORTEGA CS 50. 7200 101, 44 3 CS 4329327 KETCHUP. TNTO FCY SE FOIL PKT 500/9 OR MONARCH CS 140600 44. 88 1 CS 4371571 CAPPUCCINO, FRNCH YML 1NST 6/2 LB RITUALS CS 52. 0800 52. 00 1 Q 5311600 CONE, 10E ORM CAKE 22S FLAT 36/20 EA joy COME: CS 3E). 3600 38. 36 2 2 CS 5597968 CHIP, CORN ORIG TFF SS BAG 64/2 OZ FRITOE; CS 30. 0900 61 . 78 1 1 CS 5601679 UHIP, PTATO REG PLN SS BAG 64/1. 5 OZ LAY'S us 30, 8900 30- 89 1 1 CS 56OS522 CHIP, NNLTGRW GRIG SS BAG 64/1, 5 OZ SUN CHIPS -CS 30. B900 30. 89 1 1 EA 6210777 CANDY, XIT RAT YNDO 80 1. 5 Z 36 EA KIT RAT EA 25, 9400 CS 9463680 CHIP, TORTLA CORN YLW RND 6/2 LB EL PAGADO CS 19. 7300 1 1 CS 9934371 LID, CUP 12 Z STRAW SLTD PLST 10/50 EA MONOBRAN CS 21. 5500 21. 5l REFRIGERATED READY TO EAT - Please Refer to Return Policw READY TO EAT - Please Refer to Return P01C -- - READY TO EAT - Please Refer to Return Polic I CS 1000452 SALAD, TUNA ALBCR TFF REF 2/5 LB WERCE 'B CS 39, 1400 39.94 To EAT - Please Refer to Return POJQL, 3. CS 4800843 MIL& 21 REDUC FAT PLST REF 12/1 PT PRAIRIE FN CS 1005 0 CS 4800884 MILK, CHOC 1% LOW FAT PLST REF12YI PT PRAIRIE FN _ _ ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO. N8, DATE NO, NUMBER LOC . REP ORDERED 90569922 2868221 07/27/12 90569575 1054 0062� 07/26/ 12 Bill Route 5291 / 1O ORDER NUMBER 59O256 Ship Remit CARMEL CLAY PARKS&RECREAT US Foods, Inc . To�. .AT` 116 , r` o , TO: 1235 CENTRAL PARK DRIVE E To: BOX 660088 46032 46032 INDIANAPOLIS iil! 317 S43 3073 46266-OOSe Att: MICHELLE COMPT01',1 DEPT # 00 coo 420 2119, 3Ai�Frn/� 12301 CUMBERLAND RD FISHERS IN ShipD�' 07/27/12 --- � - Page 02 of 03 WTrms � � Spcial ENTER OFF OF 111TH STREET ! ! ! 'ytTrms: NET 30 DAYS instm Qty Pty Sales Product Descripton Pack Size Label C Weiqht Pricing Unit Extended /rdered Shipped Unit Number D Unit Price Price '---------'� ...... ��---- ....... -.........-- ... .......... ....... --- ..... - ....... 10 CS 4804151 ICE CREAM MIX. SOFT SRY VML 4%2/2, 5 6A PRAIRIE FM CS 32. 1100 321. 10 READY W EAT - Please Refer to 1� � 1 CS 5006556 BANANA, RRN FRESH REF 10 LB Return PACKER' CS 7. 7800 7. 78 1 CS 5332242 LETTUCE, WRO SHRD 1/4" CLND 415 LB CROSS VALY iq CS 17. 1100 17. 11. READY TO EAT - Please Refer to Return 1 l-- 1 WEL1. CS 32.9000 32, 90 4 4 CS 6483952 BEEF, PTY GRND 80/20 4: 1 RMD 56/4 0Z CTLMN SLCT CS W9300 175. 72 io 10 CS 7451354 TCE MILV MIX, SOFT SRV CHOC 0212. 5 GA PRAIRIE Q% CS 32. 1100 321. 10 READA TO EAT - Please Refer to Return PalicV 1 1 US 2014652 MUFFIN, WRY W 24/4 OZ SARA LEE CS 21. 7000 21- 70 12 12 CS 2639250 10E CREAN CUP, CKY DOUGH 12/2. 9 OZ ITTIBITZ Cs- 12.5300 150.60 4 CS 2649796 ICE CREAM CUP, CUTH WDY 12/2. 9 OZ ITTIBITZ CS -No W 3 2 48/4 0Z STATE FAIR CS 6�6 -1-11 8 6 CS 3330OV9 HVT DOS, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS 29. 9700 239. 76 1 3 CS 5509708 PTZZA, CHS 7" DEEP DISH FZN W/36/10,22 8Z BOSCO 'S CS 61.7800 185. 34 2 CS 5741228 BUN, HOT DOG 6" HINGE SLCD TFF12/12 EA HILLTOP HR CS 31.2400 62. 48 5 5 CS 7175128 10E CREAN CONE, VWL TFF 2/12/4. 6 OZ BB CHAMP CS 22, 9000 114. 5v 1 1 CS 8552j!7 MUFFIN, CDF CAKE PECN CIN 1W 24/4 CZ SARA LEE CS 25. 6200 25, 62 0 CS 9763061 POPSICLE, ORNG CHRY GRAPE SG012/6/1, 65 OZ POPSICLE PRODUCT CLASS RECAP ** TOTAL DRY PIECES ORDERED: 29 PIECES SHIPPED: 29 ITEMS SHIPPED: 24- 970, 62 TOTAL REFRIGERATED PIECES ORDERED: 36 PIECES SHIPPED: 35 ITENS SHIPPED: 12 losem TOTAL FROZE14 PIECES ORDERED: 70 PIECES SHIPPED: 68 ITEMS SHIPPED: 16 1562. 12 �� ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE . ^ NO. NO. DATE NO. NUMBER LOC . REP ORDERED � ^ 90569922 2944298 07/31/ 12 90569575 1054 006 07/30/12 Route: 2251 / 5 Re m it ORDER NUMBER 592��75 CARMEL CLAY 8ill Ship CARMEL CLAY PARKS&RECREAT I US Foods, Inc . To: To: 1235 CENTRAL PARK DRIVE E To: BOX 66008a CARMEL. IN CARMEL IN 46032 46032 INDIANAPOLIS' IN 317 843 3873 46266-0088 Att: MICHELLE COMPTON DEPT # 00 900 428 2118 ThipFhm: 12301 CUMBERLAND RD FISHERS IN Ship& 07/31/12 --- Page 03 of 03 'rtrrms � � Spcial ENTER OFF OF 111TH STREET{ ! � `ytFrms: NET 30 DAYS Instr: Qty Qty Sales Product Descriptom Pack Size Label C Weight Pricing Unit Extended /rdered Shipped Unit Number D Unit Price Price 114VOICE SUMMARY TOTAL UGT SHIPPED: 1107. 94 PIECES ORDERED: 123 PIECES SHIPPED: 121 ITEMS SHIPPED: PRODUCT TOTAL $ 3268.93 * Federal Ocqupationjafety and Health Standards. SectioD 1110. 1200 on Hazard * Communication requires manufacturers and distributors to apovide Material * Safetv Data Sheets on non-food products defined to be hazirdous. Products * such is cleaning products and pesticides are included in the scope of the -.'4 Standard. In C60ph-hie-with the law. MSDS are available to US Foods, Inc. customers and can be abtainTd bV contacting the Procurement Manager in our TAXABLE AMOUNT S .00 district office or by advising your sales representative. OEM SALES TAX Of) You maV contact KEVIN BURTON at phone 0 (371? S85 - 6822. This amount is an estimate at time of shipping prior to any adjustments made at deliverV: Purchase LAUG 0 7 2012 Ob G.L.#------- L?CJ ' - | Budget We Descr Purchaser uate— � D�e_____ / ) � --___ / ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE NO, NO DATE NO. NUMBER LOC. REP ORDERED 90569922 2944�98 07/31/ 12 90569575 1054 0062� 07/30/12 Route: 2251 / 5 ORDER NUMBER: 592875 8ill Sbip Remit � CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc . To : To: 1235 CENTRAL PARK DRIVE E To: BOX 660088 46032 INDIANAPOLIS 317 643 3873 46266-000.-i �0 4tt: MICHELLE COMPTON DEPT # 00 800 429 2118 ;hipFim: 12301 CUMBERLAND RD FISHERS IN Ship& 07/31/12 Page 02 of 03 -rtrrms . SpciaJ ENTER OFF OF 111TH STREET ! { ! `yt0ms: NET 3O 0 AY8 Instm Qty Qty Sales Product Descpipton Pack Size Label C Weight Priciog Unit Extended rdered Shipped Unit Number D Unit Price Price 1 1 CS 7197775 YOGURT, ASST STRUBMA 8 RSPBRY 12/6 OZ YOPLAIT CS 10. 3400 10. 34 I I CS 7331380 APPLE, RED DLC 138 CT XFCY 138 EA CROSS VALY CS 38. 4700 38. 47 FROZEN 10 10 CS 2639235 ICE CREAN CUPI CKIES a CRM 12/2. 9 OZ ITTIBITZ CS 12.5500 125.50 10 10 CS 2639250 ICE CREAM CUPj CKY DOUGH 12/2. 9 OZ !TTTPITZ CS 12. 5500 125. 50 6 6 CS 2639268 ICE CREAM CUP, BANA SPLT 12/2. 9 OZ ITTIBITZ CS 12,5500 75.30 3 3 CS 3041423 CORN DOG, AN CN FZN 0/4 OZ STATE FAIR CS 33. 4100 100.23 10 10 CS 3330099 HOT DOG, AB 6: 1 6" RLR GRIL 10 LB PATUXENT CS 29. 9700 2T9. 70 4 4 CS 5210062 ICE CREAM SANDWICH, VNL 24/6 OZ BLUE BUNNY CS 17, 1400 68.56 28.2& 0 2i 2 2 CS 5741228 BUN, HOT DOG 6" HINGE SLCD TFF12/12 EA HILLTOP HR CS 31. 2400 62. 1a 2 0 CS 9763061 POPSICLE, ORNS CHRY GRAPE SGIF12/6/1. 65 OZ POPSICLE PRODUCT CLASS RECAP TOTAL DRY PIECES ORDERED: 37 PIECES SHIPPED: 37 ITEMS SHIPPED: 23 1285- 43 TOTAL REFRIGERATED PIECES ORDERED: 14 PIECES SHIPPED: 14 ITEMS SHIPPED: 10 373. 37 TOTAL FROZEN PIECES ORDERED: 72 PIECES SHIPPED: 70 ITEMS SHIPPED: 0`1 1610. 13 ^ , / � ACCOUNT INVpIgg INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE- ` wU. NO. NO. NU118ER LOC . REP ORDERED ' 90569922 294429g O7�31 /12 9O56c7575 1O54 DO6� O7/3O/12 � _ -_ � - - _ - - �� / -� �� --~ . ~~`'� .' . �"' ^� Route� 2251 / � A- 2-/3�~/ �� ORDER NUMBER:� 592875 8ill Ship Remit CARMEL CLAY PARKS&RECREA C CARMEL CLAY PARKS&RECREAT To: To: 1235 CENTRAL PARK DRIVE E. To: BOX 660008 46072 46032 1 INDIANAPOLIS 11411 317 843 3873 1 46a66-00138 Att: 1`4114,'HELLE COMPTON DEPT # 00 L800 428 23. 18 7h1pFrm: 12301 CUMBERLAND RD FISHERS IN ShipD: 07/31/12 Page 01 OP 07� -rt7r ms: Spcie2 ENTER OFF OF 111TH BTREET ! } l `ytTrms: NET 30 DAYS Instr, Qty Pty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended rdered Shipped Unit Number D Unit Price Price _ DRY 1 1 CS 0791616 CUP, FM 32 Z WHT 25/20 EA MONOGRAM 1 1 CS 0814236 CUP, FM 16 Z WHT 20/25 EA MONOGRAM -- ~~ `~~` - "� `" 1 1 CS 0814541 CUP, FM 20 Z WHT 25/20 EA MONOGRAM -- ^' ~^`' ^' "^ - 1 1 CS 2404325 GLOVE, POLY LO TXTD AMBDX 10/100 EA MONOGRAM - -^ ~~`` ^^ `= 1 1 CS 3256104 LID' CUP 12-24 Z BBL PLST 1000 EA WINCUP - -- '^ ^~`~ 2 2 CS 3708773 SPOON, TEA MW WHT POLYP BULK 1000 EA MONOGRAM -- ^~ '^`` ^° '� 1 1 EA 4004289 CANDY, BAR SHCKR 2.07 OZ 48 EA SNICKERS -- ^~ `' ~` ^^ �- -' 34. 2700 34. 27 6 6 CS 4260238 SAUCE, CHS NACHO SHLF STABL 4/107 OZ ORT[GA 1 1 CS 5280391 ONION, CHPD PKT SS 200/9 OR HEINZ CS ~- '^`` ~`' ~^ 1 1 CS 5311600 CONE, ICE CRM CAKE 22S FLAT 36/20 EA JOY CONE -- ^~ `' `` ^~ -' 1 1 CS 5585476 CHIP, PTATO BKD ORIG GLTN/FR 64/1 . 125 OZ BAKED LAYS -- -- ~-~~ ~~ ~~ 1 1 CS 5597604 CHIP, CHS CMCHY PLN S3 BAG 64/2 OZ CHEE-TOS �- ^' ~~`` ~' ~° 1 1 CS 5597851 CHIP, TORTLA NACHO CHS TRGLE 64/1 . 75 OZ DORITOS -- -- -' -- ~` ~' 2 2 P. CORN ORI8 TFF SS BAG 64/2 OZ FRITOS -- ~- ~' `` ~` ~' 1 -- 5601679--CHIP, PTATO REV PLN SS BAG 64/1. 5 OZ LAY'S 1 1 CS 5601927 CHIP, PTATO KTL JLP SS BAG 64/1. 375 O2 MISS VICKI - 00,81 ~` "` ~' 1 1 CS 5805472 CHIP, MULTGRN CHEDR SS BAG 64/1. 5 OZ SUN CHIPS -- ~^ �~~~ ~^ ^` 1 -- 30. 8900 ^`1 C3 6329213 RELISH, SWT SS SHLF STABL 200/9 GR MONARCH °' 2 2 CS 6820039 TRAY, PLYS NACHO 6X8X1. 75 CLR4/125 EA PACTIV -- ^ ' ` '~` ^- ~� 1 1 EA 8053126 CANDY, RESES P#T BUTR CUP 36 EA REESE'S -- �^~ ^~~` ^~ =" 1 -' 25.9200 25.92 1 CS 8355927 NAPKIN, DIGPR lNFLD WHT 6. 5X1024/250 EA EASYNAP � 6 6 CS 9463688 CHIP, TORTLA CORN YLW RHO 6/2 LB EL PASADO -- ~' '~`` ~' ~^ ~- 19. 7300 110.30 2 2 CS 9954371 LID, CUP 32 Z STRAW SLTD PLST 10/50 EA MONOGRAM REFRIGERATED 2 2 CS 0654269 HUMMUS, RSTD RED PPR NONDARY 12/4.56 OZ SABRA READY TO EAT - Please Refer to Return PolicY -- ^- ' ~`` '' �" 2 2 CS 0654301 HUMMUS, GRLC RSTD NONDARY REF 12/4.56 OZ SABRA READY TO EAT - Please Refer to Return P li -- �- `~'~ '' ~~ o c 1 1 CS 2000453 SALAD, CHIX CRMY REF 2/5 LB �IERCE E.READY TO EAT - Please Refer to Return Policv -- �' '~`` -' ~~ 1 1 EA 4365219 CHEESE, AMER SLCD 135 SUPRCR 3 LB 8LNVW FRMS 1 i CS 2% REDUC FAT PLST REF 12/1 PT PRAIRIE FN - ^`' 19.3800 1 4�C�884 MILK,-CHOC 1% LOW FAT PLST REF12/1 PT PRAIRIE FM 1 1 CS 5332242 LETTUCE, ICBRG SHRD 1/4" CLMD 4/5 LB CROSS VALY ~� SAW ^` ~~ READY TO EAT - Please Refer to Return Policy -- -' ---- -� � ^~ 3 J CS 6483952 BEEF, PTY GRND 80/20 4: 1 RND 56/4 OZ TLMN SLCT CS ___- 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 7/12/12 2446900 Concessions 31098 $ 125.90 7/13/12 2477581 Concessions 31098 $ 5,269.41 7/17/12 2548606 Concessions 31099 _ $ 3,505.83 7124112 2759763 Concessions 31101 $ 2,812.95 7/3/12 2191433 Concessions $ 405.76 7/18/12 2612660 Concessions 31111 $ 556.39 7120/12 2666613 Concessions 31112 $ 2,911.14 7/27/12 2868221 Concessions 31113 $ 3,591.27 7/31/12 2944298 Concessions 31126 $ 3,237.26 Total $ 22,415.91 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 5-11-10-1.6 120_ Clerk-Treasurer Voucher No. Warrant No. 353824 U S FoodService, Inc. Allowed 20 Box 660088 Indianapolis, IN 46266-0088 In Sum of$ $ 22,415.91 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members Dept# 1095-1 2446900 4239040 $ 125.90 1 hereby certify that the attached invoice(s), or 1095-1 2477581 4239040 $ 5,269.41 bill(s) is (are)true and correct and that the 1095-1 2548606 4239040 $ 3,505.83 materials or services itemized thereon for 1095-1 2759763 4239040 $ 2,812.95 which charge is made were ordered and 1095-1 2191433 4239040 $ 405.76 received except 1095-1 2612660 4239040 $ 556.39 1095-1 2666613 4239040 $ 2,911.14 1095-1 2868221 4239040 $ 3,591.27 1095-1 2944298 4239040 $ 3,237.26 9-Aug 2012 T Signature $ 22,415.91 _ Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund