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HomeMy WebLinkAbout212386 08/28/2012 a CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1 ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $2,818.16 CARMEL, INDIANA 46032 PO BOX 7137 a o�, INDIANAPOLIS IN 46206-7137 CHECK NUMBER: 212386 CHECK DATE: 8128/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 108231145 1, 754 . 91 FOOD & BEVERAGES 1207 4239040 208161206 39 . 98 FOOD & BEVERAGES 1207 4239040 208161207 1, 023 .27 FOOD & BEVERAGES ;I CUSTOMERS (1 ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO Good things come from 'i DEIv DATE I;::CUSTOMER BROOKSHIRE GOLF CLUB+++ �1/5C®� 12120 BROOKSHIRE PKWY TRCKsoP 412940 208161206 7 1 SYSCO INDIANAPOLIS, LLC . CARMEL IN 46033 4000 'W 62ND ST 7777777 INDIANAPOLIS, IN 46268 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER CITY OF CARMEL MA VERENZ - 11 1 CIVIC SQUARE DRIVER: JOHNST N, LEWI EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 FIR 60-1.4. 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE.1. QTY PAC SIZE ITEM DESCRIPTION ITEIV( 11NtT EXTENDED T 1. If Ti CODE PRICE PRIICE 4. MEATS F S. 276 OZ ZDVANCE PORK FRITTER BRD AAW 6606' 2205383 39 98 39 98 . GROUP TOTAL** * 39.98 ORDER S ::RY 47266 o I M ;:REMIT TO';`. P.O. BOX 7137 1 r.5 INDIANAPOLIS IN SUB a IMPORTANT: PERISHABLE PRODS$UCTS ARE NOT ELIGIBLE FOR RETURN ggAFTE 4206-7137 TOTAL 39.98 1 FOR VANV SHOR AGCHECK ER VIO UI H AIE E$I DINED.WILL ECEOST BE rMUSTE TAX NO. PC S OUST. NO. PCs TOTAL DRIVER'S DEL VD. SIGN REC. INVOICE SIGN CC C 77EE p gg p RE p 39.98 I qTU EHpPER HAggL TIONL 61CPLOF O7MH,MEOD R%S IILF7E�GR CULTIURALV COMMApDITIESL�cTUB�Eg Cg Tpl�Ou THE S9 gAE7l1C OT HE RS ESLT�ER p TOTAL 7 THEESE RS DMODITIES RETAINS A TrLU5DILAIM OVER TH SE COMMODITIES, ALL INVENTORIES °F EO'04D ORI�THER PRODUCTS PAYABLE ON OR BEFORE 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 9/14/12 LAST PAGE .FULL PA MENT IS RECEIVED. CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO . Good things come from DE(V DATE CLUCK - . BROOKSHIRE GOLF CLUB+++ 12120 BROOKSHIRE PKWY ®scO SCO IN IS LL TftcKS °P 412940 208161207 5 1 ROUTE CARMEL IN 46033 4000 W D62NDPOT C __ . .. .. . INDIANAPOLIS, IN 46268 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER CITY OF CARMEL 1 CIVIC SQUARE DRIVE"JHN N, LEWI CARMPT, 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,11 111-1111 C2T.Y 6 ITEM: UNEF EXTENDED iI T 1 . SIZE ITEM DESCRIPTION N'PAP PRIICE A 1+1' 111:'1::. jL :T.::: ..:::: 1111.. ::: 1 ':1. CQDE_ P,R10E ;;; x DAIRY C S NL 5: LB LCLS SL. AMER YEL 12A S1I. 28131 6697114 17 80 J7 800 .; GROUP TOT L* * 1 8 I LL I L * MEATS *** . 1 F S. 605,.33 AB BEEF PATTY GRND STKBRGR FRZN, 99763151 6703.049 67 88.:: 67 88„ F S, 10 L HNSV.LE BRATWURST 5X1 PRCK. SKLS 3188 , 2199198 33 97 :. 101 91, F S. 110 LB BRLCLS FRANK ALL MEAT 5X1 6 IN 3773:6 070.; 1137736 25 32.; 75 96:: <-::: C S' 2.5 BRLCLS HAM SLICED HNY WTR ADD FRESH HHN850SLB 8286429 44.37 44.37 . GROUP TOTAL** * 29!0.12 ** POULTRY *** C S 2.5 BRLCLS TURKEY BRST SLI 3/ MESQT SMK MSTB940SLB 4860003 43 98 43.98 GROUP TO. AL**** 43.98 _: ..* FROZEN:... ._.__ .. _.. ** ***1111 ........ ....... ......... ......... ..1111... ...._..._1 .._11...... 1. ........ 111..1._ _ _ 1111.._.. _ .............._.. . _ .. .. _..... .... _ _ _. L LLL 1I I I I.. '<;: F _ ..S,... 244..25 .... KRSIMP MUFFLN ASST_„BL/BAN/CHOC/CH...I/W 073473021825. 7813114 23 94.. 23 94 F S' 42:5L ANTLZR ONION RING BEER BTR 5/8' 30423 0855296 26-71 26-71 F S 5 LB YS IMP POTATO FRY 318 SKON PHANTM PLU SY003108 : 4356465 31 62 : 31.62 R P TOTAL** <* 82.27 ** CANNED`& DRY C A L 48 C ICKER CANDY BAR SNICKER 1 2.07 'OZ 01202 4348389 32.61 32.61 D S 641,1 KDLAYS CHIP POTATO BKD REG BIG GRAB 443968 6725313 29.85 29.85 D S 160. C. AYS CHIP VARIETY .SYSCO/FRITO LAY 31831 6586.721 26 98 53.96 ' D S 1 23 0 RIZONA DRINK TEA ARNOLD PALMER LITE 0554968 14.94' 89.64 D S: 16240 2 E REC KETCHUP SQUEEZE BTL HOUYA24 9617218 26.76 26.76 . D S 1 1'2 ENCHS MUSTARD YELLOW CLS SQUEEZE 4150075677 4736070 21.94 21 94 ;: D S 481:7 Z LANTER PEANUT SALTED 07708 9549379 26.97 °26.97 ' I ;:> ..REMIT T. , P.O. BOX 7137 z 2 2 26 21.1 362 INDIANAPOLIS{ IN SUB I IMPORTANT: PERgISHABLE PRODg$UCTS ARE NOT ELIGIBLE FOR RETURN ggAFTE 4b206-7137 TOTAL v FFOR ANY SHORTAGE AFTER YW NHAOVIEESIGNE4 1PIECES RECEIVED A T E TAX v No. PCS Cu ST. N0. PCS TOTAL DRIVER'S DELVD. SIGN � SIGN C 7 RE o RE C. INVOICE I FFULL IRIZISEHpAggggLyyEE gggqEEGGCCF,IICUNLTUC OF07�,1HMEODEI RIIEg}S{AI,gISE7E�G�IC�ILTISR IgNLVOOMMApDITIESL�CEUB�Eg C3o17OU THE �S99AETUC OR HET TRUST TOTAL Y COMMODITIES RoOETASSI(INS�A TRUST PCLAIM OVER THESE CUOMMODITIE S, ALL INVENTORIES OFSF O"OD OR1THER PRODUCTS PAYABLE ON OR BEFORE I O FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2 0 q YMENT IS RECEIVED. Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO come from aELV aArE - ';CUSTOMEIR ::: .. BROOKSHIRE GOLF CLUB+++ SO®SCC1� 12120 BROOKSHIRE PKWY TR cK s QP 412940 208161207 5 2 I SYSCO INDIANAPOLIS, LLC CARMEL IN 46033 4000 W 62ND ST Rou:.E INDIANAPOLIS, IN 46268 A. 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER CITY OF CARMEL 1 CIVIC SQUARE DRIVER: J HN T N, LEWI EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 FIR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE. {y' ITENt UNET ffiXT:ENDEf3 T QTY 7.i PAG SIZE ITEM DESCRIPTLON X 1. COQE PRICE PRICE a C. PU .. 15;: GA ` ;: CHWR.TZ PI>CKLE :CRS CUT KO : _ 2:9658270756? 102$,919 39 86: 39.86 '11 D ;> :S 601:.-::.:7 SNACK MIX CHEX TRDTNL FLVR 12140000<i 7:. .I 921.4:8 :.29 87< :'.: S7;1 D:.::::.:::.::::.:::::: S ..1 01:,:l...'' RLCI,5 SNACK :1!�IX SPCY CREOLE 91069: 9960:329 33.97.>. 33.97 GROUP TOTAL***.* 385 43 ll,** PAPER :& DISROSABLE *** D :5: 25 3: G YSCO; LINER TRASH 33X39 5 Mtl BLK H6639MBS> 4075958 38 78: 38.78 11 D 5: . . 55 G SCO LINER TRASH 36X58 ':.7 Mli BLK 147258HBS< 084;679 :69 98 ; 69.98 :: *ki .PRODUCE ** GROUP TOTAL**** 108.76 C =5 5,LB S IMP ON30N RED FRESH JUMBO . " 10;39494;: 1039;494 9 84 ;9 84 111.1 C S; 5::; LB :;:; BRLL,MP SALAD CHICKEN 51071:; 2510:717 41 08 ;: 41,08 C'' :S: 2: B Y5 .:IMP TOMATO ::SLICED 1 4." 40451:::: 6113:765 3$ 99. 38.99 !1 ..11 GROUP TOTAL**** 89.91 MI:S RG S :. I HGS :FOR ;:F:UEL SURCHARGE; 5.00 I. ORD S RY 47267 . .. .. .: .. i .. .... . REMIT Ta;; I P.O. BOX 7137 2 8 6.3 125 INDIANAPOLIS IN SUB A IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN gAFTE 4206-7137 TOTAL 1023.27 E 3 2 34 27.4 487 FORI ANY SHORTAGE AFTER THIS HVAOVIE E$IGNE WILL NOT BE VET UISTE TAX v NO. P;MK;;;;;; NO. PCs TOTAL DRIVER'S OELVD REC. - INVOICE I qS I7EGN R�Hn ggyE ggEGC ICpN 5� ME EI EggH Lg E7 GoR E gESL�E TOTAL 0 THESE �`p'(�MODITIES�RETAIN AFTRUSTO�C RAI UA %I�TH SE COMMD MIES, ALLI VEN7RIES0F'F000R�C THER PRODUCTOS PAYABLE ON OR BEFORE 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 9/14/12 LAST PAGE o FULL PAYMENT IS RECEIVED. 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)) 08/16/12 208161206 Food $39.98 08/16/12 208161207 Food $1,023.27 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF $ 4000 W 62nd Street Indianapolis, IN 46268 $1,063.25 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1207 208161206 42-390.40 $39.98 1 hereby certify that the attached invoice(s), or 1207 208161207 42-390.40 $1,023.27 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday, August 17, 2012 Director, Brookshire olf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO come from DELV DATE CUSTOMER BROOKSHIRE GOLF CLUB+++ 12120 BROOKSHIRE PKWY l®Sco TR — oP 412940 208231145 3 1 SYSCO INDIANAPOLIS, LLC CARMEL IN 46033 4000 W 62ND ST aoL1s INDIANAPOLIS, IN 46268 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER _MKNTF7= 4b6912 NORMAL 1) CITY OF CARMEL ' 1 CIVIC SQUARE DRIVER: JOHNSTON, LEWI CARMEL IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFIR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE. CITY;PAC 51ZE ' ITEM 77D77E77S7C77R77I7P7�T ITERlt lJN[T E�CTfffDED a X. COD . PRICE x DAIRY C.A. NL 5 LB BRLCLS CHEESE AMER YEL 120 SLI' 28131 6697114 17.90 53.40 GROUP TOTAL** * 53 40 ** MEATS_ *** ..... IF S 605,3302 AB BEEF PATTY GRND STKBRGR FRZN 99763151 6703,049 67,88. 135.76 F S 110 LB HNSVLE BRATWURST 5X1 PRICK SKLS. 3188: 2199198 33 97 67.94 F 110 LB„ BRLCLS FRANK ALL MEAT 5XI 6 IN 37736-070 1137736 25.32 101,28 Ill C 42 5 LB. BRLCLS HAM SLICED HNY WTR ADD HHN850SLB 8286429 44 37; 177 48.. F S 276 OZ kDVANCE PORK FRITTER BRD RAW 6606 2205383 39.98 39.98 GROUP TOTAL** * 522.4.4 ** POULTRY *** C S 42.5 LB BRLCLS TURKEY BRST SLI 3L4Z MESQT SMK MSTB940SLB 4860003 43 98` 175 92 ` GROUP TO AL** * 175.92 ** FROZEN *** F S 12CT RCTYBK COOKIE CHOC CHNK DWNHM 30Z .............W 8349439 59.23.' 59.23... F S 244.250Z KRSIMP MUFFIN ASST BL/BAN/CHOC/CH I/W 073473021825 781,3114 23.94 23 94 F ( S 42`.5LB ANTLZR ONION RING BEER BTR 5/$" 30423. 0$55296 26.71 ' 26.71 F S 5 LB YS IMP POTATO FRY 3/8 SKON PHANTM PLU SY003108' 4356465 31 62 1:.62 F S 2 3 9402 NPRIDE SANDWICH SAUS EGG CHS CROIS .IW 482 5196581 29.96 29.96 GR©UP........... * E*.. _ 171.46 **. CANNED & DRY *** C NL 36 CT qARS. . CANDY BAR MILKY WAY 4367363 27 74 27.74 C NL 2:4 CT ERSHEY CANDY BAR PAY DAY 80723 7030.414 16.59 16 59:': C S NL 4$ CT NICKER CANDY BAR SNICKER' 2 07 OZ 01202 43483$9 32.61 12.61 D S 801 OZ BRLCLS CHIP POTATO REG 18560: 6080871 28 99': 28 99 REMIT To':: P.O. BOX 7137 z 2 6 29 15,6 320 INDIANAPOLIS 4�206-7137 SUB R IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN AFTE TOTAL E DELIVERY. PLEASE CHECK THIS INVOICE. WE WILL NOT BE RESPONSIBLE Y FOR ANY SHORTAGE AFTER YOU HA SIGNED. PIE.CES RECEIVED MUST TAX AGRFF WITP ­­ .11 NO. PCS CUST. NO. P S TOTAL DRIVER'S DELVD. SIGN EC. INVOICE SIGNS H C M p ES p R gp 7 � , o gTHfHOPRIR DA @fit .�Ak F IIICJUNVL 5(C OF OTHME Op EIRISHALgI LETEAGRIC,JTLHURALVOICE A ,J?LAC$LUB�gECCTT TOL1 TCE 4TgggEE C OR H TRSUES O TOTAL THESE CMVI�'C RETAIN�A TRUST CLAIM OVER THESE COMMODITIES, ALL INVENTORIES OF'FOOD ORTHEF PRO C 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 (:USTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO C® come from pgLV 6AT� cusTO,teER BROOKSHIRE GOLF CLUB... S�/S 12120 BROOKSHIRE PKWY s Tft cK s °P 412940 208231145 3 2 SYSCO INDIANAPOLIS, LLC CARMEL IN 46033 4000 W 62ND ST RO[tE INDIANAPOLIS, IN 46268 317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER AL DELIVERY CITY OF CARMEL 1 CIVIC SQUARE DRIVER: JOHNSTON, LEWI CARM J, I-N 46032 EQUAL OPPORTUNITY AND AFFIRMAFIVE ACTION CLAUSES OF 41 CFR 60-1.4 60-250.4 AND 60-741.4 ARE INCORPORATED HEREIN BY REFERENCE. .. ...: F QTY PAC SIZE. ITEM pESCRIPTION ITEM uN1T EXTENDED A C0.6E P.;RICE "'.: PRICE D S 6;0 CT. AYS CRT P VARIETX`SYSCOJ„F.RITO LA:X ;31831;! 6585:;721 26 98, 26 98' ' D >:S 1: 15 2QZ ROP;CNA JUIGE ..CRNBRY CKTAIL PET 0086:4' 4760;062 17 33 17.33> DI. .> S ...1 1 LTR; JR PPR. MIX..COCKTAIL:>BLOY?MARY 47700 087470 46.3 0: :* >4G.30 . D'.:.; 5 9 1:.2502 BRLCLS PRETZEL:;MINI ;. 21738; 0175:529 26 40: 26 40 ; D 5.. ..2. 2: 02 . ABA5:C0 .SAUCE TABASCO HOT 00004:: 400781.1 38 30; 38. 30'> .:... D S ] 1; LB BRLCI,S SNACK MIX SPICY CREOLE 91069;: 9960329 33..97; 1:35 88:; GROUP TOTAL**** 397.12 ** PAPER .. .DIS'POSABLE **:* D. S 25. CT ERENE CARTON .CARRY ;DINNER 9X.5X3 FBF9YSi 6000 0728;121 ....'99 87 .. 99 BT; D, S 1.:2” Y5 CLS FILM PUC 20.0OFT 'ROLL SLI CUTR 905;9!; 0496:026 19 82: 19.82!! :: D NI; SOOCT: YSCO> FOIL SHEET 9;X10 7:<51N SILVER : W6:9:372 6938;50 12. 25. 100 CT XS CLS...GLOVE LATEX :FDSyC: PWDRREE MED 3047:50022! 347;841 39.9b,; 39.95: *ye.. CHEMI.:CAL '* GROUP TOTAL 185.61 D' S. 3202 EYSTON CLEANER. MULTI SURFACE _RTU ORNG 61:00063'1: 7682';802 29. 58.: 29 8 ; :PRODUCE ***; GROUP TOTAL**** 29.5 C %S 12 .CT : PACKER.-,.x LEMON FRESH <; 1Q39478. 039.478 10: :.5.6:::: 10.56: C S 5 LB YS NAT LETTUCE ROMATNE .GOURM SNGLS.. .. 5063;599 29 49 ; .. 29.49 ; C S kli2 CT' ACKER LIME FRESH; " 1283!787 7 .75:: 7.75;: C ;S 5` LR ;; YS IMP ONION RED FRESH JUMBO 1039494; 1039;494 9 84: 9.84:; C SAS B.. LB YS CLS SALAD POTATOjMUSTARD.CLASSIC 7;1117:;;67785:: 1611:383 39.25 ]17.751 I. C 5 2 5 LiB YS I!iMP TOMATO ;SLICED 1� 40451 6113765 38 99; 38 99 • RpMlr TO!i ry . P.O. BOX 7137 z 2 2 23 17.9 293 INDIANAPOLIS IN SUB 'R IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETURN$$ggAFTE 4 206-7137 TOTAL v FOR ANY SHORTAGE AFTER YOU H AIE E$IGNE 0 IP EC ET RECEIVED MUSTE TAX v NO. PCS OUST. NO. PCs TOTAL DRIVER'S DELVD. SIGN �--- REC. INVOICE � SIGN 7E p �SHp gg�yE gq�GCR ICpN 5u p� ME p 7R Eg Lg FT DGORI UL L ME p E gEp C Eg C37p L7' FIr E7 RT E gEg`L p TOTAL THESERC OEMMODITIESTRETAINCS�AF7RUHS TOPLAIMAOVERATHESE OMMOD TIES,DIALL SI NENTOIRIE S�OFbOD OR�C THER PRODEUCTS PAYABLE ON OR BEFORE 1 DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT• ON PAGE 3 o FULL PAYMENT IS RECEIVED. � It CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO Good things come from v DATE CUSTOMER BROOKSHIRE GOLF CLUB... ysco Pi 12120 BROOKSHIRE PKWY rRCKSOP 412940 208231145 3 3 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 T N, LEWI .T. IN 46032 EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION CLAUSES OF 41 CFR M-1.4 60QWA AND SO=1.4 ARE INCORPORATED HEREIN BY REFERENCE. CITY ;:PAC SIZE IT.EIYI DESCRIPT.fON TEIVt UNIT EXTEfQED T GROUP TOTAL 214.3 9NI511 CH WOE sillog HGS ;FOR FUEL SURCHARGE ARDER WAR08 MAN YKAMi Bums 1 so MIN MINN 113201 IMMAD BONN 9 mi HBO polls looll���i I.XX.i I 4:UU PM REMIT TO::: Auz P.O. BOX 7137 INDIANAPOLIS SUB 1754.91 R IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR RETN gAFTE TOTAL E 4 8 52 33.5 613 OOR ANV SHOR TAGE RAFTER YOUI HAOVIE SIGNTD TTAKRECEIV'A USTS TAX v DRIVER'S NO. PCS TGN PCS TOTAL DEWD. SIGN ( REC. INVOICE qS I7EG NppEE ZZggEE ggyE SgEGC Ury U( q 7M ME pEI EgS LgSE7 Got U gE CS Eg Cg 7p \ E TOTAL 1754.91 o THE SERt�'OMIM OLDITIES 'kSAT5�1C) OFTORUHSTP RAIMAOVER�THIE ELTCOMMOD 71E�DALL�IN ETPITORIESI 0�I.SF �C THER PRSODUCTOS AI S A E PAYABLE ON OR BEFORE 1 DERIVED FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 9/21/12 LAST PAGE o FULL PAYMENT IS RECEIVED, 1 :j 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)) 08/23/12 108231145 Food $1,754.91 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 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Sysco Indianapolis LLC IN SUM OF $ 4000 W 62nd Street Indianapolis, IN 46268 $1,754.91 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 I 108231145 I 42-390.40 I $1,754.91 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 24, 2012 Director, Brookshir oIf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund