HomeMy WebLinkAbout214434 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 359366 Page 1 of 1
0 ONE CIVIC SQUARE SYSCO FOOD SERVICES CHECK AMOUNT: $944.23
s° a CARMEL, INDIANA 46032 PO BOX 7137
INDIANAPOLIS IN 46206-7137 CHECK NUMBER: 214434
CHECK DATE: 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 210251280 944 . 23 FOOD & BEVERAGES
Good things CUSTOMER'S ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
owa come from DELV:;DATE :.:CUSTOMER::. .
OOKSHIRE GOLF CLUB... ��®�
120 BROOKSHIRE PKWY �® TR CK'S oP 412940 210251280 9 1
SYSCO INDIANAPOLIS, LLC
RMEL IN 46033 4000 W 62ND ST R°" E
INDIANAPOLIS, IN 46268 44r,9 f3:::AL:
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
3 NORMAL DELIVERY
CITY OF CARMEL ' EVERENZ
1 CIVIC SQUARE DRIVER: JACKSON, JEFF
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:. PAC SIZE _ ITEM RE,SCRIPTION ITEM uavlF EX3ENDEFJ._
CODE „P.,R10E PRICE
DAIRY ..:. :.:
S NL 5 LB 889LCLS CHEESE AMER YEL 120 SLI
28131 6697114 17.80 3 .6
$ NL 5 LB A$ASOL CHEESE CHDR JACK SHRD FCY 10999CS 240618.9 18.98. 37*96
.MEATS ***
GROUP:. TOTAL*** 73. 6
S 605.3302 AB 9976.3151, 6.703049 . 67.88 67.88
BEEF ;PATTY .GRND STKBRGRF,RZN,
S 110 LB JHNSVLE BRATWURST.. 5X1 PRICK SKL5 3188 21.99198 33.97 33,97
.. .
S 110 LB 88RLCLS FRANK ALL-MEAT 5X1 6 IN 37736,-070 ,1137736 25.32 75 96
GROUP TOTAL**** : 177.81
** FROZEN ***
S 45 LB JTM. CHILI TEXAS JACK S 43030 4871372 49.85 199.40
S 12CT RCTYBK COOKIE CHOC CHNK DWNHM 3.OZ IW
", :. ,. 8349439 5:9.,.23,:. . 59.23
S, „244 OZ _ ARALEE MUFFIN BLUEBERRY IW 08625 ,119„„2863, 23.95 23 95
S... .. 5 LB SYS IMP POTATO FRY 3 8 PHANTM PLU SY003108 4356465 31.62 31.62
:: / SKON .
GROUP TOTAL*.,*..**. .... 314.2Q::
** CANNED & DRY,.***
IS NL 24 CT ERSHEY CANDY BAR PAY DAY 80723 7030414 16.59 16.59
IS NL 48 CT 3NICXER CANDY BAR SNICKER 2.07 0Z 01202' 4348389 32.61 32.61
S, 5002 PK iSE REC CRACKER SALTINE 7486502808 420,499.6 16.._87„ 16.,87
S
121 LTR 4JR PTR MIX COCKTAIL BLDY MARY 47700 8087470 46.30 4'6:30
S 101 LB BRLCLS SNACK MIX SPCY CREOLE 91069 9960329 33.97 141.81
GROUP 21 ;2
........
*,< PAPER & DISPOSABLE ***..... ....
S ONLY50OCT SYSCO FOIL SHEET 9X10.75IN SILVER W69372 6938500 12 98 12.98
FS[. 4100 'CT YS CL GLOVE LATEX FD5VC :PWDRFREE MED 304750022 8347841 39 96` 39 96
RpMIT.JO;..:
P.O. BOX 7137
1 7 25 12.9 327 INDIANAPOLIS IN SUB
IMPORTANT: PERISHABLE PRODUCTS ARE NOT ELIGIBLE FOR REEg"RNgg RILE
4 206-7137 TOTAL
FOR ANY SHORTAGE AFTER YOU HAVE ESIGNEO(PIECES RECEIVEEl TE TAX
NO. PCS COST.
NO. PCS TOTAL
DRIVER'S DELV SIGN REC. INVOICE
qS I7EG NO gE� ggyE�EGC CN Q%0 E ES ggLE Go RI �JL MEMp E� Cg gC3p �J �{C q gE7 �) NE7 gEgL�E p
`THESE C MMODITIES�ROETA NCS�A PCLAIM AOVER THESE TL�OMMODCTIES,D�ALL SINDAvj N'TORIE Si OF FOOD90R�CO7HP PRODUCTS PAYABLE ON OR BEFORE TOTAL
DERIVED FROM THESE COMMODITIES, AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL ONT. ON PAGE 2
FULL PAYMENT IS RECEIVED.
Good things CUSTOMERS ORIGINAL INVOICE CONFIDENTIAL PROPERTY OF SYSCO
COmefrom tlELV;DATE ` ;;CUS,T„D,MER
BROOKSHIRE GOLF CLUB+++
12120 BROOKSHIRE PKWY l/ TRUCK STOP 412940 210251280 9 2
SYSCO INDIANAPOLIS, LLC
CARMEL IN 46033 4000 W 62ND ST
INDIANAPOLIS, IN 46268
317-846-7431 DUE FRIDAY 4 WEEKS AFTER ORDER
MANTFE�'J'j 46-30�3 NORMAL DELIVERY
CITY OF CARMEL
1 CIVIC SQUARE DRIVER: JACKSON, JEFF
CARMEL TN 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.
S12E:. EM .UNIT EXTENDED.;; T
TY ITEM;pES,CRIPI ION Al oTY
„I:ITEM : .;PRtCE.., PRICE
S :1100 CT :YS CLS'GLOVE POLY CAST DISP MED 303363/12 34824:5 42.60 42.60 ::
*.* PRODUCE ***
GROUP TOTAL**** 95.5.4
C S 15 LB 3YS IMP ONION RED FRESH JUMBO 1039494 039494 9.84 9.84
$ < 5 LB :::.: YS;'I MP.:.;ONI ON;:YETLOW,.DI CEB 1 4 61678 6 0 ..;,12:.9,2 12: 2
,
5 5 LB BRLI:MP SALAD CHICKEN 51071 2510717 41.08 41.08
GROUP TOTAL**** 63.84
M:IS RG S HG.S. FOR .FUEL :;ISURGHARGE;:
..
ORDER,:.» :. . . ,12445
I ............. ........ . . .... ...,,,...... .
(R IEMI,T'TO ..
P.O. BOX 7137
4 1.6 27 INDIANAPOLIS IN Sub
R IMPORTANT: PERISHABLE PRODgUCTS ARE NOT ELIGIBLE FOR RETURN gAFTE 4206-7137 TOTAL 944.23
E 2 7 29 14.5 354 EORI VANY SHORAGE AFTER YIOUI HAOVIE ESI GNEO IP PIECES RECE VED MUSTE
TAX
DRIVER'S NO. PCs CUST. NO. PCs TOTAL
DELVD.
gSIGN
p IZI gg�yE ggEGC IC 5U( 7M ME pE ES g E7 DGO �JL SIGN
p gEpS Cg Eg�p �J �{C gE7 7)' HERESCEgL�E p INVOICE
THtSECO MODITIES�IROTAINCS�A�ORUHS TOPCLAIMAOVERATHESE TCOMMOD TIES,DALL INDAVETfYfORIESI OF FoO D90R�COTHER PRODUCTS PAYABLE ON OR BEFORE TOTAL 944.23
I DERIVE” FROM THESE COMMODITIES. AND ANY RECEIVABLES OR PROCEEDS FROM THE SALE OF THESE COMMODITIES UNTIL 11/23/12 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
$944.23
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 210251280 I 42-390.40 I $944.23 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, October 26, 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))
10/25/12 I 210251280 I Food I $944.23
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