214856 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE,INC
CARMEL, INDIANA 46032
PO Box 660088 CHECK AMOUNT: $1,646.38
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 214856
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4359000 2334084 92 . 78 SPECIAL PROJECTS
1095 4239040 2431588 65 .20 FOOD & BEVERAGES
1091 4359000 2654982 643 . 21 SPECIAL PROJECTS
1095 4239040 2785706 845 . 19 FOOD & BEVERAGES
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO, DATE NO NUMBER LOC . REP . ORDERED
90569922 2314084 10/12/12 90569575 1054 0062 1D/11/12
Route: 5291 / 10 ORDER NUMBER: 666517
Ship Remit
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREA''I" US Foods, Inc .
To: 1411 E. 116TH ST To: 1215 CENTRAL PARK DRIVE E To:
BOX 660088
CARMEL IN CARMEL IN
46032 46032 INDIANAPOLIS IN
317 843 3873 46266-0088
Att: MICHELLE COMPTON DEPT # 00 800 428 2118
TipFPn? 12301 CUMBERLAND RD FISHERS IN Ship& 10/12/12 Page 01 of 01
�"tTrms: SpciaJ ENTER OFF OF 111TH STREET ! | !
'yt0ms: NET 30 DAYS Instr:
Aty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number D Unit Price Price
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 2 PIECES SHIPPED: 2 ITEMS SHIPPED: 1 92. 7
*** INVOICE SUMMARY ***
TOTAL WGT SHIPPED: 40, 00 PIECES ORDERED: 2 PIECES SHIPPED: 2 ITEMS SHIPPED: 1
Purchase PRODUCT TOTAL $ 92. 7
Description LC TED J 10, Q ID,
OJT
P.O.# PorF IL
8L# OCT 18 2012
Budqyt Line Descr TAXABLE AMOUNT $ . 00
GEN SALES TAX % O
Pum��o Date—
Approval Date_____
Thiy amount is an estimate at time of shipping prior to any adjustments made at delivery: $ 92. 78 {
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DA�E
NU
NO DATE N�� WUM8ER LOC . REP � ORDERED
9O569�22 24�1598 1O/16/�2 9[>56�575 �� 1O54 OO62 1O/15/12
�7 /�� ^�\.�
Route: 2251 / 4��� &Y / �� (��
B� ll Shi - -
' P R ------'------
Tm� 1411 F. 116TH ST To� E--R ' L �A'-' '-I-- � \�``- `~`� ` --- -' ^''`' .
110 66O888
EL IN � IN
2 INDIANAPOLIS IN
462,-'-N6 0088
�tt: ELLE COMPTON \ � 8OD 428 2118 }
�----------'-----------'--'_--____'_J
. L_'_-______-_-___-'___'__-___-______|
U7ipFr/n. 12301 CUMBERLAND R0 FISHERS IN ShipD.' 1Q/ 16/12 Page 01 of D1
r�Trms
' �pcja2 ENTER OFF OT", 111 4 STREET ! ! }
`yt7'rms: NET 30 DAYS Instr:
�ty �ty Sales Product �escripton P�ch Size LabeI C �eig�� Pric�ng Unit tendpd
rdmred Shipped Un�t Number D Unit Price Price
_-_-�__-____-_____ ......_-....... ...........
38 9500
IV4`Vf,'UCE SUMMARY
FIRD. 0RIM"flilic 6. 25
rII CU,
PRODUCT TOTAL.
Purchase
Description CID-1 10 7:�D
P.O.# .f r)C- P 01 Fj C1,14"GES 6. 2 5
Bud t TAXABLE 'ANOUNT 00
Line GEDI "IAl ES TAX
Purchaser Date
Approval ~~`~------ ___-'-------_
This amount is an estimate t ti f hi -~-
-----'-------------'------------''-------'--r--------------
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO NO. DATE NO. NUMBER LOC. REP ORDERED
90569922 2654982 10/23/ 12 90569575 1054 0062 10/22/12
Roote: 2251 / 5 ORDER NUMBER: 675226
8ill Ship Remit
To: 1411 Q 116TH ST To: 1235 CENTRAL PARK DRIVE E Tw 317 843 3873 1 46266-0088
Att
�bipFi�/ 12�O1 CUM8iRLAND RD FISHER,'-.) IN Ship& 10/23/12 Page 02 of 02
-rt7rms
Spc�aJ
~ytFrms: NET:30 DAYS Instr
'
Ted ' Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number D Unit Price Price
INVOICE SUMMARY
FUEL SURCHARGE 6, 25
TOTAL UGT SHIPPED: 221. 93 PIECES ORDERED: 23 PIECES SHIPPED: 22 ITEMS SHIPPED: 12
PRODUCT TOTAL $ 636. 96
CHARGES 6, 25
GEN SALES TAX %
This amount is an estimate at time of shipping prior to anV adjustments made at deliverV: 643. 21
Purchase
'
�
uasonnnon
oL.°
='
We Descr
pu ^ D��`�----
'�=~~
Approval ' oato______
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE OR-DER SALES SALES DATE
NO. NO DATE NO. NUM8
90569922 2654982 10/23/12 90569575 54 0062 10/22/12
Route: 2251 / 5 ,�p�� ! DER NUMBER: 675226
8i 11 Ship Rem
Toi 1411 E. 116TH ST To: 1235 CENTRAL PARK DRIVE F To:
46032 46032 INDIANAPOLIS IN
317 843 3873 46266-008e
Att: DEPT # 00 600 4212 2118
TipFrm. 12301 CUMBERLAND RD FISHERS IN Shjp& 10/23/12 Page 01 of 02
i"tTrms: Spcial
ytTrms: NET 30 DAYS Instr:
�ty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number D Unit Price Price
DRY
1 0 CS 0061028 MARSHMALLOW, WHT STD 24/10 OZ KRAFT
4 4 EA 4053336 CANDY, BAR MILK CHOC 36/1. 55Z HERSHEY EA 26. 8800 107. 52
1 1 CS 02930 KETCHUP, TMTO FCY SS FOIL PKT 500/1 OR MONARCH, CIS 14. 9600 14.96
i I CS 5329289 MUSTARD, YLW SS 5.5 OR SHLF 500/5.500 OR MONARCH CS 12. 7300 12. 73
2 2 CS 5601679 CHIPi PTATO REG PLN SS BAG 64/1 .5 OZ LAY'S.,; CS 30. 6900 61 . 78
REFRIGERATED
I i CS 6483952 BEEF, PTY GRHD 80/20 4: 1 RND 56/4 OZ CTLNN SLCT CS 43. 5,000 43. 1?0
FROZEN
. 1 1 CS 1792399 BEEF SUBj PTY NEATL VEG 3 36/4.25 OZ CHEFS LINE CS 46. 4600 46. 46
5 5 CS 3330099 HOT DO& AD 6: 1 6" RLR GRIL 10 LB PATUXEHT CS 27. 4500 147. 25
2 2 CS 5741228 BUN, HOT DOG 6" HINGE SLCD TFF12/12 EA HILLTOP HR CS 31,2400 62. 48
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 14 PIECES SHIPPED: 13 ITEMS SHIPPED: Ifi 336. 87
TOTAL REFRIGERATED PIECES ORDERED: I PIECES SHIPPED: I ITEMS SHIPPED: 1 43 TO
TOTAL FROZEN PIECES ORDERED: 8 PIECES SHIPPED: B ITEMS SHIPPED: 3 2019
|
ACCOUNT INV ICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO 1148 DATE NQ. NUMBER LOC . REP . - ORDERED
9Q569922 2785706 10/26/12 90569575 1054� OO��' 10/25/12
Route: 5291 / 10 ORDER NVy12ERi 679501
Ship Remit
To: To: L P I E * To:
� —'--'— ' � � ~� ' ~~� =' Inc .
�
BOX 860O88
CARMEL N � NARMB_ IN
1 1317 843 !NDIANAPOLIS IN
3 46266-0088
Att: 8O0 428 2118
DEPT # 00
�
________ _1 L
?WpFrm: 12301 CUMBERLAND RD FISHERS IN ShjpQ 10/26/12 Page 02 of 02
'rtTrms �
� spciaJ ENTER OFF OF 111TH STREET ! ! !
'ytTrxrs: NET 3Q DAYS Instr:
Aty Qty Sales Product Descriptnn Pack Size Label Weight Pricing Unit Extended
r6ered Shipped Unit Number D At Price Price
___ ___ ...... ......... ......... ___ ......... ____ .................. �______ ___ ......
_
*** %HVDICE SUMMARY ***
FUEL SURCHARGE 6. 25
TOTAL WGT SHIPPED: 376. 72 PIECES ORDERED: 27 PIECES SHIPPED: 27 ITEMS SHIPPED: 16
PRODUCT TOTAL $ 838, 94
CHARGES 625
TAXABLE AMOUNT $ OO
GEN SALES TAX % 0O
_ This amount is an estimate at time of shipping prior to any adjustments made at delivery: $ 845
' ~
purchiso
Al 5
— '
PLi,o __~ ��
uuoe_�___
Approval_ D "-
'
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
PKI NO DATE N0 NUMBER LOC . REP
ORDERED
90569922 2785706 1O/26/12 90569575 �� 3 1054 OO6� 10/25/1
2
~Route: 5291 10 °
ORDER NUMBER: 679501
8 hip Remit
cARMEL CLAY PARKS®REAT ' CARMEL CLAY PARKS®REAT' US Foods, Inc
To: 1 1411 E 116TH ST To: 1235 CENTRAL PARK DRIVE E To:
i BOX 660088
CARMEL lM `
46032 16032-- -
1317 843
.,
Attl � MICHELLE COMPTON � � ~ � 46266-0088 -
�-------------------_______�. , 42B 2118
ihipFrx ' 123D1 CUMBERLAND RD FISHERS IN ShjpI 10/26/12
Pa ge 01 of 02
-rtrrxws:
spcial ENTER OFF OF 111TH STREET ! } !
jtfrms: NET 30 DAYS Znstm
Qty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdyred Shipped Unit Humber D Unit Price Price
DRY
1. CS 0814236 CUP, FM 16 Z WHT 20/25 EA MONOGRAM CS 17.6100 $ 17
1 1 �S 0814541 CUP, FM 20 Z WH� 25/20 EA NOMOGRAM CS 21. 8300 21 "�
2 2` CS 4260230 SAUCE, CHS NACHO SHLF STABL 4/107 OZ GRTE8A CS 52.2500 104� ~~
1 1 C� 6260665 COOKIE, FUDGE STRPE MINI SS 60/2 OZ KEEBLB� CS 26. 1600 26� ~�
1
117 EA 8036576 CAwDY. MIN ' T 1. 74 Q2 48 EA M � M EA 34� 190O 34� �~
2 2�/ CS 9089079 POPC/JR#' R AIT W/ OIL & SAiT36/8 OZ FANCY FAPU CS 24� 72OO 49� ^'
3 3�/ CS 9463688 CHIP, TDRT"A C8R� YLW RND 612 LB EL PASADO CS 24� 360D 73� °�
/ REFRIGER
1 1'/ CS 0654269 HUMMUS, RSTD RED PPR =MARY 12/4. 56 OZ SABRA CS 23. 7500 23. 75
READY TO E - Please Refer to Return Policy
1 C9 4800843 MILV^ 2% REDUC FAT PLST REF 12/1 PT PRAIRIE FM CS I1 0100 11� `^
1 1°/ CS 4800884 MILK, CHOC �1% LOW FAT PLST REF12/1 PT PRAIRIE FM CS :10,� 93O0 10
FROZEN �
4 41 2811278 PRETZEL, KING SOFT BK8 FZN 50/5 OZ SUPR PRTZL CS 32. 5500 130
1 1 CS 2372920 CHILI, Q/ EAH HEAT a SRV FZN 415 LB WHITYUND8R CS 55� 97O0 55' ^'
3 3 CS 3O41423 CORN DOB, M CH FZN 48/4 0Z STATE FAIR [S 33� 9lO0 101� ' `
3 3 CS 3330099 HOT DQG, AB 6: 1 6'' RLR GRIL 10 LB PATUXENT CS 29 450O 88 ' ~
1 1 ./^ CS 4636718 SOUP, CHIX NDL TFF RTU POUCH 4/8 LB CLSC TUREE CS 48. 6400 48' ~~
1 1 v/ CS 6153027 BROW#IE, C$ C 2. 5 Z UNSL BKD 40/2. 5 O2 OREQ CS 41 �5500 41 � "`
** PROD8CT!CLASS RECAP **
TOTAL DRY PIE 11 I�ENS SHIPPED' 7 326
TOTAL REFRIGERATE8 p ----- SHIPPED: "^
��� 3 ITEMS SHIPPED: 3 45
TOTAL FROZEN P --- - - -- ' � "'
�� 13 ITEMS SHIPPED: 6
-__-__-_______'__ .......... ..... .......... ...... --___-_
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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
10/12/12 2334084 Fall Frolic supplies $ 92.78
10116112 2431588 Concessions $ 65.20
10/23/12 2654982 Fall Frolic food 29105 $ 643.21
10/26/12 2785706 Concessions 29129 $ 845.19
Total $ 1,646.38
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.
353824 U S FoodService, Inc. Allowed 20
Box 660088
Indianapolis, IN 46266-0088
In Sum of$
$ 1,646.38
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. 4CCT#/TITLE AMOUNT Board Members
Dept#
1091 2334084 4359000 $ 92.78 1 hereby certify that the attached invoice(s), or
1095-1 2431588 4239040 $ 65.20 bill(s) is (are)true and correct and that the
1091 2654982 4359000 $ 643.21 materials or services itemized thereon for
1095-1 2785706 4239040 $ 845.19 which charge is made were ordered and
received except
15-Nov 2012
A
kk&
Signature
$ 1,646.38 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund