215436 12/11/2012 I
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: $1,292.31
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 215436
ON
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 556136 298 . 39 FOOD & BEVERAGES
1096 4239039 556137 464 . 59 GENERAL PROGRAM SUPPL
1095 4239040 861796 529 . 33 FOOD & BEVERAGES
�\�COUNT IN V 0 ICE INVOICE S ER PURCHASE ORDER �ALES SALES DATE
NO� NO �ATE NO� NU�18ER /~/L LOC R�P ORDERED
9O569�22 J5�6� 3� 11�2O/12 9�569575 (7 �/ —\ 1O5� QO6� 11/19/12
. ��
Route� 2251 / 6 / «� �� ORDER NUMBER 7O3�72
--------'--------.........
'-----_ Ship --------- --'--- ;�exnit ---- - -- -- —'--- ��--------
L CLAY P & ARMEL CLAf P4RKS&RECRE4T c
�T � 2�5 CEN�R/�L PARK DRIVE E To�
T o
6C132 IN
17 843 38�3
I HELL� CQMPTON DE PT # O{} / \
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��z�fr�/n 123O� CHMBERLAND RD FISHERS 12/2O/12 Page 01 of D1
Tras� OFF OF 11iTH STREET � } �
�ty Qty Sales Product C Weight Pricing Umit Extended
)rdered S�ipped Unit Number ' D Unit Price Price
6O
42 23 8 »w;
� SAUCE, CHS NACHO SiLF STABL 4/107 OZ ORTEGA CS 52 2500 $
90�9O79 PDPCQ8N, RAW KIT W/ OIL 8 5ALT36/8 OZ FAMCY FAR� CS 26 0000 -' ' ~-
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� 2 � Cu oII27 8 F E[ L K.T.Nfj SOFT 111"D FZ# 50/5 QZ SUPFR-77L.
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_ 0 R_E R E D 3 PIECES SHIPPED:_ ~�
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Purchaser Date—
This "Ifflumnt, j.5, an r-,st:Jfri�,�te vk, tiaie of` t5h:4-.lP-!Yq ',(I avl�� adik-ist-ific.,nts afadel at dc.,livert/: 2,�
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE,.-,
NO. i%!-D. DATE NO NUM0ER LOC. REP . ORDERED
90569922 0556137 11/20/12 90569575 1054 0062 11/19/ 12
Route: 2251 / 6 ORDER NUMBER' 703374
Bill Ship Re�it F-US Foods, inc -
TO: 1411 E 116TH ST To: 1235 CENTRAL PARK DRIVE E To: BOX 66008F3
CARMEL IN
46032 146032 INDIANAPOLIS iN
0�17 843 3B73 46266-0088
Att: MICHELLE COMPTON DEPT # 00 200 428 2118
�- ------------ ... L_______-
7hipFYm: 12301 CUMBERLAND RD FISHERS IN ShipQ 11120112 Page 01 of 01
-
r t7 r x,s: Spcial ENTER OFF OF 111TH STREET ! ! !
�yt 71ms' NET 30 DAYS {nstr.
Qty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
/rdenad Shipped Unit Number D Unit price Price
_--__-_........-_--__-____....... _-_________ _... ....
DRY
7 7 CS 4243358 CANDLE, VGTV 10 NR WAX WHT 4/72 EA CNDLE LAMP CS 66, 3700 $
' ** PRODUCT CLASS RECAP **
TOTAL DRY PIECES ORDERED: 7 PIECES SHIPPED: 7 ITEMS SHIPPED: l
*** I00ICE SUMMARY
TOTAL WGT SHIPPED: 147-00 PIECES ORDERED: 7 PIECE8 SHIPPED: 7 ITEMS SHIPPED: 1
' PRODUCT TOTAL $
IN&V 2 1612 0 Z TAXABLE AMOUNT S
GEN SALES TAX %
This amount is an estimate at time uf shipping prior to any adjustments made at delivery: $
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO, DATE NO. NUM8ER LOC . REP ORDERED
90569922 0861796 11/30/12 90569575 1054 0062 11/29/12
Route: 5291 / 9 ORDER NUMBER:� 711966
8ill 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:
CARMEL CARMEL. IN BOX 660088
46032 46032 INDIANAPOLIS IN
317 843 3373 46266-008E---.�
Att:
3hipFrm: 12301 CUMBERLAND RD FISHERS 1N ShjpD: 11 /30/12 �--- --�---- Page 02 of 02
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yUrms: NET 30 DAYS Instr:
Qty Qty Sales Product Descrip on Pack Size Label C Weight Pricing Unit Extended
irdered Shipped Unit Number D Unit Price Price
�
INVOICE SUMMARY
FUEL SURCHARGE 6. 25
TOTAL lJGT SHIPPED: 211.86 PIECES ORDERED: 17 PIECES SHIPPED: 17 ITEMS SHIPPED: 13
PRODUCT TOTAL $ 523. 08
CHAR6ES 6. 2S
TAXABLE AMOUNT $ . 00
RECCEIV ED GEN SALES TAX
DEC 4 201Z
s amount is an estimate at time of shipping, prior to any adjustments made at deliverv- 0
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Description
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Punxhsmp oexo_____
Approval oate_____
ACCOUNT' INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO . NO. DATE NO NUMBER LOC REP ORDERED
90569922 0861796 11/30/12 90569575 y, �� �__7 �- 1054 006E 11/29/12
\. ��^-� / --�
Route� 5291 / 9 ` ORDER NUMBER: 711966
8ill Ship Remit
CARMEL CLAY PARKS&RECREZi CARMEL CLAY PARKS&RECREAT
T US Foods, Inc ,
o; 1411 E. i16TH ST �o� To:
CARMEL CARMEL IN BOX 660088
46032 460-32 INDIANAPOLIS 1
1117 843
Att: � } 800 428 2118
ThipFrm: 12301 CUMBERLAND RD FISHERS IN Ship& 11 /30/12 Page 01 of 02
-rtTrms '
Spcia2
OytTrms: NET 30 DAYS Instm
Qty Aty Sales Product Descrip "n Pack Size Label C Weight Pricing Unit Extended
>rdered Shipped Unit Number U Unit Ppice Price
�.
1 dig 0 DRY
445098 TAPE, THRML CASH RGSTR WHT 50 RL MONOGRAM CS 87, 8900 8789
1 1/1-S- 076SI23 LID, CUP 12-20 Z DOME W/ HOLE 10/100 EA MONOORAM CS 47. 2600 47. 26
1 G 3961505 SNACV MIX, HOT A SPICY CHX SS 60/1- 25 OZ CHEX CS 3& 1200 30. 12
3 �!!S ?08907? POPCORN, RAW KIT W/ OIL a SALT26/8 OZ FANCY FARN �:`S 2-6.0000 78.00
3 3 VCS 9463600 CHIP, TORTLA CORN YLU RMD 02 LP EL PASADO CS 24. 3600 73. 08
REFRIGERATED
READY TO EAT - Please Refer to Return Policy
1 1 V EA 2000453 SALAD, CHIX CRNY REF 5 LB PIERCE r! EA 26, 9900 26, 99
READY TO EAT - Please Refer to Return Policv
1 J CS 4800843 MILR, 2% REDUC FAT PLST REF 12/1 PT PRAIRIE FM CS 11 .3000 11. 30
I CS =0= MILK, CHOC IX LOW FAT PLST REP12/1 PT PRAIRIE Fil CS 11. 2100 11. 21.
FROZEN
1 1 AS 2011276 PRETZEL; KING SOFT BVD FZN 50/5 0Z SUPR PRTZI.- CS 32. 5500 32. 55
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 12 PIECES SHIPPED: 12 ITEMS SHIPPED: 9 417. 2e
TOTAL REFRIGERATED PIECES ORDERED: 4 PIECES SHIPPED: 4 ITEMS SHIPPED: 4 73.25
TOTAL FROZEN PIECES ORDERED: I PIECES SHIPPED: I ITEMS SHIPPED: 1 32. 55
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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
11/20/12 556136 Concessions 29194 $ 298.39
11/20/12 556137 Candles for Luminary walk 29140 $ 464.59
11/30/12 861796 Concessions 29221 $ 529.33
Total $ 1,292.31
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.
353824 U S FoodService, Inc. Allowed 20
Box 660088
Indianapolis, IN 46266-0088
In Sum of$
$ 1,292.31
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1095-1 556136 4239040 $ 298.39 1 hereby certify that the attached invoice(s), or
1096-60 556137 4239039 $ 464.59 bill(s) is (are)true and correct and that the
1095-1 861796 4239040 $ 529.33 materials or services itemized thereon for
which charge is made were ordered and
received except
6-Dec 2012
Signature
$ 1,292.31 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund