215788 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE,INC
0 CHECK AMOUNT: $504.26
CARMEL, INDIANA 46032 PO BOX 660088
s� INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 215788
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 1085600 504 . 26 FOOD & BEVERAGES
ACC INVOIGE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO, NO, DATE NO. NUM8ER LOC . REP . ORDERED
90569922 1085600 ' 12/07/12 90569575 '� ' 1054 0062 12/06/12
Route: 5291 / 10 ORDER NUMBER:� 718683
8ill Ship � Remit
CARMEL CLAY PARKS&RECREAT' CARMEL CLAY PARKS&RESEAT
To: 1411 E, 116TH ST To: 1215 CENTRAL PARKDRIVE E To:
46032 4603F.
INDIANAPOLIS IN
317 843 3873 46266-0088
Att: DEPT # 00 800 428 211B ' |
�
;hipFrx � 1E301 CUMBERLAND RI) FISHERS IN Shi. D�� 12/01/12 Page 02 of 02
�rtTrm ciaI
`ytTrms: NET 30 DAYS InstK '
Qty Qty Sales Product Descriptom Pack Size . .Label C Weight Pricing Unit Extended
'rdered Shipped Unit Number ' D Unit Price Price
INVOICE SUMMARY
FUEL SURCHARGE
TOTAL. WGT SHIPPED: 187,77 PIECES ORDERED: 16 PIECES SH&PEO: 16 ITEMS SHIPPED:
PRODUCT TOTAL $ 4?8. 01
Purchase
CHARON 6. 25
Descriptio
Bud �Pt
TJ-A*rd�d1(:-MJn2,'- is an 251 of shippino,prdnto apV adjustments made at del7very: $_ "*04
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10 202
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
` NO NO � DATE NO. NUMBER LOC . REP . ORDERED
_- -_ 9O569922 1O856O0 12/07/12 90569575 �� / 1054 0062 12/06/12
�� vn _� b/ w �
Route: 5291 / 1O �r// � �~ ORDER NUMBER: 718683
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:
OX
46032 146012 INDIANAPOLIS IN 1
317 843 3873 46266-OOSB
Att: DEPT # 00 j 8 0 0 -42 E.) 2 118
WpFrm: 12301 CUMBERLAND RD FISHERS IN �it"jpD: 12/D7/12 Page 01 of 02
7rtTrms. spcja2
`ptTrms: NET 30 DAYS Instm
Qty Oty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
irdered Shipped Unit Number D Unit Price Price
i c�; -j373423 SMACK BAR, CRL COCOA PUF SS 96/1. 4 OZ GEML MILLS CS 34. 4300 34. 43
1 69 0373431 SMACK BAR, CRL CIN TOAST SS 96/1. 4 OZ GEML MILLS CS 34. 4400 34. +f!
I CS 0791616 CUP, FN 32 Z WH 25/20 EA MONOGRAM CS 35, 4300 35. 43
CS 0814541 CUP, FM 20 Z WHI 25/20 EA MONOGRAM CS 21. 8300 21. 83
IV/ CS 3256104 LID, CUP 12-24 Z BBL PLST 1000 EA WINCUP CS 16,9200 16.92
2 2 j, CS 4260238 SAUCE, CHS MACHO GHLF STABL 4/107 OZ ORTE0 CS 54. 5500 109. 0
1 0 CS 6260665 COOKIE, FUDGE STRPE MINI SS 60/2 OZ KEEBLER' CS 26. 1600 26. 16
2j CS 9463689 CHIP, TORTLA CORN YLW RMD 612 LB EL PATADO CS 24. 3600 48. 72
EFRIGERATED
I / EA 2000453 RSALAD, CHIX CRMY REF 5 LB PIERCE IR EA 26, 9900 26, 07
READY TO EAT - Please Refer to Return Palic-
READY TO EAT - Please Refer to Return Puliq�
FROZEN
1. V, CS 5741228 BUM, HOT DOG 6" HINGE SLCD TFF12/12 EA HILLTOP HR CS 31, 2400 31. 24
PRODUCT CLA88 RECAP **
TOTAL DRY PIECES ORDERED: 12 PIECES SHIPPED: 12 ITEMS SHIPPED: 101 379. 98
TOTAL REFRIGERATED PIECES ORDERED: 2 PIECES SHIPPED: 2 ITEMS SHIPPED: 2 45. 24
TOTAL FROZEN PIECES ORDERED: 2 PIECES SHIPPED: 2 ITEMS SHIPPED: 2 72. 79
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
12/7/12 1085600 Concessions 29240 $ 504.26
Total $ 504.26
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$
$ 504.26
ON ACCOUNT OF APPROPRIATION FOR
109- Monon Center
PO#or INVOICE NO. ACCT#1TITLE AMOUNT Board Members
Dept#
1095-1 1085600 4239040 $ 504.26 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
13-Dec 2012
Signature
$ 504.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund