217847 02/26/2013 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: $1,058.71
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 217847
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 189578 701 . 37 FOOD & BEVERAGES
1095 4239040 2917753 357 .34 FOOD & BEVERAGES
ACCOUNT INVO IC;� INVOICE CU ER PURCHASE ORDET" SALES SALES DATE
NO. NO DATE NO. NUMB ER LOC . EP ORDER�D
90569922 O189578 O2/15/13 90569575 1054� 0062� O2/14/13
Route: 5282 / 9 ORDER NUMBER:� 7794O7
8ill ShiP Ramit
To: To: To:
CARMEL IN CARME1 IN BOX 6'008R
46032 4.6 03 2 INDIANAPOLIS I ki
31-7 843 3B73 46-66 0088
Att:
;hipFrm: 12301 CUMBERLAND RD FISHERS IN ShjpD� O2/15/13 Page O c� D2
-r ��Trms Spciai UNIFIER OFF O� 111TH STREET ! } �
/ytTrms� NET 3O DAYS Instr.
qty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit, Extended
rdered Shipped Unit Number D Unit Price Price
INVOICE SUMMARY
FLU.- SURCHARGE 6;.12 115
TOTAL WGT SHIPF'El): 23 2.8 0 PIECES ORLDE-RED: 2 0 SHIPPED,: 3.9 ITEMS SHIPPED 13,
PRODUCT TOTAL $ t'%95. 12
CHAR.6ES 6. '25
GElq SAUS TAX . 00
This amcunt, is an estimate at tifne crl shipping py-jor, -to any adjustments made at deiivey.y: $ 70.1. 3 7
Purchase
P.O
Bud t
Line c
Dato_____�
Approval Date___'
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO NO. DATE NO. NUM8ER LOC REP ORDERE
�/ D
O569922 O1B957B O2/15/13 9O569575 1 �
O54 OO62 O2/14/13
Routei5282 / 9 ORDER NUMBER�� 779407
Bill Ship Remit '
CARMEL CLAY PARKSORECOEAT CARMEL CLAY PARKS&RECREAT US Foods, Inc .
To: 14.11 E. 116TH ST To: 1235 CENTRAL PARK DRIVE E To:
CARMEL BOX 660088
46012 IN CARMEL IN I
46032 INDIANAPOLIS IN)
317 843 3873 Att: '
,hipF'rm: 12301 CUMBERLAND RD FISHERS IN Ship& 02/15/13 -�- Page Of of 02
-rtTrms �
� Spcial ENTER OFF OF 111TH STREET! ! !
`ytTrms: NET 30 DAYS lnstr.
Qty Aty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number D Unit Price Price
DRY
4 IV/ P54 11260238 SAUCE, CHS MACHO SHLF STABL 4/107 OZ ORTEGA CS 54,6200 218. 48
1 J/, C9 5402540 SPONGE, W/ SCRBR NYLON CELLU 20/1 EA MONOGRAM CS 24.�`'?00 24.59
1 1. CS 9341223 CREAMER, HALF a HALF UHT DARY 360/. 375 OZ GLNVW FRNS CS 17. 2500 17. 25
2 2y CS 9463688 CHIP, TORTLA CORN YLW RND 6/2 LB EL PASADO CS 24. 3600 48- 72
REFRIGERATED
CS 0654301 HUMMUS, GRLC RSTO MONDARY REF 12/4. 56 OZ SABRA CS 23. 7500 23. 75
READY TO EAT - Please Refer to Return Polic
READY TO EAT - Please Refer to Return Polic
1 00 CS 7197775 YOGURT, ASST BLNDED LOW FAT 12/6 Q TOPLAIT
FROZEN
2 CS 2011278 PRETZEL, KING SOFT BKD FZN 50/5 OZ SUPR PRTZL CS 32. 5500 65. 10
1 //v
CS 2372928 CHILI, W/ BEAN HEAT & SRV QN 4/5 LB WHITYWNDSR CS 55 ?700 55-0
2 2 CS 33300?9 HOT DOG, AB & 1 6" RLP GRIL 10 LB PATUXENT CS 29. 4500 52. 01()
1 R/ CS 6153027 BROWNIE, CHOC 2. 5 Z UNSL BkD 40/2. 5 OZ OREO CS 41. 5500 -41. 55
PRODUCT CLASS RECAP ** I
TOTAL DRY PIECES ORDERED: 11 PIECES SHIPPED: 11 ITEMS SHIPPED: 7 429. 32
TOTAL REFRIGERATED PIECES ORDERED: 3 PIECES SHIPPED: 2 7ENS SHIPPED: 2 44. 2a
TOTAL FROZEN PIECES ORDERED: 6 PIECES SHIPPED: 6 &ENS SHIPPED: A? 221. 52
-�
� � � `
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SA ES SALES DATE
9Omu6q22 2qNO�53 02/0S/ lb q 5 NUMBER L C� REP . ORDERED
-- � ^ ' ' ' ~~' ��or�/ 1054 0062 O2/O7/13
Route� 5/82 / 9
B� ll Ship P it �ORDER NUM8ER� 773074
1411 E. 116TH ST Rem
To:
/ o� To:
�
� 46032 IN
46032
� INDIANAPOLIS
Att: MICHELLE COMP-['01pi 317 e43 3073 46266-0088
12301 CunuE:L*mu RU FISHERS IN Ship& 02/08/13 Page 02 of 82
. . ,^~ Spcial ENTER OFF OF 111TH STREET! ' '
rrms � NET �O DAYS
I , _ � Instr.
� qtyred ShQtyed Sales Product Descriptou Pack Size Label C Weight Pricing Unit Extended
' ' _- H_--^' D Unit Price Price
QVGICE SUMMARY
FUEL SURCHARGE
TOTAL LJGT SHIPPED: 08. 35 PIECES ORDERED: 16 PIECES SHIPPED: i4 1TEMS SHIPPED: 12
PRODUCT TOTAL
CHARGES
TAXABLE AHIOUI--ff I.
GEN SAVES TAX
This amount is an estimate at time of shipping prior to any adjustments made at deliverV: 357, 34
Purchase
-.PorF FEB 13 2013
n�#
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Date-
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ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES
DATE.
i'111 , NO DATE NO N }�IER LOC. REP ORE
D
90569922 2917753 02/08/13 90569575 3/( �U 1O5/ DD6� O2/07/ 1
3
* t 52b2 9
Rem� ORDER NUMBER 771074
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc .
� ill Ship t ��
To: 1411 E. 116TH ST TO: 1235 CENTRAL PARK DRIVE F Tod
BOX 6600e,�4
46032 146032: !NDIANAPOLIS
317 843 3877 46266-OOeO
Att: MICHELLE COMPT01,4 IDEPT 00 800 428 2118
;\ipFrm: 12301 CUMBERLAND RD FISHERS IN fNipD: 02/08/13 Page Of of 02
'WtTr
ms� Spcial ENTER OFF OF 111TH STREET! ! {
`ytomw NET 30 DAYS instm
Aty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
rdered Shipped Unit Number D Unit Price Price
DRY
/ 1 CS 0814541 CUP, FM 20 Z WHT 25/20 EA MONOGRAM CS 22. 9300 $
1 CS 5429303 JUICE, ORNG 100% PET PLST BTL 24/10 OZ THIRSTER CS 20.8600 -- ' -
1 CS 5597851 CHIP, T8RTLA NACHO CHS TRGLE 64/1. 75 OZ D8RITOS CS 30. 8900 -' --
2 2^/ CS 9089079 POPCORN, RAW KIT W/ OIL a SALT36/8 OZ FANCY FARM CS 26.6100 30. 85''
1 1� CS 9463688 CHIP, TORTLA CORN YLW RND 6/2 LB EL PASADO CS 24� 3600 ^� ^�
REFRIGERATED
1 1,t CS 0654269 HUMMUS, RSTD RED PPR NONDARY 12/4.56 OZ SABRA CS 23. 7500
READY TO EAT - Please Refer to Return Policv -- ' -
1 CS 065430 1 HUMMUS, GRLC RSTD NONDARY REF 1214. 56 OZ WRA
READY T5 EAT - Please Refer to Return Policv
1 ^� CS 4800843 MILK' 2% REDOC FAT PLST REF 12/1 PT PRAIRIE FO CS 11. 4500
1 1v' CS 4800884 MILK, CHOC 1% LOW FAT PLST REF12/1 PT PRAIRIE FM CS 11 360O ^^ �
^^ ^^ ~
l 1 CS 53322�2 LETTUCE ICBRG SHRD 1/4" CLND 4/5 LB CROSS VA�Y B �- ��� �--- �
~ , � �� �. �^�00
READY TO EAT - Please Refer to Return Policy ' �-
1 CS 7197775 YOGURT, ASST BLNDED LOW FAT 1216 OZ YOPLAIT
FROZEN
2 .2vK CS 2011278 PRETZEL, KIM SOFT BKD FZN 50/5 OZ SUPR PRTZL CS 32.5500
1 1"t CS J041423 CORN DOG, AM CM FZN 48/4 OZ STATE FAIR CS 34. 6300 -- --
5741228 BUN, HOT DOG 6" HINGE SLCD TFF12/12 EA HILLTOP HR CS 12. 0100 ^- ""
** PRODUCT CLASS RECAP **
TOTAL DRY PIECES ORDERED: 6 PIECES SHIPPED: 6 ITEMS SHIPPED: 5
TOTAL REFRIGERATED PIECES ORDERED: 6 PIECES SHIPPED: 4 ITEMS SHIPPED:� 4 ^~^ ^~
TOTAL FROZEN PIECES ORDERED: 4 PIECES SHIPPED: 4 ITEMS SHIPPED� 3 131. 74~ � /
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
2/8/13 2917753 Concessions 29441 $ 357.34
2/15/13 189578 Concessions 29453 $ 701.37
Total $ 1,058.71
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$
$ 1,058.71
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
Po#or Board Members
Dept# INVOICE N0. ACCT#/TITLE AMOUNT
1095-1 2917753 4239040 $ 357.34 1 hereby certify that the attached invoice(s), or
1095-1 189578 4239040 $ 701.37 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
21-Feb 2013
Signature
$ 1,058.71 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund