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221279 06/18/2013
"*F 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: $1,456.49 ToH,`o INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 221279 CHECK DATE: 6/18/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1095 4239040 354127 353 . 93 FOOD & BEVERAGES 1095 4239040 566539 1, 102 . 56 FOOD & BEVERAGES INVOICE Page 1 of 2 ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED 90569922 354127 05/24/2013 90569575 29826 1054 62 05/23/2013 FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS 874903 NET 30 DAYS 5191 ENTER OFF OF 111TH STREET!!! BILL TO SHIP TO REMIT TO CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc. 1411 E. 116TH ST 1235 CENTRAL PARK DRIVE E BOX 660088 CARMEL, IN 46032 CARMEL, IN 46032 INDIANAPOLIS, IN 46266-0088 ATTN: MICHELLE COMPTON Dept.:0 (800)428-2118 (000)000-0000 (317)843-3873 SHIPPED FROM: 12301 CUMBERLAND RD,FISHERS,IN DRIVER NAME: George Roach ROUTE NUMBER: 5191 SHIPPED DATE: 05/24/2013 DRIVER ID: 3229623 STOP NUMBER: 5 INVOICE LINE DETAILS QUANTITY SALES I PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED ORD SHP ADJ UNIT NUMBER UNIT PRICE PRICE DRY 2 2 0 CS 5328885 BASE,BF FLVR SHLF STABL JAR HARVEST VL 1211 LB B CS $33.5000 $67.00 2 2 0 EA 6210777 CANDY,KIT KAT VNDG STD 1.5 Z KIT KAT 36 EA EA $25.9400 $51.88 1 0 0 EA 8053126 CANDY,RESES PNT BUTR CUP REESE'S 36 EA $0.0000 $0.00 FROZEN 5 5 0 CS 2011278 PRETZEL,KING SOFT BKD FZN SUPR PRTZL 50/5 OZ CS $34.4000 $172.00 2 2 0 CS 5741178 BUN, HMBGR 4"SLCD TFF BKD FZN HILLTOP HR 10/12 EA CS $28.4000 $56.80 PRODUCT CLASS RECAP PRODUCT CLASS TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL ITEMS TOTAL WEIGHT TOTAL EXTENDED ORDERED SHIPPED ADJUSTED DELIVERED SHIPPED SHIPPED PRICE DRY 5 4 0 4 2 30.76 $118.88 FROZEN 7 7 0 7 21 109.75 $228.80 DELIVERY SUMMARY TOTALS 12 11 0 11 4 140.51 $347.68 Page 1 of 2 INVOICE Page 2 of 2 ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED 90569922 354127 05/24/2013 90569575 29826 1054 62 05/23/2013 FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS 874903 NET 30 DAYS 5191 ENTER OFF OF 111TH STREET!!! DELIVERY SUMMARY AS SHIPPED DELIVERY AMOUNT $353.93 Product Total Adjustments $0.00 Total Charges Adjustment $0.00 Total Allowance Adjustment $0.00 Sales Tax Adj: Rate:VAR $0.00 TOTAL ADJUSTMENT 0.00 DELIVERED AMOUNT $353.93 INVOICE SUMMARY Product Total $347.68 FUEL SURCHARGE $6.25 Sales Tax Rate: 0.00 $0.00 PLEASE REMIT THIS AMOUNT BY 06/23/2013 $353.93 CUSTOMER ACCEPTANCE Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a) 1-1/2%per month or(b)the maximum rate that the customer may lawfully contract to pay,and in all events calculated in accordance with applicable law. Purcha 4lon 4 D�script;on P.O.# _MM�St�J p P or� ff Li '71 I_l1c^Le-sCr Purchaser Date Approval Data CUSTOMER SIGNATURE: natalie miller SIGNED AT: 05/24/2013 12:52 PM(UTC) We appreciate your business.Please visit our website www.usfood.com for a fast and easy way to order. Or contact customer service at: (877)583-9659 Page 2 of 2 ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES --DATE- D AT'E fti O, NUMBER LOC . -- REP ORDERED - -90569922 0566509 05/71 /i3 9G569575 29859 1054 0062 05129113 Routs: 5282 ' / '? - - - - f_'JRDER-- NUMBER: -I.3E30086 Bi II �.�__. � �_ _ _M. , w_ �_ �;!7'i I] W�._.._..w_...:_:. _._._.._._. ___ __ __ r c f1's i''t -_•-•.--�_____�_ .,� _ _ - _M,__ P�RtS&R ECRE -'US rbads, 'Inc .tLA` `ARCr° REfiRE^7 CLAY f To: - 1411 Ez 116TH ST' Aw--1235 CENTRAL- PARK DR J:VE --I - To: - -- - - -- - - - - - - 1 t�1X 660_. _ - - CARME:L.. - - " -:Iii - CARMEL_ I!�- .. _ .._ .. - 3 68 46012 4•'032 - - - 4.6032 v " _.. - - - - INDIANAPOLIS; rN - 31 7 843 3873 - - - -- 46266-0088 At 1;: - - - DEPT # 0 - 800 428 -21 1 9 f •`t`Jlp rm7 12301 -CUMBERLAND -RD- -_-TISHERS----- - IN S.igip& -05 3"1 11 - =-- -P;:age 02 of 02 PU firms: NET 30 DAB'S - 7 �•tJ��r : — dt'y qtV -- Sales--Product- - Descripton- Site - Label- C -Weight -Pricing -. .. . Unit Extended Order��!d Shipped Unit- tlt.mber - - _ - ._.. .. - ... D- _. -Unit -. Price -Price- FUEL - - -- -- - - _ - _- - - - SURCHARGE 7-- ... 6. 25 . TOTAL. WGT SHIPPED: ?02. ?9- - PIE E$ ORDERED 08 PIECES- SHIPPED: 28 ITEMS-S!°}IP.PED: - 15 PRODUCT TOTAL - - 1096. 31 Ci"iF$i'�OW 1Q5 1 - - - - - H SALES i iTAX 0 0 u 00 7A • t --This afvrn;t nt- is 3?i -e-s'ti I;ate" At -time of-shipping prior to "zany adjustments rude at`deliv i°y: - t 1102. 0n Purchase --__._._.__.. - - - Description - - - -- - - - --- Lirie escr - '- -- - --- _ - - JUN- 0 3 2013 -- - - - - - Purchaser - .._.._ ---Date - - - - - - _Approval ME-R E ORDER :ALES SALES D� ° E AcCCL?iti1T 7 � J7cr 7:ltiJUT ;[ - i1:� O NO - -p1Ei_ .... . DAB TE- - - -l�U. r�IIJ!`iLRI I� ---1 OC . R-EP : - - OP%-E) R-=r� 9056§`7'22- 0.5566 x`:59-- (� '� .:f:I.-.: r : . . r 7. 4 %� Est _' - - - - - - - - ---,Route-: 52 "�--- - B a:-1-1 �_ ��___ _._�__ _ -_ _ _.��_ _ �- - __� _._. _ _ __ - _ NHL / -O •I�i - SSUU�3cS_ CAR ME L. f°ef�'.I.._)=_ R L RE-AT (J� � C� t{��r- T`T1E . - --f"� � v7....r�!{_.. .1±GF2�EAT __ ..�_.._ .�� AF�h'I1WL. �'�,,.Wr�'tf 'e AFi4�'"7�.:{�'�'�..• - - - -- To: 1-411 E. 116TH ST To: 4235 GENITRAL FSr34`!; DR-1-V 1_:-- Tv. - - _ , . ... - -- - --C-ARI°"I1^L- - hI--- - - 60:31WL 11J - ; �. 41.603 - - - - -:tI�IL�IAI!t�SPC3Ll'5... I-1�1..: t :'317 843 -4t1, 6--C)C?I3I3 c3 i3 U 4 c.'S 2-118 _.._.._._..._...._._.________.._.._._.._� r r; r: 12701 -CU1YlBERLAI'Z RD F-ISF-11=R5� t1�1 iii: ,,rr. . U"�. �3i-11:i - Page 01 o-f 02 pvtTrM'S": POET 30 0 4,V Qt:t -Product- Descr ip-tgyi -. - - Pack e La,be1. C - -Weig1-,•t -Pricing .. Unit Extended Ordered Shipped Uni.�t Humber u _. _.. _ _. D Unit Price F'r4re t,sc 2404: 25 13LO E, �• -j,X, r r' 1^ .1 � i ' 2 i 1 1. :_. - � ' I`'C7LY L.� TL7 Ah'lE�l�x i1�r1.uQ I:�A IUhlG7t"ar':ia1°I C - CS � ?. 5"�u{i � � 1. b:_ 4 R ;" ?c'�oc3 ?C�o >f�Il1': i i_Y; !' i:L!�� TNSLT -F'LST 5/106 EA fli:IhlOGRAN I S 1t}-�.-f 800 1D` . 6�? 1 1 -=_S 3•0''?4700 ✓ YRUP. FONTN GFHRY ICE CAP -F'L,ST4/1 :Girl - L-Y ONS 41AG -CS 4' '2t 00 1 47.1E I .' CS 42tS0.}3L? AUI E, C k3S 1'1ACIi0 SHI_F i!i ?!. I1:r ? OZ UR'i" CYA C 3 �34. 9500 1i} . 9r� 1 1 1 C + 8312'71 ✓:,'YR(JF', -FONTN RSF` RLU ICE -CAF'- 4/1' GA L'EONS I' AG- CS 45. 4800 45. 48 { 1 1. C'S 96696-n ,�{{ _ R(`U 14-IT W/ OIL a SAL.T3 t ICS OZ ``A IC'Y f ARN -CS -�6-. 610 26. 6 ��1"'�1F`I.{'}1-'{I'-1r r cx ..r r t�ri_ i i' �. � 1- 1 1 CS 9.139 09I3 ✓iY1zI.1F', FONFti LINE ICE CAF'J'LST4;`1, GA t_YONS I"IAG - ' CS 44. 3400 44. 34 "S ? CS 94636Si3 ,/iiTF', 1'OR'rI A COF:!+I Y!._lJ Rh1ii :'' 1..:1s �� F'ASAUO - --' C5 ? i. 4000 47. 80 i w .. --RE:.FRIGERATED - ! 6 a' CS 48841 51 ✓f CE CREAI°I I SIX, ;SOFT' :ARV VNL 41:°:;'2.. S-GA- -PRAIRIES FM____ -._ aS ;2. 0500 1921. 30 READY TO EAT -Plea-se Rrrfer •tca-'Re•turn F'calicu _ 1 1 CS •`_i340047- -SYRUP, FONTH 1:MN67 1.CE�-CAF' RTU 4/1.- GA _ - -LYONS MAC, - - CS ��. a50G ��. ;:j4 1 1 CS 61,64081 SYRUP;- FONTN- GRAPE- :ICE CAP I;YLJ4/1 ON LYONS IIAG- C5 43. 8100- 6 6 CS 7451354- vfCE MILK MI-X,: SOFT- SRV--CHOC 47.2/2. 5--GA F`RA1RI.E_ 'FM CS 3,3. 1500 196. 90 1 READY TO-EAT -- -PIL:vase -Refer t o--Return Pol icv Y FR07EII 2 t CS 20112713 V RETZEL,- KING-25OFT---140 F':'N 50!a, 0Z' u L13°`R F'RTIL. - GS 34. 4000 68. 80 1 1 CS .3330099 ✓'-IOT DOG; -AB -6:-16 6 -RLR -GRIL. '10 Llc PATUXENT C5 - -3:1-. 5900-- :31: 59 I :1 1 I:�r :a343 X054 �EEF-, F='i=r' IiRNCr :s ..7 F`UEc 1=1 ACIE w�3/.3 O�' - C I LI"!i 1 511:7' C:;,- X45. 66;:70 48, 66-. ��:• I='RODIJC;7' CLA`:-::'s-�•RECAP �•� ; TOTAL. DR ---.----PlECES ORDERED.- 1;i F'IF:CF.S- 311I'Ff'I.D - 10 T.;I"r.NS SHIPPED-: O- - 161.-70 OTAI_- REFRIGERATED -F'I'EG`FS -ORDERED: 14 ---F'I-EGES -SH-T.F'PED...__ -_._ :1.E4- _ . ITENS SH It.P 'ED-:. 4. .-_..... _- . 479.-56 TG'T'AI_. FROZEN _._ .- _ _.•--- P-IEC S- ORDERED: --- 4- ITf=11S _S11:-PPED: _ . . 3- --- 149_.-05 - -2013- -- ' = -- - . . 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 5124/13 354127 Concessions 298269 $ 353.93 5/31/13 566539 Concessions 29859/29726 $ 1,102.56 Total $ 1,456.49 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$ $ 1,456.49 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or Board Members Dept# INVOICE NO CCT#/TITL AMOUNT 1095-1 354127 4239040 $ 353.93 1 hereby certify that the attached invoice(s), or 1095-1 566539 4239040 $ 1,102.56 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-Jun 2013 PVj Signature $ 1,456.49 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund