223677 08/27/2013 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: $4,691.74
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 223677
CHECK DATE: 8/2712013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 2150573 13 . 15 FOOD & BEVERAGES
1095 4239040 2671145 1, 129 . 26 FOOD & BEVERAGES
1095 4239040 2785330 3 , 057 . 80 FOOD & BEVERAGES
1095 4239040 2970137 -23 . 45 FOOD & BEVERAGES
1095 4239040 59011 514 . 98 FOOD & BEVERAGES
DELIVERY INVOICE
Page 1 of 1
ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP DATE ORDERED
90569922 2150573 07/23/2013 90569575 30088 1054 62 07/22/2013
FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
934608 NET 30 DAYS 100 ENTER OFF OF 111TH STREETM USF-PO#195825
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)643-3873
SHIPPED FROM: DRIVER NAME: ROUTE NUMBER: 100
SHIPPED DATE: 07/72/2013 DRIVER ID: STOP NUMBER: 1
INVOICE LINE DETAILS
QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
ORD SHP UNIT NUMBER UNIT PRICE PRICE
DRY
1 1 EA 8681967 OPENER,CAN MNL SIS SWING-AWAY 1 EA EA $13.1500 $13.15
Shipment Tracking 413982477636091,FEDEX
PRODUCT CLASS RECAP
PRODUCT CLASS TOTAL PIECES TOTAL PIECES TOTAL ITEMS TOTAL WEIGHT TOTAL EXTENDED
ORDERED SHIPPED SHIPPED SHIPPED PRICE
DRY 1 1 1 0.7D $13.15
DELIVERY SUMMARY TOTALS 1 1 1 0.70 $13.15
INVOICE SUMMARY
Product Total $13.15
Sales Tax Rate: 0.00 $0.00
PLEASE REMIT THIS AMOUNT BY 08/2212013 $13.15
CUSTOMER ACCEPTANCE
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a)1-112%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.
Promotional allowances,cash discounts,prompt pay discounts,growth programs and all other incentives are retained by U.S.Foodservice®and do not reduce Product Price.Product Price is defined as the
supplier,packer,or any vendor delivered cost or f.o.b unit price plus standard freight less off-invoice discounts or off-invoice allowances(i.e.,manufacturer generated discounts or allowances on particular items
for set periods of time and which are specifically reflected on the invoice).
We appreciate your business.Please visit our website www.usfood.corn for a fast and easy way to order. Or contact customer service at: (877)583-9659
Page 1 of 1
Cc -J-)
75CO e�� F
CREDIT MEMO
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ACCOUNT NUMBER CREDIT MEMO NUMBER INVOICE NUMBER ORDER NUMBER PURCHASE ORDER# SALES LOCATION SALES REP
90569922 2970137 2066041 935487 30074 1054 62
CUSTOMER NUMBER CREDIT MEMO DATE INVOICE DATE ORDER DATE SPECIAL INSTRUCTIONS
90569575 2013107123 07/20/2013 07/2312013
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
IMPORTANT NOTICE
THE PRICE SHOWN ON YOUR INVOICE MAY NOT BE NE i OF ALL DISCOUNTS,ALLOWANCES AND INCENTIVES. ANY INCENTIVE,DISCOUNT OR ALLOWANCE PROVIDED IS PROVIDED AS A
DISCOUNT WHICH MAY SUBJECT YOU TO REPORTING AND/OR DISCLOSURE REQUIREMENTS UNDER APPLICABLE FEDERAL OR STATE LAW.
INVOICE LINE DETAILS
QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
UNIT NUMBER UNIT PRICE PRICE
FROZEN
-1 1 CS 3328606 BUN,HOT DOG 6"SLCD TFF BKD HILLTOP HR 8/12/1.7 OZ CS $23.45 ($23.45)
INVOICE SUMMARY
Product Total $23.45 CR
Sales Tax Rate. 0.00 $0.00
AMOUNT $23.45 CR
CRF-DtT
Epp i oR S�lGRv Oft
tOq� - 1 - U23g0��
Page 1 of 1
ACCOUNT INVOIS-E INVOICE CUS'T'OMER - PURCHASE ORDER _ SALES SALES DATE _ _
-NO. -- 1\10,»_ _ DATE. 1_ Nio__ - NUMBER LOC . REP . ORDERED _
90569922 2671.1.45 08/09/13 13 ``0569775 36057 1054 0062 08/08/13 Route: 5282 ,! .9 __. - ORDER NUMBER: 953044 -
Ii S h i-p R e m i t
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc .
To: 1411 F. 116TH ST --To-: 1235 CENTRAL PARES DRIVE E: To:
BOX 660098
CARMEL JN -CARMEL IN
4 032 46032 INDIANAPOLIS IN
843 1873 IL
_._At t: MICHELLE COMP TON DE " U 46266-0088 0 2 2_1_�i_S
12301 CUMBERLAND RD FISHERS IN Shi pD: 08/09/13 Pace 02 of 02
spc x a I ENTER OFF OF 111TH STREET ! ! i
Pvt'lY"ms: NET ZO DAYS Ins tr:
Oty Qty Sales Product Descripton Pack Size Label C Oeight Pricing Unit Extend d
Ordered Shipped Unit Number D Unit Price Price
INVOICE SUMMARY
FUEL.. SURCHARGE 4. 00
TOTAL_ WGT SHIPPED: PIECES SHIPPED: 33 ITEMS SHIPPED: 24
3f�3. 60 PIECES S C'J�;I:)E�tED: �� �'3:IWCF.S
1 PRODUCT TOTAL 1125. 26
CHARGES 4. 00
TAXABLE AMOUNT $ . 00
GEN SALES TAX x . 00
I _
This amount is an estimate at time of chipping prior to any tad justments made at delivery: $ 1129. 0-6
AUG 13 2013-
C4�CfSSID 'ts
fly: -
a05r7 _F
'
ACCOUNT INVOICE 'INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO NO` DATE NO. NUMBER LOC. REP . ORDERED
90569922 2671145 08/09/13 90569575 36057 / 1054 0062 08/O8/13
- - _
- Route: 5282 / 9 ' ORDER NUMBER: 953044
8ill --Sh ip Remit
CARMEL CLAY PARKS&RECREAT -- - -CARMEL CLAY PARKS&RECREAT US Foods, Inc .
To: To�
BOX 660088
46032 46032 INDIANAPOLIS IN
843 3871 - 46266-0099
- '
_
Att: MICHELLE COMPTON --- DEPT. 0 00 800 428.2118
Shi�Fvm� 12301 CUMBERLAND RD' ' -- -FISHERS - ' - IN' ShipD� 08/09/13 Page 01 of 02'
F�'t7rms., l ENTER OFF OF 111TH STREET | V
P tTrms NET ]D DAYS _ _
0ty Qty Sales Product Describton----- -- '-- Pact- Size -label C Weight Pricing Unit Extended'
Ordered Shipped Unit Number - _ - _ - D . �� Unit price Price '
I CS 0791616 CUP, FM 32 Z WFIT 25/20 EA MONOGRAM CS 37. 2000 $ 37. 20
3 W CS 0814236 CUPo_ FN 16 Z WHT .20/25 EA MONOGRAM CS 17. 9900 53. 97
2 2 CS 0814541 CUP, FM 20 Z WHT 25/20 EA MONOGRAM CS 22. 9300 45. 86
1 CS 1811215 PEPPER, JLP SLCD NACHO HOT 4/t GA ELPA/GRANS B CS 35. 1100 35. 11
1 CS 2255396 CONO ICE CRM,CAKE FLAT BOTM 28/45 EA JOY CONE CS 69. 6800 69. 68,
1 (IS 3256104 LID, GUP 12-241 BBL- RLST 10DO EA WINCUP CS 17. 7700 17. 77
1 CS 4260238 SAUCEI -CHS NACHO SHLF STABL 4/107 OZ ORTEGA CS 54. 9500 54. 15
1 CS 4329397 KETCHUP, TMTO .FCY SS FOIL P& 500/9 GR MONARCH CS 15. 1600
1 CS 5605431 CHIP, MULTGRN-GRDN SALSA SS 14/1. 5 OZ SUN CHIPS CS 30. 8900 30. 89
1 'TE _ CS 5605472 CHIP, MULTGRN-CHEDR SS BAG - 64/1�5 OZ SUN CHIPS CS 30.6900 30.89
1 CS 5605522 CHIP, MULTORN ORIG -SS BAG 64/1. 5 OZ SUN CHIPS CS 30. 8900 30. 89
1 CS 6799050 CUP, PAPR_ MDU 16 Z HOT 20/50 EA MONOGRAM CS 132. 5200 132. 52
1 05 6799084 CUP, PAPR MDW- 12 Z HOT 20/50 EA MONOGRAM CS 100. 1300 100. 13
2 CS 9089079 POPCORN, RAW &IT W/ OIL & SALT36/8 OZ FANCY FARM CS 26. 6100 53-22
FROZEN
I CS 3041423 CORN DOG,- AN bN FZN 48/4 OZ STATE FAIR CS 35. 0600 35106
1 (IS 5218862 ICE CREAN SANDWICHo WNL 24/6 OZ BLUE BUNNY CS_ 17. 8400 17. 84
G) CS 5383054 BEEF, PTY GRND 3 Z ,PUB. FLAME 53/3-AZ CTLMN SLCT CS 48. 6600 97. 32
CS 5403548 ITALIAN ICE, -LMN DBL CUP-FZN 12/16, OZ CHILL CS 23. 2500 116. 25
PRODUCT CLASS RECAP
TOTAL DRY �f�cEs _6RDERED: 21 P I IE.CES SHIPPED: 22 JT I EMS SHIPPED: 18 808. 0 6
TOTAL FROZEN -PIECES ORDERED: 11- PIECES SHIPPED: 11 ITEMS SHIPPED: 6 317. 20
' -
'-- - - -
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ODDER- SALES SALES DATE
NO-. NO. DATE NO. NUMBER LOC . REP . ORDERED
90569922, 2785330 09/13/13 90569575 36063 - 1054 0062 08/12/13
Route: 2251 ! 4 ORDER NUMBER: 956301
Bill _ - - . Ship _�_ _ . _ _ ._ Remifi _ _ _ . -
CARMEL CLAY PARKS&RECREAT __.. ._ CARMEL_ -C "LAY -:PARKS&RECREAT - 4__-US Foods, -Inc .
To: 1411 E. 116TIA ST' - - _.T6 1235 CENTRAL--P-ARK- DRIVE E_ _ To: _
_ _ - _- BOX 660088
CARMEL _ - IN -CARMEL - IM
46032 _ 46032 _._-_-- ___ .. . _ INDIANAPOLIS IN -
317 843 3873 46266--0088
Att: MICHELLE COMPTON DEPT # 00 800 428 211.8
ShipFrm: 12301 CUMBERLAND RD F=ISHERS IN 6h.i;?D: 08113f13 Page 02 of 02
F"r t Triv : gip- t .2 ENTER OFF OF 111TH STREET ! ! !
f-;ttTrms: NET 30 DAYS in5tr':
�tv qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
Ordered Shipped Unit Number D Unit Price Price
# PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 32 PIECES SHIPPED: 3? ITEMS SHIPPED: 13 1001. 54
TOTAL. REFRIGERATED PIECES ORDERED. 15 PIECES SHIPPED: 15 ITEMS SHIPPED: ? 497. 15
TOTAL FRO-ZEN PIECES ORDERED: 63 PIECES SHIPPED: 63 ITEMS SHIP'P'ED: 16 1559. 11
INVOICE SUMMARY #?�
TOTAL WGT SHIPPED: 1755. 78 PIECES ORDERED: 110 PIECES SHIPPED: 110 ITEMS S!-LIPPED: 31
PRODUCT TOTAL $ 3057.80
TAXABLE AMOUNT $ . 00
GEM SALES TAX . 00
This amount is an estimate at time of shipping prior -to any adjustments made at delivery: $ 3057. 80
ConCesslons
3�oOlv3
AUG 14 20-13
#2390TV
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO, DATE NO. NUMBER LOC . REP . ORDERED
90569922 2785330 08/1.3/1.3 90569575 36063 1054 0062 08/12/13
Route: 2251. / 4. __ ORDER NUMBER: 956301 -
B i l l --- - S h i ___ ___ --- .. .__ R e rn i t -
CARMEL CLAY PARKS&RECREAT CARMEL CLAY PARKS&RECREAT _ __ US Foods, Inc .
To: 1411 E. 116TH ST _To: 12'35 CENTRAL PARK DRS-VE. E To: ' - _
_ BOX 66x0088
CARMEL IN CARMEL IN_ _
45032 _ 46032 -INDIANAPOLIS I-N
317 843 3973 __ ___ __._____. __- _ _ ___46266-0088
•
Att: MIC.HEL.L.E COMPTON - DEPT .# 00 . . . -800 428 2118
Sh i pFrm: 12301 CUMBERLAND R IN Sh i pD -08/13/13 Page 01 o-f'° 02`.,
F r t Trms: _D._._ FISHERS Sp i I. ENTER OFF' OF- 1-11TH STREET ! ! !
P v t Trm s: NET 30 DAYS In-5 t n_, _ ..
otr , qtt/ Sales Product D�.scrip'�ton Pack Size Label C Weigh-'I- Pricing Unit Extenddd
Ordered Shipped Unit' __ Number _ _- ___ _ __ ___- ___ _._- - _ -D- Unit Price -Price _.
--- - 'DRY _
V6 6 CS 0 779991- -WATER, SPRG PLST BTL TWIG-ST,`CAP24/16. 9 OZ THIRSTER CS 5. 6600 $ _ 33. 96
✓ 1. CS 0791.616 -CUP, FM 32 Z WHT 25/20 EA MONOGRAM CS 37.2000 37. 20
✓1 1 CS 0814541 CUP, F11 20 Z WHT 25/20 EA MONOGRAM CS 22. 9300 22. 93
✓8 8 CS 4260238 SAUCE, CHS NACHO SHLF- STABL 4/107 OZ ORTEGA CS 54. 9500 439. 60
�1 1 CS 4329397 KETCHUP, TMTO FCY SS FOIL PKT 500/9 OR MONARCH CS 15. 1600 15.16
✓1 1 CS 5585476 CHIP, FTATO BKD ORIG GLTN/FR 64/1. 125 OZ BAKED LAYS CS 29. 8500 29. 85
✓1 1 CS 5597604 CHIP, CHS-CNCHY PLN SS BAG 64/4 OZ CHEF-TOS CS 30.8900 30. 89
✓1 1 CS 5597968 CHIP, CORN ORIG TFF SS BAG 64/2 OZ FRITOS CS 30.8900 30. 89
✓1 1 CS 6329213 RELISH, SWT SS SHLF 'STABL 200/9 OR MONARCH CS 14. 3500 14. 35
i /2 2 CS 6805923 TRAY, PAPR BORD FOOD 5 LB CLAY2/250 EA MONOGRAM CS 31. 9500 63. 90
/2 2 CS 8355927 NAPKIN, DISPR' INFLD WHT : 5X'1024/250 EA EASYNAP CS 58. 4100 116. 82
✓1 1 CS 9089079 POPCORN-, RAW _KIT W/ OIL SAL.T36/8 OZ FANCY FARM-_ __ - CS 26. 6100 26: 61
./6 6 CS 9463688 CHIP, TOE I LA CORN YLW RND 6/2 LB EL PASADO CS 23. 2300 139. 38
REFRIGERATED
10 10 CS 4884151 ICE CREAM MIX'' SOFT SRV VNL 4/2/2. 5 GA PRAIRIE FM CS 32. 7700 327. 70
READY TO EAT `- Please Refer -to Return Pol ictrr
5 5 CS 7451354 ICE MILK MIX,'- SOFT SRV CHOC 4X2/2. 5 GA PRAIRIE FM CS 33.3900 . 169. 45
READY TO EAT --- Please Refer -to Return Policy
FROZEN
� I 1 CS 1792399 BEEF SUB, PTY, MEATL VEG 3 36/4. 25 OZ CHEFS LINE CS 46. 4600 46. 46
=�2 12 CS 2011278 PRETZEL, KING` SOFT BKD FZN 50/5 OZ SUPR PRTZL CS " 34. 4400 412.80
,/'2 2 CS 2260099 ICE CREAM SANDWICH, CKY & CRM 24/4. 5 OZ BLUE BUNNY CS 22. 9700 45. 94
✓5 5 CS 2639'235 ICE CREAM CUP, CKIES S CRM 12/`; OZ ITTIBITZ CS 12. 5504 62. 75,
,i 5 CS 2'639250 ICE CREAM CUP, CKY DOUGH 12/5 OZ ITTIBITZ Cs 12. 5500 62. 75
S/5 5 CS 2649796 10E CREAM CUB`, COTN C:NDY 12/5 OZ _ _ _ ITTIBITZ CS 12. 5500 62. 75
t/3 3 CS 3041423 CORN DOG, All CN FZN 48/4 OZ_ STATE FAIR CS 35. 0600 105. 18
✓ 5 CS 3328606 BUN, HOT DOG 6" SLCD TFF BKD 8/12/ 1. 7 OZ HILLTOP HR CS 23. 4500 117.25
6 6 CS 3330097 HOT DOG, AB 6: 1 6" RLR GRIL _ 10 LB PATUXENT CS 29. 2900 175. 74
1 1 CS 5218862 ICE CREAM SANDWICH, VNL 14/6 OZ - BLUE BUNNY CS 17. 8404 17.84
V2 2 CS 5328604 BUN, HMBGR 4" SLCD TFF BKD-FZNB/12/2. 1 OZ HILLTOP HR CS 22. 4000 44: 80
1 1 CS 5383054 BEEF, PTY GRND 3 Z PUB FLAME 53/3 OZ. CTLMN SLCT CS 48. 6600 48.66
10 10 CS 5403548 ITALIAN ICE, LMN DBL CUP FZN 121:1.6Of - CHILL CS 23, 2500 232: 50
%/2 2 CS 5444835 ICE CREAM SANDWICH, CHgC CWIP_ 24--EA _ - - GOOD HUMOR CS 21.6400 43. 28
%0011 1 CS 7175128 ICE CREAM CONE VNL TFF 2/12/4. 6 OZ BB CHAMP CS 23. 7500 23. 75
? 2 'CS 8187999 ICE CREAM BAR, CHOC -TACO- VNL24/4 OZ _ - KLONDIKEE CS 28. 3300 56.66
ACCOUNT INVOICE INVOICE CUST0i`1ER PURCHASE ORDER SALES SAL.E2, DATE
1'.O, - NO DATE +O. UMBL R LOC . REP . ORDERED
90561222 00596_V
08120V13 90569575 ,- 36084 1054 0062 OS/19/13
B i 1 1 _..___.—____.�......._._...__ _..__ _ __._ __. __ _
ORDER NUMBER: 963685
�_.._.` ARMEL_ CLAY PARKS&OEC95AT _ CARM L.__GC 4'y''_ i'W5WCREST IUS Foods; Inc
To: � 1 411 E. 116TH T 1231. QEN � RAi_.. PARK Di~I'JE E:: To: � I3 X
CAR MEL_ [N -- c AREblEL IN
' I� �I�h � 'CL l e= 03E' � _� 3' - . IN
317 843 '3b7'33 46266-0088
At t: MICHELLE C OMPTON _ DEPT #t 00 � 800 428 2.118
J> IL D I � �� : 08/"fi t 123 q6 FISHERS /13 Page 01� of 01
F- f, Trfrr.: c ._la! ENTER OFF OF 1 11TH STREET I ! :'IV
f'r't r'm : NET 30 DAYS fr7 S W
AV Qty Sales Product i encr_i__ tr,n Lab l C Weight Pricing Unit. Extended
Ordered Shipped Unit Number C; Unit Price Price
---.._.._._.._. .___..____....._..__...._..._.........._..._..._.__.__.__. .,..__._..____..._ __. __.._. _.___.__.._._..__.__._....__._.___........_-.__.__._._..._._..__._._....__..._
DRY 1
I I CS 0791.61.6 CUP, FM �)2 7 WHT✓' 2010 EA MONOGRAM CS 3'r.�}C�(;U � 37. 20
1 1 CS 0814236 CUP, FM 16. Z WH T f 20/25 EA MONOGRAM CS 17. 9900 17. 99
1 1 CS 0814541. CUP, PM 20 I.. WHT✓ � 2'5/ 0 EA � MONOGRAM OGRAM Ci 22. 9300 `'2. 93
3 3 CS 2404325 GLOVE, POLY LC TXTD AMW " 10/100 EA MONOGRAM Ii CS 40. 6200 1'21. 86
2 2 C 3256104 LID, CUP 1::.'°-24 ,:. BBL_ PLST .LOOM EA ✓ . WINCUP CS 17. 7700 35. 54
2 2 CS 4260238 `AUCE, CHS NACHO SHLi° STABL 4/107 OZ / ORTEGA CS 54. 9500 109. 90
2 2 CS 4329397 VETCHUP; TNTO FCY SS FOIL PVT 50019' GR MONARCH CS 15. 1600 30. 32
} 2 2 CS 6805923 TRAY, PAPR BOND FOOD 5 LB GLAY2/250 EA j) MONOGRAM CS .31. 9500 63. 90
2 2 CS 9463688 CHIP, TORTLA CORN YLW RHL1 6/2 LB" EL PA aADO CS 23. 2300 46. 46
'1 I CS 9954371 LID, CUP-32 Z:S T RAW SLID PVST '10/50 EA MONOGRAM C5 22.5300 22. 63
t
PRODUCT CLASS RECAP rix
TOTAL DRY PIECE_L?_ [ORDERED: 17 PIECES; SHIPPED: 17 ITEMS, SHIPPED: 10 508. 73
-INVOICE SUI"IMARY ar3t
FUEL SURCHARGE 6. 25
TOTAL_ WGT SHIPPED: 179. O8 PIECES ORDERED: 17 PIECES SHIPPED: 17 ITEMS SHIPPED: 10
PRODUCT TOTAL 508. 73
CHARGES 6. 25
3(0 $4 F AUG 2 0 2013
J 2 TAXABLE AMOUNT $Pi 00
+23��� G SALES TAX 00
This amaut is n estimate at time of shipping prior o any; ardjus-tments made at delivery: $ ;.514. 98
_ f
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
7/23/13 2150573 Concessions 30088 $ 13.15
7/23/13 2970137 Credit for short order $ (23.45)
—819L.1.3_._. ~_ _.2671145, _ _Concessions 36057 1 $ 1,129.26
8/13/13 2785330 Concessions 36063 $ 3,057.80
8/20/13 59011 Concessions 36084 $ 514.98
Total $ 4,691.74
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
120_
Clerk-Treasurer
Voucher No. Warrant No.
353824 U S FoodService, Inc. Allowed 20
Box 660088
Indianapolis, IN 46266-0088
In Sum of$
$ 4,691.74
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1095-1 2150573 4239040 $ 13.15 1 hereby certify that the attached invoice(s), or
1095-1 2970137 4239040 $ (23.45) bill(s) is (are)true and correct and that the
1095-1 2671145 4239040 $ 1,129.26 materials or services itemized thereon for
1095-1 2785330 4239040 $ 3,057.80 which charge is made were ordered and
1095-1 59011 4239040 $ 514.98 received except
22-Aug 2013
$ 4,691.74 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund