224156 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 353824. Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC CHECK AMOUNT: $4,771.81
CARMEL, INDIANA 46032 PO BOX 660088
`? INDIANAPOLIS IN 46266-0088
.o CHECK NUMBER: 224156
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 254029 1, 084 . 93 FOOD & BEVERAGES
1095 4239040 284101 3 , 686 . 88 FOOD & BEVERAGES
ACCOUNT INVOICE INVOICE CUSTOMER MER PURCHA aE ORDER ,'`.3tAL•.ES ;ALES DATE
NO. !'�O. S..ATr'.'. _NO. r!UMBER -_ 1._OC: . REP . ORDERED
70569922 0284 101 08/27/13 90569S7.S 361_L6 :i.�54 __0062 08/26/13
Route: 22Si. . r 4 _ ORBER_-NUMBER: 971552
CARMEL_ CLAY PARK!••S&RECREAT CARME6_ Cl._AY t'AR�iSt<RECRT AT US Foods, Inc .
To: 1411 E. 1. 1.6�TH ST To: 123S . CENTRAL PARK DRIVE To:
` Bean, 66008
I
C/tARt•�MEL IN LAR1�Il ,L I1�1
4603x`"•..?^f (�46C3.'3c INDIANAPOLIS IN
31'r S. 43 3873 46266-0088 �^'}
Att: MICHL:.LL_rIE COMP TON � DEPT # 00 800 428 211B
ShipFrm. 123071 CUMBERLAND RD F1SHE:RSS IN ShipQ 108/2:7'/1:L.3Z ' T Page 02 of 02'
Fr�tFrn?•�: �-y ''F?r:I.�I ENTER OFF OF 111TH STREET ! ! !
P 6�t Trm s: NET ..30 DAYS F'n s W'? ..
0t+,: {Flit/ Sales Product De:-•crip_ on Pack Size L.abea? C Weight Fricina Unit 1_`.xtenide
Ordered Slipped Unit Number D Unit Price Price
W.._._._.__._........___ _.__.___._._, . _ ...._____.__._..._._._._.__.__. ____._____......
.____..._._._.____._._....__.____.._..._._..._....__
117 CS S4030S - ITALIAN ICE, .i_.MN DBL. CUP FZN 12/16 OZ CHILL. CS 23. 2500 23250 s
5 CS E40483S ICE CREAM SANDWICH, CHOC .CHIP 24 EA GOOD HUMOR CS 21. 6400 108. 20 '
✓5 a 08 7175128 ICE CREAM CONE, VNL. TFF /12/4. 6 OZ BB CHAMP Caw 23. 7500 i18 3S �
i ` 10 ifs CS 0187999 ICE CREAN BAR, CHCIC TACO & VNL24/4 OZ KL.ONDIKE CS 28. 3300 2133. 30
PRODUCT CLASS RECAP *
� TOTAL DRY 1 PIECES ORDERED: 49 PIECES SHIPPED: 48 ITEI'1.a SHIPPED: 2..� 14Y�•. 4tr
i
TOTAL 1;'nsj:�EN PIECES ARDEf ED: E=li PIECES SHIPPED: 3f ITEMS SHIPPED: 12 221:3. 48
•ttu••u• IhIVLJIC;E .5111`!!°iAEtY ��•�
TOTAL WGT SHIPPED: 1:382. 94 !-NIECES ORDERED: 130 PIECES SHIPPED: 129 ITEMS SHIPPED: 37
3
('EiCIDL1e..1 TOTAL 'N 3706. aS
r , ALLOWANCES w'u. OOCR
1
TAXABLE AMOUNT
GEN SALES TAX . 00
1
This amount is an estimate at time ref • hipRi.ng prior to any a�i jwtments made at delivr_.•art/: 3686. 8
W UtTs ICTY�S.
-ECEWED
F G 28 2013
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NO. DATE NO, NUMBER LOC . REP . ORDERED
90569922 02841O1 08/27/13 90569575 36116 1054 0062 08/26/13
Route: 2251 / 4 ORDER NUMBER: 971552
8ill Ship Remit
CARMEL CLAY PARKS&RECREAT I I CARMEL CLAY PARKS&RECREAT - US Foods, Inc .
To: 1411 E. 116TH ST To: 123S CENTRAL PARK DRIVE E To:
BOX 660088
46032 -4603E 843 3273 - INDIANAPOLIS . , IN
--
Att: MICHELL F C 0 MPTO N DEPT DO S06 42B 2118
Sh ipFrw 12301 CUMBERLAND RD FISHERS` - IN Ship&- 8 -27/1�3. __--_ - Page 01 of 02
Fr tTrms�' ' - - - ' 2 ENTER OFF _OF' 1 1 1TH STREET ! ! '
p tTrms: NET 38 DAYS Instr: --
Qty Qty Sales Froduct - ' '-Descripton- '_. -_.__--_Pack_Size_ ---Label C_-Weight. Pricing Unit Extended
Ordered Shipped Unit Number D ___ ' Unit Price Price
qqjj DRY
2 2 CS 07 WATE0 _SPRG PLST BTL TWIST CAP24/16. 9 OZ THIRSTER CS S. 6600 $ A. 32
I CS 0791616 CUP, FM 32 Z WHT 25/20 EA MONOGRAM CS 37. 2000 37. 20
CS 0814236 CUP, FN 16 Z-WHT 20/25 EA MONOGRAM CS Q. 9900 35. 98
CS 0814541 CUP, FM 20 Z,WHT 2S/20 EA MONOGRAM CS 22. 9300 22. 93
I CS 1462803 SPOON, TEA NU WHT POLYP BULK 1000 EA PRIME CS 14. 0700 14, 07
VJ 1. CS 240432S GLOVE, POLY LG TXTD AMBDX 10/100 EA MONOGRAM B, CS 40. 6200 40. 62
v/4 10
I EA 3OS3808 STRAW, jMB 7. 7S" TNSLT UWRPD 250 EA DIXIE P. EA 2. 29C 2. 29
8 CS 4260238 SAUCE, CHS NACHO SHLF STABL 4/107 OZ ORTEGA CS 54. 900 439. 60
i CS 5329289 MUSTARD, YLW .S8 5. 5 GR SHLF 500/5. 500 GR MONARCH CS 12. 9800 12. 98
I CS SS97851 CHIP, TORTLA NACHO CHS TRGLE 64/1. 7S OZ DORITOS CS 30. 8900 30. 89
VVI I CS 5S97968 CHIP, CORN ORIG TFF SS BAG 64/2 OZ FRITOS CS 30. 8900 30. 81?
I CS 5601679 CHIR, PTATO REG -PLN SS-BAG 64/1S OZ LAY'S CS 29. 8500 29. 25
I CS 5605431 CHIP, MULTORN GRDN SALSA SS 64/1.S OZ SUN CHIPS CS 30. 8900 30. 89
I Q 56054?2 CHIP, MULTGRN- CHEDR SS BAG 64/1. S OZ SUN CHIPS CS 30, 8900 30. 89
I CS 560SE22 CHIP, MULTGRN-ORIG SS BAG 64/1. 5 OZ SUN CHIPS CS 30. 8900 30. 59
I CS 6329213 RELISH, SWT SS, SHLF STARL 200/9 GR MONARCH CS 14. 300 14. 35
/2 2 CS 6BOS923 TRAY, PAPR BORD FOOD 5 LB CLAY2/250 EA MONOGRAM CS 31. 900 63. 90
1 C5 7002988 SAUCE, CHILI -HOT .DOG W/ BEEF 6/108 OZ CHEF MATE CS 67. 8200 67. 82
0 EA 8914855 STRAW, JNB 7-75" CLR UWRPD ST000 EA MONOGRAM B
3 CS 9089079 POPCORN, RAW VIT U/ OIL & SALT36/8 OZ FANCY FARM CS 26. 6100 79. 83
0 10 CS 9463688 CHIP, TORTLA ZORN YLW RND 6/2 LB EL PASADO CS 23. 5700 235. 70
vy i i CS ?9S4371 LID; CUP 32 Z STRAW SLTD ,PLST 40/0 EA MONOGRAM CS 22. 6300 22. 63
FROZEN
60 10 CS 2011278 PRETZEL, KING-SOFT BKD FZN So/S. OZ SUPR PRTZL CIS'' 34. 4000 344. 00
S 5 CS 3041423 CORN DOG, AN ON FZN 48/4 OZ STATE FAIR CS 35. 0600 17S. 30
to to CS 3328606 BUN, HOT DOG 6" SLCD TFF BKO 8/12/1. 7 OZ HILLTOP HR CS 23. 4500 234,S0
1/10 10 CS 3330099 HOT DOD, AD 6: 1 ,6". RLR GRIL 10LB PATUXENT CS 29. 9700 299. 70
YOUR POWERBUT SAVINGS 20. 00--
S 5 CS S218862 ICE CREAM SANDWICH, VNL 24/6 OZ BLUE BUNNY CS 17. 8400 89. 20
3 3 CS S383OS4 BEEF, PTY GRND 3 Z PUBOFLAME S3/3 OZ CTLMN SLCT CS 48, 6600 14S. 98
`
,
ACCOUNT INVOIC INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NOS ;7NO. DATE NO. NUMBER LOC. REP. ORDERED
use 905569 R 025WOP-9 U3/ ,. /x °�Ci> "- / 1054 0062 08/26/13
FOOM �
C DELIVERY ROUTE:
BILL CARMEL_ CLAY PsLaRKt`-s�RE(�q,`.f--A;` SHIP CAF`ZMEL. �'...`1..AY PARKhar.r. REA MIT Urr �'Dt ds, �:r'iC .
TO:. 1.411 E. 1 16TH ST TO: 1 235 CENTRAL- PARK DRIVE E TO: 660088
C P'0RMEL. , Ct�rPK41EL IN
46032 46032
IN
317 843 3873 /--16266-0088
ATT. MICHELLE COMPTON DEPT # 00 � 800 428 21q. 3
SHIPPED FROM: 1 C}"1 CUK�KC3 RL.r�K\f✓} P1} K 1 K� P n 1 ` : OCi/c: ,d'1) K�i�tre.
SHIP DATE: ° 1Q G r t
FREIGHT TERMS: _ SPECIAL C U 4°t o G T' t..p i 1 T3 U
PAYMENTTERMS: NET 30 DAYS t � INSTRUCTIONS: �
CITY. QTY. SALES PRODUCT p Wb PRICING YN1 EXTENDED
ORDERED SHIPPED t� UNIT NUMBER DESCRIPTION PACK SIZE LABEL E WEI�WT;- .�N�T--- 'PRICE PRICE
_. 1-4 Y
3 - 3 CS 42602-38 sAU , , CHS NAC,HU SHLF STAi L 4/107 OZ ORTEGA CS ,54:9500 1.x,4.5.
�. r f?89(?? f'OK sN, F;'AW -K�`TT W/ OIL A SALT36/3 02 FANCY K°AK"M CS 26,6100 ... `o. 6
- CS__ ' K S 6C3U. Cif: r� TORTLA CCKFtK�K-YLW RNE) 6/" LB EL. PA ADO C5 23.:17{D� 70. 71
FR'ZKSKd
1 CS 1792399 BE 17 ',SUB, PTY MEATL VEC 3 36/4.25 OZ C4 F'S LINE CS 46.4600 45. 46
sa LS 2(J11278 F'ftET cLs K4.T.Kd `SOFT B14D F'7N 50/5 Oz ^aK,�PR PRTZL taS 4.�t?00 tai;Si:
- 2 C S 22AOO?9 ICK� ,t��:EAM SANDWICH, C`KtY �& CRM 24/4.5 CZ BLUE BUNNY t113 ''_2.9700 4�':.��
3 3 C S 3325646 BU` }q"�yHOT 006 ba` SLCD JTFF BkD 8/1'2/1. i OZ HILLTOP HR CS 23.4500 70 -35..
"3" _tS 334 D99 HCK �JCj a K3 &: 1 b,,r PLfw L�K EL 1t L P"ATCK}�ENT CS "'9.9700 5+x:9
- - - ._ -" YO -Pr4;�3JK:K�BU SAVINGS 6.00-
2 _2 . - CS 521'886 2 ICE 'REAM 9.Ah DWICK;I, , HL 24/6 OZ BLUE BUNNY CS 17,8400 - 35. 68
3 3 C9. 5:383054` 1', PTY #�trND 3 Z PUB FLAME 53/3 OZ CTLMN SLCT>. CS 40.66tN 145. 92
4 LS a4G�iS S ITA[ 'AN ICE, K.,.K'M DL;L. CUP FZN 1.;x/1.6 OZ CHILL CS 23.2500 K' 93-'00 ,-
? 2 CS - 54� 483;) --l-GE `REAM'. Sl-tE�DUICH., CHOC CHIP' 24 EA GOOD RiK.KK�KOR CS 21.x"7400 4;a;`;2-8
3 3 'S 5 41175 ��3.JN, FPM GR 4" i>L(,) TFF _IIK<D F'Zhl10/12 E:A HIL.L.TOP HF CS 2C3, �zt}(4�Gq� S5,2/0
2 2 CS `71:75128 ,-T:CE REAM CONE, VNL TF F 2/12/4- 6 OZ bB CHAMP CS 2 3. :7500 di e1.. 50
2 2 GS 81.37979 wE FiF�1K"K Dr�K�, K KKtTC 7`t�CC1 � VKtKL24:'4 OZ- KCLCKrKi�Z`K;E US` 28.;3300 56 66
** INVOICE CaK.IK'1i(�}ARj1y` ( ( {_ ORDERED;�y Jy pL PIECES
.
TOTAL I IPPE +: d1"C?4.,91 PIECES "A.,RLTP:RED; 36 PIK.�rE a"ti. SHIPPED: - 36 _
IrKOK7C,tCT 1090.93
RRC ALLOWANCES 6.0 CR
�2
AUG 28 2013
TAXABLE Ai"KC3UKdT- ' 00
BY GK;N SALES TAX . 00
PLEASE REMIT THIS AMOUNT BY 09/25/13 �t#�C�'UNT' � 1{ K3 . "t3
1
The perishable agricultural commodities listed on this invoice are sold subject o the statutory trust auttwrized d, tlon5(;)otthe Visit www.ustoods.com for a fast and easy way to order.
Perishable Agricultural Commodities,Act,1930(7U.S.C.499e(c)).The seller of these commodities retainsatrus[claim over tlese X
commodities,all inventories of food or other products derived from these commodities,and any receivables or proceeds from thesale of
thesecommodrims until full payment is received. CUSTOMERS SIGNATURE:
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of(a)1'h%per month or f
(b)the maximum rate that the customer may lawfully contract to pay,and in all events calculated in accordance with applicable law. ) d CUSTOMER COPY 4T/g�y?L(I,LQC[Q�C�AGI2>�LCQllEEQ4.
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
8/26/13 254029 Concessions 36115 $ 1,084.93
8/27/13 284101 Concessions 36116 $ 3,686.88
Total $ 4,771.81
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$
$ 4,771.81
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1095-1 254029 4239040 $ 1,084.93 1 hereby certify that the attached invoice(s), or
1095-1 284101 4239040 $ 3,686.88 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
5-Sep 2013
$ 4,771.81 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund