224313 09/23/2013 *F CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC CHECK AMOUNT: $332.45
�4� o CARMEL, INDIANA 46032 PO BOX 660088
ti,roN`a INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 224313
CHECK DATE: 9/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 729434 95 . 17 GENERAL PROGRAM SUPPL
1096 4239039 854919 237 . 28 GENERAL PROGRAM SUPPL
ACCOUNT INVOICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO NO, DATE NO' NUMBER LOC . REP ORDERED
90569922 0729434 09/10/13 90569575 MC004573 1054 0062 09/06/13
Route: 2251 / 4 ORDER NUMBER: 984289
8ill Ship Remit
CARMEL CLAY PARKS&RECREAT . CARMEL CLAY PARKS&RECREAT - US Foods, inc .
To: 1411 E. 116TH ST '- : 1215 CENTRAL PARK DRIVE E To:
BOX 660088
4,6032 46032 INDIANAPOLIS I 1\1
31Z 843 3073 46266-0089
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Att: MICHELLE COMPTCHN PEPT 00 8Q0 428 2118
ShipFrm.' 12301 CUMGERLAND RD -_ '.lFISHERS IN Ship& -O9�1O/13 -' � Page 01 of 01
rrtTrms. Socia/ ENTER OFF OF 111TH STREET ! ! !
P tTrms: NET 30 DAYS - _ Znstr:
$ty Qty Salas Product - -Descripton, Pack Size Label C Weight Pricing Unit Extended
]rdered Shipped Unit Number ' - D Unit Price Price
DRY
i 0 CS 6672323 CRACKER, CHS 4 CT 192/33 OZ AUSTIN
REFRIGERATED
3 3 CS 0878173 ORANGE, CA CHO FRESH REF 188 EA CROSS VALY CS 29. 6400 88. 92
PRODUCT CLASS- RECAPW*_
TOTAL DRY PIECES ORDERET 2 PIECES SHIPPED: 0 ITEMS SHIPPED: 0
TOTAL REFRIGERATED PIECES ORDERED: 3 PIECES SHIPPED: 3 ITEMS SHIPPED: 1 8492
INVOICE SUMMARY **-X
FUEL SURCHARGE 6, 2S
TOTAL WOT SHIPPEW 114. 00 PIECES ORAREW1 S PIECES SHIPPED: 3 1TEMS SHIPPED: I
PRODUCT TOTAL 88. 92
CHARGES 6. 25
GEN SALES TAX
This amount it an estimateAt tile of shipping prior to any adjultments made at delivery: $ 9S. 1,17
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ACCOUNT IN;A' 9' INVOICE CUSTOMER PURCHASE ORDER- SALES SALES DATE
NO. NO DATE NO. NUMBER LOC . REP , ORDERED
90569922 -0854914 O9/13/139O569�75 ' � 1054 0062 09/11/13
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Route: 5282 / q _ ORDER NUMBER: 989360
8ill Ship, Remit_
_ CARMEL CLAY PAMS&RECREAT US Foods, Inc .
To: 1411 E. 116TH ST To: 1235 CENTRAL PARK ,DRIVE E To�1 BOX 660088
CARMEL IN -CARMEL -IN
46032 A6032 1NDIANAPOLIS IN
317 S43 3073 46266-0088
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Att: MICHELLE COMPTON DEPT 4 00 800 428 2118
ShipFim: 1230 1 CUM8ERLAND RD FISHERS IKLShipD. 09/13/13 Page 01 of 01
Frt7rms: ' SpciaJ ENTER OFF OF 111TH STREET ! ! !
"'A"tTrms� NET 30 DAYS Instr. '
ty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
Ordered Shipped Unit Number D Unit Price Price
DRY
25 25 CS 0779991 WATER, SPRG PLST BTL TWIST CAP24/16, 9 OZ THIRSTER CS 5. 6600 $ 141. 50
1 1 CS 6672281 CRACKER, CHS PNT BUTR 216/1. 38 OZ AUSTIN CS 44. 9800 44. 98
1 1 CS 6672307 CRACKER, CHS 6 -CT 216/1 . 38 OZ AUSTIN CS 44. 5500 44. 55
PRODUCT CLASS RECAP
TOTAL DRY PIECES ORDERED: 27 PIECES SHIPPED: 27 ITEMS SHIPPED: 3 231.03
INVOICE SUMMARY
- FUEL SURCHARGE .. 6. 25
TOTAL WGT SHIPPED: 671. 01 PIECES ORDERED: 27 PIECES SHIPPED: 27 ITEMS SHIPPED: 3
PRODUCT TOTAL 231. 03
CHARGES
TAXABLE AMOUNT $ . 00
GEN SALES TAX . 00
This amo I-unt is an estimate at time of shipping prior to any adjustment, made at delivery: 237. 28
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SEP 16 2013
FBY:
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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
9/10/13 729434 Food for Tour de Carmel $ 95.17
9/13/13 854919 Food for Tour de Carmel $ 237.28
Total $ 332.45
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$
$ 332.45
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-60 729434 4239039 $ 95.17 1 hereby certify that the attached invoice(s), or
1096-60 854919 4239039 $ 237.28 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
19-Sep 2013
$ 332.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund