227134 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 353824 Page 1 of 1
ONE CIVIC SQUARE U S FOODSERVICE, INC
CARMEL, INDIANA 46032 PO BOX 660086 CHECK AMOUNT: $145.42
INDIANAPOLIS IN 46266-0088 CHECK NUMBER: 227134
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 477466 145 .42 GENERAL PROGRAM SUPPL
ACCOUNT INvdICE INVOICE CUSTOMER PURCHASE ORDER SALES SALES DATE
NO. NCO'. DATE NO. NUMBER LOC . REP. ORDERED
,. 90569922 0477466 12/03/13 90569575 MC004838 1054 0062 12/02/13
Route: 2251 / 4 ORDER NUMBER: 72762
Bill Ship ------- -- -- Remit
CARMEL CLAY-PARKS&RECREAT CARMEL CLAY PARKS&RECREAT US Foods, Inc .
To: 1411 E. 116TH ST To: 1235 CENTRAL PARK DRIVE E To:
CARMEL IN CARMEL IN BOX 660088
46032 46032 INDIANAPOLIS IN
317 843 3873 46266--0088
Att: I MICHELLE COMPTON DEPT # 00 800 428 2118
3hipF"rm: 12301 CUMBERLAND RD FI-.SHERS IN Shipp: 12/03/13 Page 01 of 01
F"rtTrms: SpCial ENTER OFF OF 111TH STREET ! ! !
Pvffrins: NET 30 DAYS rnstr:
0ty Qty Sales Product Descripton Pack Size Label C Weight Pricing Unit Extended
Ordered Shipped Unit Number D Unit Price Price
DRY
3 3 CS 0738872 BAG, C-OUT 6 LB PAPR WHT 2/500 EA MONOGRAM B CS 46. 3900 139. 17
PRODUCT CLASS RECAP #
TOTAL DRY PIECES ORDERED: 3 PIECES SHIPPED: 3 ITEMS SHIP'P'ED: 1 139. 17
INVOICE SUMMARYa�
FUEL SURCHARGE 6. 25
TOTAL WGT SHIPPED: 60. 00 PIECES ORDERED: 3 PIECES SHIPPED: 3 ITE11S SHIPPED: 1
PRODUCT TOTAL $ 139.-17
CHARGES 6. 25
TAXABLE AMOUNT $ .00
GEN SALES TAX y .00
This amount is an estimate at time of shipping prior to any adjustments made at delivery: 145..42.
F T 013
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
12/3/13 477466 Bags for luminary walk $ 145.42
Total $ 145.42
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$
$ 145.42
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1096-60 477466 4239039 $ 145.42 1 hereby certify that the attached invoice(s), or
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-Dec 2013
$ 145.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund