EVT0010957_-_Exhibit_A_-_Sample_Delivery_Receipt.pdf
PDF 118 KB Posted
- Solicitation number
- EVT0010957
- Issued by
- Sedgwick County, Kansas
About this file
This is a sample delivery receipt for the Department of Children and Family Services (DCF) submitted to SKFB Food Distribution in Topeka, Kansas. The document outlines a food delivery order containing 16 line items of USDA-approved food products, including grocery items and frozen foods. The grocery category includes macaroni, sliced potatoes, applesauce, cling peaches, dry pea beans, canned tomatoes, rice cereal, and instant dry milk, with quantities ranging from 5 to 24 cases. The frozen foods section includes beef chuck roast, sliced peaches, turkey breast, and cultured blueberries, with quantities between 5 and 50 cases. The total order consists of 209 cases with a combined shipment weight of 7,902 pounds and a cube measurement of 231.4 cubic feet.
The total order value is $543.40, consisting of $335.40 in grocery items and $208.00 in frozen foods. Terms are listed as monthly payment by the 10th of each month. The delivery receipt includes standard provisions for damage claims upon receipt, a 10% restocking fee for returned merchandise, and interest charges at the maximum legal rate for past due accounts. The document is formatted as a standard delivery receipt with fields for customer signature, delivery driver information, route stop designation, and special instructions, indicating this serves as proof of delivery for the food distribution transaction.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| EVT0010957_-_Attachment_A_-_Data_Security_Agreement_.pdf | ||
| EVT0010957_-_Exhibit_B_-_Example_of_Report_of_Shipment_Order.pdf | ||
| Soup_Kitchen_Food_Bank_Storage___Delivery_Services.pdf | ||
| EVT0010957_-_Vendor_Questions_Template.xlsx | XLSX spreadsheet | |
| EVT0010957_-_Bid_Documents.pdf | ||
| EVT0010957_-_EXHBIT_C_.xlsx | XLSX spreadsheet |
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Text version
Exhibit A CUSTOMER PHONE NO. P.O. NO.
ORDER # CUSTOMER # SLSM DATE INVOICE PAGE
SOLD TO DCF EES [ CITY ] - SKFB
FOOD DIST 915 SW HARRISON
DSOB 681-W
TOPEKA KS 66612
SHIP TO CUSTOMER NAME CUST #
% NAME SKFB
ADDRESS
CITY STATE ZIP
TERMS
MONTHLY / BY 10TH
SHIP VIA
PICKED BY CHECKED BY All claims for damages or shortages must be made upon receipt of merchandise. Returned merchandise may be subject to 10% restocking fee. If this account is placed for collection, customer agrees to pay reasonable attorney’s fees and related costs. Past due accounts accrue interest charges at the maximum legal rate.
CUSTOMER SIGNATURE
DELIVERED BY
ROUTE STOP
SPECIAL INSTRUCTIONS <
SLOT QTY UNIT PACK SIZE DESCRIPTION ITEM NO. PRICE PRICE EXT.
H-220A 20 CS 24 1 LB SKFB MACARONI USDA $5.5671 82511 2.60 52.00
H-222A 20 CS 24 NO 300 SKFB SLI POTATOES-CND USDA $7.7913 82517 2.60 52.00
H-225A 20 CS 24 NO 300 SKFB APPLESAUCE USDA $6.3887 82576 2.60 52.00
H-234A 10 CS 24 NO 300 SKFB PEACHES-CLING USDA $14.4044 82521 2.60 26.00
H-237A 10 BAG 1 25 LB SKFB DRY PEA BEANS USDA $6.0178 82555 2.60 26.00
H-239A 24 CS 24 NO 300 SKFB TOMATOES -CANNED USDA $7.1018 82533 2.60 62.40
I-228A 20 CS 12 13 OZ SKFB RICE CEREAL USDA $6.3356 82553 2.60 52.00
I-232A 5 CS 6 4 LB SKFB INSTANT DRY MILK USDA $31.3142 82512 2.60 13.00
** TOTAL GROCERY $335.40 **
N-124A 10 CTN 4 10# AVG SKFB BEEF CHUCK ROAST USDA $28.5832 82537 2.60 26.00
N-132A 15 CS 12 2 LB SKFB PEACHES -SLC/FRZ USDA $19.6630 82520 2.60 39.00
N-133A 50 CS 4 14-16 LB SKFB TURKEY BREAST USDA $43.1049 82586 2.60 130.00
N-134A 5 CS 1 30 LB SKFB BLUEBERRIES CULT USDA $16.7826 82498 2.60 13.00
** TOTAL FROZEN FOODS $208.00 **
TOTAL
CASES
ODD
PIECES
SHIP
WEIGHT
CUBE SALES TAX PAY THIS
AMOUNT
209 0 7902 231.4 $543.40
File details come from the government source that posted it. Updated .