HomeMy WebLinkAbout315785 9/6/2017 CITY OF CARMEL, INDIANA VENDOR: 358941
ONE CIVIC SQUARE PETTY CASH - BROOKSHIRE GOLF COURdjCK AMOUNT: $"*iFtRf N 187.941
�? ?4 CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 315785
.oN CHECK DATE: 09/06/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 TSC 187.94 EQUIPMENT REPAIRS & M
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SUP'P'�YC°
Tractor5upply.com
17500 AUSTRIAN PINEWAY
WEST3171-89611086
Ticket: 175052 Time: 10:11 AM
Date: 8/28/17 Resister 1
Store: g3
Cashier: Lusha
Customer: RUSSELL PICKETT
Phone #: 3174201676
Company: BROOKSHIRE GOLF
Price Amount
Item Qty
TRV 27W SQUARE WORK1I6H29 99 29.99 E
1169554
TRV 27W SQUARE WORKLIGH29 99 29.99 E
1169554
TRV 4IN 4LEDS 20W AUTO LIGHT 31 .99 E
1223490
TRU 4IN 4LEDS 20W AUTO LIGHT 31 .99 E
1223490 1 31 .99
TRV 4IN 4LEDS 20W AUTO 3IG99 31 .99 E
1223490
Subtotal 155.95
Tax 0.00
Total 155.95
---------------------70.00
Cash -------------------
Chance ---------------
-
------ (14.05)
1 Cash
Tax*Exempt*Information
***s*aaa***
Name: RUSSELL PICKETT BERKSHIRE PARKWAY
Address 12120 CARMEL, IN
City/St:
'
ZIP
Code: 46032
Phone: 317-420-1676
Tax Exempt Reason: Non-Profit/ExemPt Ors
Expiration Date:
Tax Exempt Holder:
onsists of one or more
c
This transaction o exempt from state sales
items identlfByesigning below, and under_
or use tax• signee declares he
er.lury, purchase
the above
penalties afthe right to P
lesally has from
sales and use tax and
items exemptused exclusively in a
these items will be for the exemption
Failure to comply with provisions
manner which qualifies
claimed• tax laws and regulations may
of aPP
licable state and local
results well
a of
and interestti
taxes aaffirmsathat all information provided
signee address, and sales true and
ax
including name, (if re4uired) is agree that
exemption number understand and
re
accurate• I hereby may use my sisn at valid
Tractor SUP Co. completion of
tion certificate if and when necessary•
provided hereon far
exemP
visit
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TRACTORVOMPLYCO.
TractorSupply.com
2375 EAST PLEASANT ST RTE 37 S
NOBLESVILLE, IN 46060
317-776-1883
Ticket: 717344
Date: 8/28/17 Time: 10:44 RM
Store: 624 Register: 2
Cashier: Stephen
Customer: RUSSELL PICKETT
Phone #: 3174201676
Company: BROOKSHIRE GOLF
Item Qty Price Amount
TRV 4IN 4LEDS 20W AUTO LIGHT 31 ,99 E
1223490
Subtotal 31 .99
Tax 0.00
Total 31.99
-
-----------
-----------32-00----
Cash
--------------------------------------------
Change (0.01 )
Cash
Tax Exempt Information
Name: RUSSELL PICKETT
Address: 12120 BERKSHIRE PARKWAY
City/St: CARMEL, IN
Zip Code: 46032
Phone: 317-420-1676
Tax Exempt Reason: Non-Profit/Exempt Org '
Expiration Date:
Tax Exempt Holder:
This transaction consists of one or more
items identified as exempt from state sales
or use tax. Bu signing below, and under
penalties of Per,iuru, signee declares he/she ,
legally has the right to purchase the above
g items exempt from sales and use tax and
these items will be used gxclusivelu in a
manner which qualifies for the exemption
claimed. Failure to comply with provisions
of applicable tax laws and regulations may
1 result in assessment of state and local ,
taxes as well as penalty and interest. The
sisnee affirms that all information provided €
including name, address, and sales tax
exemption number (if required) is true and
accurate. I hereby understand and agree that
Tractor Supply Co. may use my signature
provided hereon for completion of a valid
exemption certificate if and when necessary.
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SOLD ITEM COUNT - 1
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