HomeMy WebLinkAbout333240 12/11/18 O�q"
J`Y� CITY OF CARMEL, INDIANA VENDOR: 306840 **t***,,,; ,
ONE CIVIC SQUARE TRACTOR SUPPLY CO CHECK AMOUNT: $ 96.95
_� ��� CARMEL, INDIANA 46032 DEPT 30-1205115593 CHECK NUMBER: 333240
vy,`;1 PO BOX 78004 CHECK DATE: 12/11/18
.grow�°' PHOENIX AZ 85062-8004
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2005266987 96.95 OTHER EXPENSES
VOUCHER NO. 183469 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 306840 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
TRACTOR SUPPLY CO CITY OF CARMEL
DEPT 30-1203341654 An invoice or bill to be properly itemized must show: kind of service,where performed,
PO BOX 78004 dates service rendered, by whom, rates per day, number of hours, rate per hour,
PHOENIX, AZ 85062-8004 numbers of units, price per unit, etc.
Payee
96.95 306840 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR TRACTOR SUPPLY CO Terms
Carmel Water Utility DEPT 30-1203341654 Due Date
BOARD MEMBERS PO BOX 78004
I hereby certify that that attached invoice(s), PHOENIX,AZ 85062-8004
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
2005266987 01-6200-06 $96,95 and received except 11/27/2018 2005266987
$96.95
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20—
Clerk-Treasurer
T�iCTOR.
)PSU"MC2
TractorSupply.com
17500 AUSTRIAN PINE WAY
WESTFIELD, IN 46074
317-896-1086
Ticket; 266987
Date; 11/21/18 Time; 10;43 AM
Store: 431 Register; 1
Cashier: Sarah'
Business Customer: WATER OPERATIONS
3450 W 131ST ST
CARMEL, IN 46074-8267
Item Qty Price Amount
6 ROUND TO 7 RV BLADE ADAPTER FLEX
1106936 1 21 .99 21 .99 E
CRESCENT 2-N-1 PLIER LINESMAN/WIRESTRIP'
1312299 1 19.99 19.99 E
CRESCENT 3PC CUSH ADJ WRENCH SET
1308860 1 19.99 19.99 E
CRESCENT 3PC CUSH ADJ WRENCH SET
1308860 1 19.99 19.99 E
JS - JUMBO/GAUGE PROFESSIONAL INFL
1308773, ' 1 14.99 14.99 E
Vu
t: Subtotal 96.95
2 2 Tax 0.00
Total 96.95
TSC Business Account - SALE 96.95
************1654 - PinPad Swiped
Authorization #: 021517
Terminal ID 001790431000100
CVM : DEFAULT
--------------------------------------------
Change 0.00
I agree to pay the above amount according to
my card issuer agreement,
Tax Exempt Information
Name: WATER OPERATIONS
Address: 3450 W 131ST ST
City/St: CARMEL, IN
Zip Code: 46074-8267
Tax Exempt Reason: Government Agencies
Expiration Date;
Tax Exempt Holder:
This transaction consists of one or more
items identified as exempt from state sales
or use tax, By signing below, and under
penalties of Perjury, signee declares he/she
legally has the right to purchase the above
items exempt from sales and-use tax and
these items will be used exclusively in a
manner which qualifies for the exemption
claimed. Failure to comply with provisions
of applicable fax laws and regulations may
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 Cif 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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