155540 01/10/2008 a CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $352.26
DES MOINES IA 50368 -9020
CHECK NUMBER: 155540
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 SEWER 352.26 6035301202510622
i
I page 1 of 3 T *i�}'��/�[1+�y{'/�
5TMC
BUSINESS ACCOUNT
6 261 3 f y n A
g f
Previous Balance 399.89 Closing Date 12/19/07
Payments 399.89 Next Closing Date 01/21/08 CARMEL UTILITIES
Credits 0.00 Payment Due Date 01/13/08 TREASURER OFFC
Purchases 352.26 760 3RD AVE SW
Debits 0.00 Current Due 352.26 CARMEL, IN 46032 2072
FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 10,000
Late Fees 0.00 Minimum Payment Due 352.26 Credit Available 9,647
New Balance 352.26
CURRENT ACTIVITY
TraIl AiC�OUPt
13818' 1 00 SRri[ltlan
DEC 14 GOODS AND SERVICES WESTFIELD IN 63.96
DEC 14 GOODS AND SERVICES WESTFIELD IN 235.54
TOTAL .6035301202515498 $299.50
DEC 3 GOODS AND SERVICES WESTFIELD IN 52.76
TOTAL 6035301202515571 $52.76
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
NOV 23 PAYMENT REF P91940OA909N7W9AL 399.89
FINANCE CHARGE SUMMARY
Current Billing Period Previous Billing Period
Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL
Subject to Periodic Bill vg PERCENTAGE Subjectto Periodic Billvg PERCENTAGE
Finance Charge Rate Period RATE Finance Charge Rate Period RATE
REGULAR REVOLVE CREDIT PLAN 0.00 00000 30 0.00 0.00 .00000 31 0. oo
t
---This account.Issued by-Citibank- (South- Dakota) Ni:A:- CiJSTOMER- SERV!CE -1 -800 -559- 8232 -FAX NUMBER
Notify Us in Case of Errors or Questions About Your Bill Copy Fee: On any matter unrelated to a billing error or disputed purchase,
we charge a $5.00 fee for each duplicate statement for a billing period that
If you think your billing statement is wrong, or if you need more information is more than 3 months prior to your request. We add this fee to your regular
about a transaction on your billing statement, write to us (on a separate revolve credit plan balance.
sheet) as soon as possible at the billing error address on the front of your
statement. We must hear from you In writing no later than 60 days after we Payment Options Other Than Regular Mail:
sent you the first statement on which the error or problem appeared. In your
letter, give us the following information: o Pay by Phone. You may make your payment by phone by using the Pay by
Phone Service. You will be charged $14.95 to use this payment service.
Your name and account number. Call by 5 p.m. Eastern time to have your payment credited as of that day.
The dollar amount of the suspected error. If you call after that time, your payment will be credited as of the next day.
Describe the error and explain, if you can, why you befieve there is an We may process your payment electronically upon verification of your
error. If you need more information, describe the item you are unsure identity.
about. Send payment by courier or express mail to the Express Payments
address: Customer Service Center, Dept. CCS 8725 W. Sahara Blvd., Las
Important Payment Instructions Vegas, NV 89117. Payment must be received in proper form, at the proper
address, by 5 p.m. Pacific time in order to be credited as of that day. All
Crediting Payments: Payment must be received in proper form at our payments received in proper form, at the proper address, after that time
processing facility by 5 p.m. local time there to be credited as of that day. A will be credited as of the next day.
payment received at the processing facility in proper form after that time will
be credited as of the next day. Please allow 5-7 days for payments by Report a Lost or Stolen Card immediately: Customer Service is available
regular mail to reach us. There may be a delay of up to 5 days in crediting a 24 hours a day, 7 days a week.
payment sent by mail if it is not in proper form or is addressed to a location
other than the address listed on the return envelope or on the front of the Your account is issued by Citibank (South Dakota), N.A.
payment coupon, or, for courier or express mail payments, to the Express
Payments Address set forth below.
Proper Form: For a payment sent by mail or courier to be in proper form,
you must:
Enclose a valid check or money order. No cash, gift cards, or foreign
currency please.
Include your name and account number on the front of your check or
money order.
Tractor Supply Co. Full Balance S902TV 10106
902TV5741006 PCT
page 2 of 3 T
T
SUPP
SUPPLY
BUSINESS ACCOUNT
CURRENT ACTIVITY
e
.S f .31... 'i 3a`� $EwAy d 'nw :C �k�
Customer Service and Billing Errors address: PO Box 689161, Des Moines,
IA 50368-9161.
CARD AGREEMENT INFORMATION UPDATE.
PLEASE KEEP THIS NOTICE.
He are adding an optional Pay by Phone Service. This service is
disclosed in the following new section which we
are adding to your Card Agreement:
"Optional Pay by Phone Service. You may request to make your payment by
phone using our optional Pay by Phone Service. Each time you make such a
request, you agree to pay us the amount shown in the Pay by Phone
section on the back of the billing statement. Our representatives are
trained to tell you this amount if you decide to use this optional Pay
by Phone Service."
1
�Y 929
Remit To: Bill To: Page 3 of 3
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301202510622 vs umyco
DEPT.30- 1202510622 JEFF COOPER
PO BOX 689020 1 CIVIC SQ BUSINESS ACCOUNT
DES MOINES IA 50368 -9020
Payment Due Date: 01/13/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP TG: INVOICE:
431000802953010 431000802952010
Purchase Order: Purchase Order:
JEFFCOOPER JEFFCOOPER
AMOUNT DUE: 235.54 AMOUNT DUE: 63.96
store: 574000431 INVOICE DATE: 12114107 Store: 574000431 INVOICE DATE: 12114 107
JKT ARCTIC 46 BN CT65 6310398 1.00 63.97 63.97 SPECIAL ORDER PAYMENT 431051771 1.00 65.96 63.96
BIB CRHT ARCTIC 40X30 6409757 1.00 75.97 75.97
BIB 40X32 INS EX BK CT6 7021201 1.00 95.60 95.60 SUBTOTAL 63.96
TAX 0.00
SUBTOTAL 235.54 SHIPPING 0.00
TAX 0.00
SHIPPING 0.00 TOTAL 63.96
TOTAL 235.54
SHIP To: INVOICE:
431000799775010
Purchase Order:
JOE278
AMOUNT DUE: 52.76
Store: 574000431 INVOICE DATE: 12/03 /07
HEATER SINK 1500W 2170712 1.00 26.38 26.38
HEATER SINK 150OW 2170712 1.00 26.58 26.38
y SUBTOTAL 52.76
TAX 0.00
SHIPPING 0.00
TOTAL 52.76
1 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801- 779 -7425
�I
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
S IUMLY U P.O. Box 9020 Tractor Supply Company
Des Moines, IA 50368 -9020 18160 U.S. 31 Nor
T,C TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westfield, IN 46074
6035 301 317) 867-3505
NAME CARMEL UTILITIES
1 CIVIL: So
ADDRESS CARMEL IN 460322584
(317) 571 -2428
CITY STATE ZIP PHONE 431 431000172 1 79977.'
12/03/2007 09:51am
CUSTOMER TO COMPLETE 2170712 HEATER SINK 1500W
1.00 2,36 2 6,38 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencie5
The undersigned certifies The undersigned party certifies their exemption from 2170712 HEATER SINK 1500W
compliance with the agricultural payment of sales and use tax on tangible personal 1100 2638 26.38 NT
sales tax exemption law of the state property as indicated below and /or purchaser is Government Asencies
indicated below and understands engaged in the business of agricultural production of
and agrees with the General Subtotal 52.76
food or fiber, horticulture, aquaculture of floriculture for
Exemption Statement at right and resale and /or uses the farm machinery, equipment or 6.004 Tax 0.00
the applicable statement of the Total 52.76
respective state printed on the other agricultural production items purchased free of TSC Card 52,76
reverse side of this form. tax, as defined by state law, and as indicated below. Acct4: #E ;5571
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Auth #:003862 Re4#:0308511481
STATE:
understand the y y p ayment ma be liable for of all taxes PO *:.ioe278
Chanse
(REQUIRED) due on the purchase price for the goods as allowed by 0100
(Exceptions: Georgia Newyork a Kentucky state law should such goods be used or consumed in Cash Sack
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws.
PURCHASER IS ENGAGED IN: (REQUIRED) Buyer acknowledses the receipt of a comple
Resale Under penalty of perjury, signee swears thP d
Government information on this statement is true and correct Ili copy of this sales slip and the purchase o
Exempt organization every material manner. A willfully false representation
Agricultural Production the described merchandise shall be in
of exemption will cause the purchaser to be subject to
Dairy Production penalty and /or other provisions as allowed under state accordance with the Cardholder Asreealen t,
Livestock Production
Floriculture /Aquaculture Production law.
Other: Sisnatttre:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity 1
Livestock Injestibles or Injectibles Exempt Organization (Entity
NC: only DOT and US Government are exempt
Fertilizer /Agrichemicals
Consumed in Production (KS) Resale (Sales Tax Permit 1 Call 800 968 within 7 days to
Ingredient or Component Parts (KS) complete a survey and be entered in a
monthly 0 for chance to win a
$250
other: $2500 s shopping spree.
(Awarded as Gift Card) NO PURCHASE
CUSTOMER SIGNATU (RE IR "�-a, MGR. APPROVAL
t
X
OP ERATIVE.
CASH' CHECK VISA M/C DISCOVER' TSC CHARGE ACCOUNT NO.'- CHI. EXCH. 'DATE
i Y. UNIT
RE C
Form No. 99 -00401 (12105) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO.
TRACTOR SUPPLY COMPANY
su"Lyco P.O. Box 9020
Des Moines, IA 50368 -9020 :i�!ti U.
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number ,i•t'.o1, f
01S
6035 301
NAME
�2
ADDRESS RECD :;s "rECT61, ORDE W: ffr.
'C't:titj Oi'dk`i• 43 1
CITY STATE ZIP PHONE Ct }hi1!'i_ iJT(LrTIFi;
CUSTOMER TO COMPLETE (317) gel -241.0
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 0%x1120 I,LK BtB 34; Sn
The undersigned certifies The undersigned party certifies their exemption from 1.00 63' yt' Gs y�
compliance with the agricultural Goret n `r7 A :ncics
payment of sales and use tax on tangible personal
sales tax exemption law of the state
indicated below and understands Property as indicated below and /or purchaser is
and agrees with the General engaged in the business of agricultural production of f
food or fiber, horticulture, aquaculture of floriculture for l o4a�
Exemption Statement at right and o "C'
t?cru =i
the applicable statement of the other agricultural production items resale and /or uses the farm machinery, equipment or purchased free of 3
respective state printed on the g p p T5C I:ai rl G3.9�
reverse side of this form. tax, as defined by state law, and as indicated below. A a c r u s a a a Sty +i
fr2.t1 f;,`f�:1 ^Cr9IB3575
Auitr.:
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they CoU `l
STATE: understand they may be liable for payment of all taxes 111 0100
(REQUIRED) due on the purchase price for the goods as allowed by
(Exceptions: Geor New York a Kentucky state law should such goods be used or consumed in
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws. Cr`Lc1t;CE U C
PURCHASER IS ENGAGED IN: (REQUIRED) }SUYE1 Vt;i'7lUUl dEJE'L 'tlr_' 10EB'!,''7 US CQL
Resale Under penalty of perjury, signee swears the
Government information on this statement is true and correct in cury.of itli� �•�t..', alit J iilB ;ulci;, �e o
Exempt organization every material manner. A willfully false representation
F1 Agricultural Production of exemption will cause the purchaser to be subject fo
F Dairy Production d::�tr'iE,,.r� I';r_`rtir,tirii�ir' x,1,,11 bo
penalty and /or other provisions as allowed under state
Livestock Production iiC,"Gr 1'a :Iii'ii 'irl; C. ,iUiald_ 1 Lu:a'r:it,
Floriculture /Aquaculture Production law.
Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity
Livestock Injestibles or Injectibles Exempt Organization (Entity
richemicals
Fertilizer /A NC: only DOT and US Government are exempt
9
Consumed in Production (KS) Resale (Sales Tax Permit 0 8 s 'x k 5 3 S 3 Z 8 E n 3 8 $1
Ingredient or Component Parts (KS)
Luc,irl rte: it �itrvey and L,t: 4n ((_1 ed in a
Other: urd,hly dt'V' "n:$ 101- it LiIa11Cr. i.3 ui•t
i'Iit:oPr�Lu G'.it t;cS',1;
CUSTOM ATU QUIRED) MGR. APPROVAL
X
USE SHADED-AREA ONLY
CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
BER.
ITEM NUM
a�
aas
10 P
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
Y ��IUTTSC BUSWESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
A.m U yco P.O. Box 9020 7r C7cr Sulrlr ial „r,,u;
Des Moines, IA 50368 -9020 i ts1 ,0 U 5. 31 our h
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number s>< r t lu, 1Lilt r
$b7 -�aCi�
6035 301 (a
NAME �fl.':iiCl- ff(1Li71.f_
1 7 1 C1.' Ic `U
ADDRESS AAA C (y�{ iG i•)
(51'7 5r1 ��f
CITY STATE ZIP PHONE 4 4310001,k? 2 0029 i
1 Z/ 1 /2007
CUSTOMER TO COMPLETE 63310 390 ARCTIC ,.6 RN Ufa,
1. 0,1 e 53.`I? 63, 01
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: F'ua. PVif:e: 7;+
The undersigned certifies The undersigned party certifies their exemption from Ki�uer r1l:en iaerr_:i.es
compliance with the agricultural payment of sales and use tax on tangible personal 777 LIT F CfthlT (1r "TIC 40 C3
sales tax exemption law of the state property as indicated below and /or purchaser is 1 0`) 0 415' Vr
indicated below and understands engaged in the business of agricultural production of�' F'r iCt`: 91, 96
and agrees with the General Guv 11.1,;1
food or fiber, horticulture, aquaculture of floriculture for ,r
Exemption Statement at right and 7fiZ1'01 fits ',0 3i,; EX 1.,;
resale and/or uses the farm machinery, equipment or yr
the applicable statement of the other agricultural production items purchased free of 1 JO L v VIA, A, R Pt
respective state printed on the I•,( Price: IV.50
reverse side of this form. tax, as defined by state law, and as indicated below. Cps, /�t,rlr1e.. t t1It nC ic3L
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they
may be liable for payment of all taxes 6 00 %i ax Z30 3 1
understand they Y Y P Y ,�,i }ox 0,0
(REQUIRED) due on the purchase price for the goods as allowed by .t.u�� 2� C
(Exceptions: Georgia, New York& Ker,mohy- state lawshould such g oods be used or consumed in
COMPLETE REVERSE SIDE) g TSC Co 1 Z{ f
a taxable manner as defined by state laws. T s .1 a a z a rFg
PURCHASER IS ENGAGED IN: (REQUIRED) ({,i k
F] Resale 41 1 tiE Res 1 fir °232990 Resale Under penalty of perjury, signee swears the Ali L{ Ui
Government information on this statement is true and correct in Flo
Exempt organization every material manner. A willfully false representation Uba 0. 0,'I
Agricultural Production of exemption will cause the purchaser to be subject to I &,c k
Dairy Production penalty and /or other provisions as allowed under state
Livestock Production ?I:+1 ter. �c E.7utltr dse� the 1' CC i r
F1 Floriculture /Aquacullure Production law' i 1 �I
Other: cot-f uJ' t{Iii SalQ!" 'Slip ind ho r
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) f h
Farm Machinery/Repair Parts Government Agency (Entity tiCCLrt 1 4411te Ulih flit Cali dhultfer ia�1`eealr i
Livestock Injestibles or Injectibles Exempt Organization (Entity
Fertilizer /Agrichemicals INC: only DOT and US Government are exempt
71 Consumed in Production (KS)
Resale (Sales Tax Permit L 3.t `t�
Ingredient or Component Parts (KS)
Other:
CUSTOME E ED) MGR. APPROVAL
X
'USt AREA
CHE VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. xH_ DATE
L a.
a
.'DE RIPTI
EM NUMBER fil P
2a
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units, r•
price per unit, etc.
Payee
306840
TRACTOR SUPPLY CO Purchase Order No.
Terms
PO BOX 689020 Due Date 12/29/2007
DES MOINES, 1A 50368
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
121291200; 4310008029; $235.54
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
Date Officer
VOUCHER 07701.8 WARRANT ALLOWED
306840 IN SUM OF
TRACTOR SUPPLY CO
0
--.PO BOX 689020
DES MOINES, IA 50368
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
43100080295 01- 7202 -05 $235.54
q(joop 74g11 01.1202.o5 5).76
�(3(000?02g5 &(.72-02:05 ".q6
005)
3,x'2.2 b
Voucher Total
r
t ost distribution ledger classification if
laim paid under vehicle highway fund