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161111 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CARMEL, INDIANA 46032 PO Box 689020 CHECK AMOUNT: $1,142.76 DES MOINES IA 50368 -9020 CHECK NUMBER: 161111 CHECK DATE: 6/25/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMO DES CRIPTION 1125 4356000 18090 PARKS 1,142.76 6035301202854988 q, t T page 1 of 3 T c 1U ii BUSINESS ACCOUNT Previous Balance 0.00 Closing Date 05/29/08 Payments (31.00 Next Closing Date 06/27/08 CARMEL CLAY PARKS REC Credits 0.00 Payment Due Date 06/23/08 ACCOUNTS PAYABLE Purchases 1,142,76 1411 E 116TH ST Debits 0.00 Current Due 1,142-76 CARMEL, IN 46032 -3455 7 FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 7,500 Late Fees 0.00 Minimum Payment Due 1,142.76 Credit Available 6,357 New Balance 1,142.76 CURRENT ACTIVITY Transactlo l ccattrnl p E�ata Clscrip n r m MAY 14 GOODS AND SERVICES NOBLESVILLE IN 617.93 TOTAL 6035301202854996 $617.93 MAY 8_ _GOODS AND SERVICES NOBLESVILLE IN 379,84 MAY 14 GOODS AND SERVICES NOBLESVILLE IN 144.99 TOTAL 6035301202855001 $524.83 Customer Service and Billing Errors address: PO Box 689161, Des Moines, IA 50368 -9161. FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic Bilking PERCENTAGE Subect to Periodic Billing PERCENTAGE Finance Charge Rate Period RATE Finance Charge Rate Period RATE REGULAR REVOLVE CREDIT PLAN 0. .00000 3o 0.00 0.0o .00000 0 0.00 CE R.V JUN 0 9 2008 BY: F .�ank;tSouth 0akotat N A CUSTO SERVICE 1-BOO-559-8232 FAX NUMBER 1- 801 779 -7425 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 billinq 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 Reqular tail: sent you the first statement on which the error or problem appeared. In your fetter, give Ass the following information: 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. Yo r Warne ar(i account nurnbet. Call by 5 pm, Eastern tirne to have your payment credited as of that day. The dollar amount of the suspected error. If you call after that time, you payment will be credited as of the next day. Describe the error and explain, if you can, wiry you believe there is an Wemay process your payment electronicaliy upon veF fication 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 Gay. 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 snail or courier to be in proper form, you must: Enclose a valid check or money order. No cash, gift cards, or foreign currency please. p Include your name and account number on the front of your check or money order. Tractor Supply Co. Full Balance S902TV 10/06 902TV5741006 FCF Remit To: BIII To: page 3 or 3 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301202854988 DEPT.30 1202854988 TODD SNYDER PU BOX 684020 1427 E 116TH ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 Payment Due Date: 06/23/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TG: INVOICE: 624000960869010 624000957803010 Purchase Order: Purchase Order: 18090 18090 AMOUNT DUE: 617.93 AMOUNT DUE: 379.84 •Store: 574000624 INVOICE DATE: 05/14/08 Store: 574000624 INVOICE DATE: 05108 /08 BOOT 12 STOE LACE UP WP 7341504 1.00 114.99 114.99 SHOE LOS 1.5 TERH2O COP 7212056 1.00 59.97 59.91 BOOT 9.5M HIKE STOE AUT 7120542 1.00 89.99 89.99 SHOE LTHR 6 IN 105E ST 7087671 1.00 139.99 139.99 BOOT 9.5M 6IN WK TTN ST 7120835 1.00 119.99 119.99 RCOAT HOOD LG OLGN WG64 6459710 1.00 29.96 29.96 BOOT IOW HIKE STOE AUTM 7120704 1.00 89.99 89.99 BOOT LTHR 6IN CES WPR 7219082 1.00 89.96 89.96 BOOT LTHR 12M TL25 7159575 1.00 109.99 109.99 BOOT LTHR LDS STOE 8.5M 7340401 1.00 59.96 59.96 BOOT IOW HIKE STOE AUTM 7120704 1.00 89.99 69.99 W2 WEATHERPRFER 2.502 T 7377569 1.00 2.99 2.99 SUBTOTAL 379.84 TAX 0.00 SUBTOTAL 617.93 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 379.84 TOTAL 617.93 SHIP TO: INVOICE: 624000960875010 Purchase Order: 18090 AMOUNT DUE: 144.99 Stare: 574000624 INVOICE DATE: 05/14/08 SHOE LTHR 12 BN HIKER R 7087134 1.00 144.99 144.99 SUBTOTAL 144.99 TAX 0.00 SHIPPING 0.00.__._._._.__,.__._____ TOTAL 144.99 Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801- 779 -7425 page 2 of 3 7 !1 BUSINESS ACCOUNT CURRENT ACTIVITY R .3 �&gA •na Transactlon� ocatioN R;� �Amvutit "I CARD AGREEMENT INFORMATION UPDATE. PLEASE KEEP THIS NOTICE. We are adding an optional Pay by Phone Service. This service is disclosed in the following new section which we y 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." REMITTS BUSINESS ACCOUNT R PAYMENT TO: TRACTO 9i 2 SUPPLY COMPANY r P.O. B 0 MUMI Des 14oin6s, IA 50368 -9020 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number 6035 301 NAME t •i27 r t(, -iJ 5T f -i Tie ��('1:3•f`�:S ADDRESS 1:'i irl 7 6 V i CI1�' STATE ZIP PHONE u�'`f izfa%fJ06 CUSTOMER TO COMPLETE CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT; The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal 7,,CQ%, T,, sales tax exemption law of the state property as indicated below and /or purchaser is 1 indicated below and understands engaged in the business of agricultural production of and agrees with the General g p g food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or z the applicable statement of the y a I 9 respective state printed on the other agricultural production items purchased free of T 'g t G090 reverse side of this form. tax, as defined by state law, and as indicated below. r,', on 4�� +f 1•;0.1 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they STATE: understand they may be liable for payment of all taxes i l:r 1, r °ur i i.i, th:, re(.ei, t of a a l l (REQUIRED) due on the purchase price for the goods as allowed by, ,j (Exceptions: Georgia, New York Kentucky state law should such oods be used or consumed in COMPLETE REVERSE SIDE) 9 r.�t• v ttr t11.iS Srcljc .i.ir i17U lit;'. 'I4 1'( °,V t; a taxable manner as defined by state laws. f PURCHASER IS ENGAGED IN: (REQUIRED) Resale Under penalty of perjury, signee swears the Government information on this statement is true and correct in Exempt organization every material manner. A willfully false representation Agricultural Production of exemption will cause the purchaser to be subject to ,i C: Dairy Production penalty and /or other provisions as allowed under state Livestock Production Floriculture /Aquaculture Production law' Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery /Repair Parts Government Agency (Entity II8M:4RR$3Z• °,.F 5 :::'f3'R: >'a8 L c. i. I �.1�}" /l'(". "Q; :,r 4: i. 'lit 1 •.ir,''� tea Livestock fnjestibles or Injectibles Exempt Organization (Entity NC: only DOT and US Government are exempt I- o IF 1 t: t C: s r n. t` Ci ,I l l i L u Fertilizer /Agrichemicals I ,ur• 11 ii z.i,,r:,. -I +I, �t cii;,,;c:e s`u +,iR Consumed in Production (KS) Resale (Sales Tax Permit }(;;5 s;', I! if- r :C Ingredient or Component Parts (KS) ff'aar I w, G: f E'.:i d) PO "'',Cfir:4f fJ 9"W 1 1-, Other- J: S t t ".'SL CUSTOM NATURE: (REQ ED) MGR. APPROVAL X USE SHADED� 0 CASH CHEC VISA MIC DISCOVt:r TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE 4 1 ITEM NUMBER, D ESCRIPTI O N' MAY 'Form No. 99 -00401 (12105) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT 9 PAYM TO: TRACTOR SUPPLY COMPANY qJJMy P.O.'Box 9020 T, ar to `kii r 1%, Ci,is.io.iv Des Moines, IA 50368-9020 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number rib 1 v., ij, (6035 301 0:T) el 9 NAME 14 T? F. 1 I ST ADDRESS 1,11 46",_0 __)'i CiTi STATE ZIP PHONE CUSTOMER TO COMPLETE 6fi0:_ VU01 1? 1 fi,LIF CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT 1. pill 111, 1, 9 V !T The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal sales tax exemption law of the state property as indicated below and/or purchaser is indicated below and understands engaged in the business of agricultural production of and agrees with the General food or fiber, horticulture, aquaculture.of floriculture for O I J F. 119..*�V Exemption Statement at right and resale and/or uses the farm machinery, equipment or the applicable statement of the other agricultural production items purchased free of i�I70N't "VIT 'iU 111,1'7 JO!: respective state printed on the tax, as defined by state law, and as indicated below. rl". 9V 'ti? .97 reverse side of this form. PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they NJOT I 1?t') STATE: understand they may be liable for payment of all taxes 1.00 13 T W. 99 ;J9.99 (REQUIRED) due on the purchase price for the goods as allowed by k.-nc _i (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in F i i i�101' I IJI IJVE STI"o n COMPLETE REVERSE SIDE) I 11 l I t I') 1 a taxable manner as defined by state laws. rl PURCHASER IS ENGAGED IN: (REQUIRED) r I L 011' 1 t t 14. E Resale Under penalty of perjury, signee swears the ?377'19 11 Z E A I H r�" I f F­l Government information on this statement is true and correct in I XO f 2.1 9 V "4 I Exempt organization every material manner. A willfully false representation I QVl" r W !"i, I /i,,. III L Agricultural Production Dairy Production of exemption will cause the purchaser to be subject to Livestock Production penalty and/or other provisions as allowed under state U t6k 7 1'10% Tz r). Floriculture/Aquaculture Production law. ts; t! i Other: Tf: I ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) fi L L 4 14` F Farm Machinery/Repair Parts Government Agency (Entity tic F Livestock Injestibles or Injectibles Exempt Organization (Entity 0 co F Fertilizer/Agrichemicals NC: only DOT and US Government are exempt a.-J Consumed in Production (KS) F Resale (Sales Tax Permit U-IfLr�_;:Jt'_ i iv ri. o' ;I ri i� Ingredient or Component Parts (KS) Other: cc) i tic' CUSTOMER SIGNATURE:( ?EQUI D) M GR. APPROVAL CiCCQF0Lt1H.L t;i'1 '10' COIG!J.W(.', I'll.31 N,' el t X HA6,EDAREA,ONLY WHEN REGISTER 61NOPERATIVE. CASH C HEC K LJ L) K VISA MIC DISCOVER T C CHARGE ACCOUNT NOL EXEXCH. DATE J DESCRIPTI N ITEM NUMBER:., 6 UNITPRICE. V �tj LA __�p MAY 1 6 ox Form Nri. 99-0040A (12M5) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT MR PAYMENTS TO: TRACTOR SUPPLY COMPANY Su P.O. Box 9020 irar tqr ;uI H1.Y Ci,nhanr Des Moines, IA 50368 -9020 23•lS La, PleasRrt t Si TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Oublesu t l l e, ii 4606U 6035 301 f 3j r ((6 -1 F10:3 NAME CARMEL CL (-)Y F Pt :C 142? C 116TH ;i i ADDRESS CARM L IN 460,123453 cs1(} 3('1.205 CIT' STATE ZIP PHONE 05 /Ofit�00i� t:: ,;3ttrt CUSTOMER TO COMPLETE 7212-0s6 SHOE Lh1 t.S 1.00 V 59„ )o' SV. t! CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Rog. Price: l5', P6 The undersigned certifies The undersigned party certifies their exemption from Ciaveritt Agerictes compliance with the agricultural payment of sales and use tax on tangible personal (OW671 SfIOt LTidh' 6 IM 10SE sales tax exemption law of the state property as indicated below and /or purchaser is t 0O fd 1.59 ui 1.59, 9r.' C41 indicated below and understands engaged in the business of agricultural production of Guvernntent ADoucies and agrees with the General 6 "Welt} (tGCl;r I1LI J Lb t I'lid W food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and i t' ;!s' 196 resale and/or uses the farm machinery, equipment or r,2 Z: the applicable statement of the 1:1'44- rnI11Unt A- 3COCUI respective state printed on the other agricultural production items purchased free of 771 BOUT LTHR 6:1:1; CE5 reverse side of this form. tax, as defined by state lave, and as Indicated below. t ou L 139;, 811.96 of PRODUCT IS TO EU ED IN THE FOLLOWING The undersigned party further certifies they Gnv:.-rnnen? Aw,�nt.ie:, STATE: 1 Y Y p ayment understand the may be liable for a ment of all taxes 7 410"1' 1 hl10 C LIKN LIN Sl d (REQUIRED) due on the purchase price for the goods as allowed by 1 OU V av 96 3`, ill Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in Ties P ice: t'' y5 COMPLETE REVERSE SIDE) a taxable manner as defined by state,laws. Goj srnster. f�sencP: PURCHASER IS ENGAGED IN: (REQUIRED) Sub tota l Ole, Resale Under penalty of perjury, signee swears the Government information on this statement is true and correct in 0.Qu Exempt organization every material manner. Awillfully false representation Tatal_ ?7N.f;4 Agricultural Production of exemption will cause the purchaser to be subject to 1:3C Lard Dairy Production penalty and /or other provisions as allowed under state A' Ct bx zatasxxta5001 Livestock Production 11u'cli 1 Ut78s ek; he{ i' 6130`1424670 F Floriculture /Aquaculture Production law' P„J RON Other: C "hanryc t },3jt} Cag I 'tic k ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery /Repair Parts Government Agency (Entity 1 Buyer itC1(TI0 J led5t—, the rereir''i of a cm t Livestock Injestibles or Injectibles Exempt Organization (Entity F Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Copy of this 50.1`5 Slip aTir1 flu. t- urchat.e, 0 r Consumed in Production (KS) C7 Resale (Sales Tax Permit 1hv described r er(.hondi•;w slia I1 he mi Ingredient or Component Parts (KS) rt al'�iance !Jt i'It itic !:c rclttDltlf r t, rl :t Lu Other: 10 C J t;i�,r.ature: 5 MERSI ATURE:(R MGR. APPROVAL V G X 9 Q .2 USE SHA DED =J�rcl VISA fC DISCOVER TSC CHARGE ACCOUNT NO.. CHG. EXCH. DATE ATEM NUMBER QUANTITY UNIT PRICE, 20Q8 L'.Y: QIISTOMER ORIGINAL 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. 18090 Terms Tractor Supply Co. Date Due PO Box 9020 Des Moines, IA 50368 -9020 Invoice Invoice Description Date Number or note attached invoice(s) or bill(s)) Amount 144.99 5/14/08 1407541884 Clothing 617.93 5/14/08 1407431164 Clothing 379.84 5/8/08 0809424670 Clothing Total 1,142.76 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Tractor Supply Co. Allowed 20 PO Box 9020 Des Moines, IA 50368 -9020 In Sum of 1,142.76 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Dept Board Members 18090 1407541884 435600 144.99 1 hereby certify that the attached invoice(s), or 18090 1407431164 435600 617.93 bill(s) is (are) true and correct and that the 18090 0809424670 435600 379.84 materials or services itemized thereon for which charge is made were ordered and received except 23 -May 2008 4 natur 1,142.76 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund