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