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Home My WebLink About163984 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 0 ONE CIVIC SQUARE TRACTOR SUPPLY CO CHECK AMOUNT: $581.75 CAR9VIEL, INDIANA 46032 Po eox sssozo DES MOINES IA 50368 -9020 CHECK NUMBER: 163984 CHECK DATE: 9/1712008 DEPA ACCOU PO NUMB INVOICE NUMBER AMOUN DESCRIPTION 1125 4237000 PARKS 581.75 6035301202854988 I I 1 page t of 3 T i aCTO f SUMYCO- BUSINESS ACCOUNT cco UNT sun�n��rg 435 34i 2 028x498$ 4N Previous Balance 279.97 Closing Date 08/28/08 Payments 279.97 Next Closing Date 09/29/08 CARMEL CLAY PARKS REC Credits 0.00 Payment Due Date 09/22/08 ACCOUNTS PAYABLE Purchases 581.75 1411 E 116TH ST Debits 0.00 Current Due 581.75 CARMEL, IN 46032.3455 FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 7,500 Late Fees 0.00 Minimum Payment Due 581.75 Credit Available 6,918 New Balance 581.75 CURRENT ACTIVITY R OME= t8t1§flCtibn �L1UC8tigN a �ARIoum AUG 21 GOODS AND SERVICES WESTFIELD IN 581.75 TOTAL 6035301202854996 5581.75 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS AUG 7 PAYMENT REF P919400KD09GBH2A3 279.97 Customer Service and Billing Errors address: PO Bo Des Moines, IA 50368 -9161. 5� FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic Bill PERCENTAGE Subject to Periodic Billing PERCENTAGE Finance Charge Rate Penod RATE Finance Charge Rate Penod RATE REGULAR REVOLVE CREDIT PLAN 0.00 .00000 29 0.00 0.00 .00000 as 0. DO This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1- 800 -559 -8232 FAX NUMBER 1 -801- 779 -7425 f 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: 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 clay. 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 believe 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. e 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 lie received in proper form at our payments received in proper farm, 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 VSWYC! BUSINESS ACCOUNT CURRENT ACTIVITY Tiensaction f 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 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." Remit To: Bill To: page a or a ®TOR TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301202854988 DEPT.30 120285,4988 TODD SNYDER SBUSINESS LY PO BOX 689020 1427 E 116TH ST DES MOINES IA 50368 -9020 Payment Due Date: 09/22/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO; INVOICE: 431000867195010 Purchase Order: 19281 AMOUNT DUE: 581.75 Store: 574000451 INVOICE DATE: 08/21 /08 TANK STL 105 GAL L SHAP 0828181 1.00 377.97 377.97 FUEL PUMP EZ8 3858904 1.00 199.99 199.99 BOOSTER CABLE 50AMP CLA 0475247 1.00 3.79 3.79 3...' SUBTOTAL 581 -75 f TAX 0.00 SHIPPING 0100 TOTAL 581.75 Please Direct Inquiries to: Phone: 800-559-8232 Fax. 801- 779 -7425 i ~i-. Z.' R TSC BUSINESS ACCOUNT PAYMENTS TO: TRACTOR SUPPLY COMPANY SUPMY P.O. Box 9020 Tractor Tractor S Company Des Moines, IA 50368 -9020 U 18160 U.S. 31 North TSC.TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westf ield, IN 46074 6035 301# (317) 867 -3505 NAME „z CARREL CLAY PARKS REC 1 1427 E 116TH ST ADDRESS CARREL IN 460323455 (317) 571 -2695 CITY STATE ZIP PHONE 431 431000170 2 867195 08/21/2008 12:40Pm CUSTOMER TO COMPLETE 0828181 TANK STL 105 GAL L S 1.00 377.97 377.97 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Agencies The undersigned certifies The undersigned party certifies their exemption from 3858004 FUEL PUMP EZ8 compliance with the agricultural payment of sales and use tax on tangible personal 1.00 199.99 199.99 NT sales tax exemption law of the state property as indicated below and /or purchaser is Government Agencies indicated below and understands engaged in the business of agricultural production of 0475247 BOOSTER CABLE 50AMP and agrees with the General 1 00 3.79 3.79 NT Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for resale and /or uses the farm machinery, equipment or Government Rsencies the applicable statement of the respective state printed on the other agricultural production items purchased free of Subtotal 581 .75 reverse side of this form. tax, as defined by state law, and as indicated below. 7,00 Tax 0.00 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Total 581.75 STATE: understand the y y p ayme nt may be liable for a t of all taxes TSC Card 581.75 (REQUIRED) due on the purchase price for the goods as allowed by (Exceptions: Geo a A cct0 :ttEEttttEttt4996 tions: Georgia, New York Kentucky state law should such goods be used or consumed in RBI th8:02199b Ref x:21 1 1 395387. COMPLETE REVERSE SIDE) PO x 09281 a taxable manner as defined by state laws. Chanse 0.00 PURCHASER IS ENGAGED IN: (REQUIRED) Cash e k F 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 d Buyer acknowledses the receipt of a comPle Agricultural Production of exemption will cause the purchaser to be subject to Dairy Production penalty and /or other provisions as allowed under state copy of this sales slip and the Purchase o Livestock Production Floriculture /Aquaculture Production law• the described merchandise shall be in Other: accordance with the Cardholder Asreement. ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity Sisnatur Livestock Injestibles or injectibles Exempt Organization (Entity Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Consumed in Production (KS) Resale (Sales Tax Permit Ingredient or Component Parts (KS) ttttEiEEEEtEtttE2tttEtttttttEEttttttt EE# EEtEEtEt tEt2EitEEEEEtEEEEEEEEEE #E orner. Call 800- 968 -0734 within 7 days to complete a survey and be entered in a TOM S AT U E•( Q MGR. APPROVAL X e o s CASH. CHECK VISA M/C DISCOVER' TSC CHARGE.ACCOUNT N0. CHG. EXCH, BATE PURMW P.O 0 P 0111D AU 2 2 2008 OLL0 une Date Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL ARKANSAS The customer, as indicated by (heir signature on the r ;ver'se, cen that he/she is engaged in the i>Usiness of ferrniilq and the inell m ohinefy and equipment purchased will be used exclusively and directly in the agricultural production o1 food or fiber as a husiness. The reverse sigoedl is .mare that any false representation made by Ill.m in an atte rnpf to purchase farm n achinery and equipment Tree born Arkansas Sake. Tax is .demeanor. GEORGIA_ Thos reverse signed hereby cerlilies that all tangible personal property purchased or leased after the r indicated date will be purchased or leased for the purpose indicated below, unless otherwise specified o a particular order, .nd that the purchases a sed a a part of a pur�.0 il in for profit. Tllfs Certihccnle Shall remain in effect until ravok.d in writing- Any tangible pa,—.1 property obtained under this certificate OI axe mption S subject to the solos and use tax if it is used or consu med by the purchrase, iu any manner Other than indicated on this certificate. (Chock proper box.) ,r,,�„ 7 91 -FARM MACHI tf' EQUIPMENT- 4 Rubber tired farm 3gyjors a d attachment whlct]yv used OXClusivefy in nil r "sale. Such crops well be planted and harvested w thin a Iwelve t/i padod Machinery andror qu{{arfient which will be used On the farm or fn the prraductio,a of poulir eg s for sale. O.G.G.A. a8�8_3(29j(A} J 3. Machinery andro q rpm t hich will he used on the f 1' r.tly the p esiit' iECSi s 1g m s Stage a u milk rain ale O. C_G. A_ 48 8 3(29)(C) Machinery andio� q ipm 1 hich will be used on tyre t f'rF Ctly tt e p U t1' l f I stock for kale O C G A 48-6-3(29)(D) J 5 Mac Winery and /o. equipma 1 htph well tZe -used on the farm directly in hire e. gi crops grow 1 and used qn [he farm as feed for poutry or livestock by a producer falling under the categ.d.e 2, f (i'.sl�oval O- 48- 8- 3(29)(E) 6- Machinery andl.r equipment hi I, will ba u i t" in halc-hing and breeding rrt eeding O'POry and Iivestock for Sale. O- C.G B -A_ 4- B- 3(29)(6) T. Machinery andr.i equipment which -tit be used tiling the soil or n an real husband, 4 LL,, Machinery and/or tap p menI -wtnch well tae us d F elusively for ire gation of fat l ;grown Or.s I including, but not ffmirb ti'Sit l'Gil, vegetalalo and out Stops. O.C.U.A 48-e 3{2sxi ...i 'a'. r< �'e j 7 9 Pecan sRrayers peceto•ahafr> =r5 antllor'othar qu p-.nt used in harverti,lg pr{Q(�''??��y Cquipme it which will be used on the farm exclusively in processing onions. OaL.`.L`r. TIMBER EQUIPMENT �i TED ATTACHMENTS- Oft -road equipment and reia led agacnmenlS which will be used exclusively i Ihf1' re sri p,eparation, planting, cultivation, or harvesting of timber. This shall include all oft -road equipment and related attachments used In every forestry procedure starting with the severing of a tree from the ground until and aicI.dino the point at which the free or its parts in any tor- has been loaded in the field in or an a ll oCk or other vehicle for transport to the place of use O- C.0-A. 413-13- 3(29)_1) LIVESTOCK, SEED, FERTILIZER, FEED, PACKAGING, ETC I 12_ Cattle, hogs. sheep. horses, poultry, and us when sold for breeding purposes- O- C.G -A. 48 -8 -3(28) 73. Seed, seedlings, fertilizers, insecticides-i rodemicides, herbicides, dololianls, soil fumigants, plant growth regulating chonlittals. desicca Sts (including shavings and sawdust from wood, peanut hulls, fuller's earth- straw and hay) and lead for tivestnck, fish or poultry when used either directly in tilling the soil or in animal, fish or poultry husbandry: and/or, nonroturil 1. rnaferiats used for packing farm products for shipment or sale. O.C.G.A. 48 -a- 3(25) (35) (A) (!if) -FUELS USED IN POULTRY STRUCTURES ELECTRICITY USED IN IRRIGATION OF FARM CROPS- j r 14. The sala o7 1 clrfcfly tor' fhc- O ration of an irrigation system which is used On a farm exclusively for it of farm crops when separately metered- O.C.G.A. 48 -8 -3(64) l5- Liquefied j�e Er leurn g s or o ar fueE usad a structure In which faro iler5. pullets, Or Other poultry erne raised when separalely -1-1.1.d. .,C..,. 48 -8 -3(49) ILLINOIS: The reverse Signerf by rtifies that the property purchased will be used pri al-fly in production n agriculture or in State o Federal agl'iculturo programs- Any farrn chemicals purchased as exempt are such pursuant to Section 130.11055. KENTUCKY: "The re. signed hereby certifies that they are a fanner regularly engaged in the occupation of. (farmer must initial appropriate line(s)) tilling and cultivating the soil for the production of crops: wsirjq,ancl feeding.. livestock or poultry the products of which ordinarily constitute food for human consumption; or sing 'and feeding llamas. aipacers, ratites, buffalo, or aquatic organisms. The reverse signed also certiffes that the tangible personal property purchased as indicated below will be used for the exempt purpose(s) provided for under KRS 139.480. Farmer must INITIAL appropriate fine(s). t,' tt i f C F rt Baling twine and wire Farm chemicals C I Ulf r l t l' tl 1 (14.t." [tf Farm machinery. attachments and repair!replace -ent parts therefor Farm work .1 t 2 t li t X E 6 :Ili S. t YI L: X t i' S t i t t i Feed and feed additives SX$E4XXdX.X °d Yl3Xt "X tX4ljXvX42:B ;a "t57! Gas Olfne, special fuels, natural gas or liquefied petroleum gas Livestock Or poultry the products of which Ordinarily Constitute food for human Consumption Ratites, llamas, alpacas, buffalo, er aquatic organisms Machinery, equipment, attachments and repainrepl.-lCe 11, en t pants thereto, to be incorporated into an existing farm isoybean 9-ir facility and poultry, livestock, ratite. Ilama, alpaca, or aquac.1tri a 11— ilitiese Seed or fertilizer' Materials to be incorporated into the renovation or repair Of an f'xis ling on -13rrn grain /sayho.-tn lacilrtie and poultry, fivastpu'k, ratite, 13ama. alpaC.'f.. nr aqu2Gl11tu Ye tacit sly. Water used in the production of crops as a business or in the raising of livestockfpoultry, ratites, (fames, alpacas, buffalo, aquatic.orga Srn and dairy cattle. SEE REVERSE SIDE SEE_ RF_VERSE SIDE_ Signature Date MICHIGAN!. The reverse signed hereby sertitfes that all items, c cept a ndicated, are purchased for u mption i n connection with the production el horticultural or agricultural products as a business onterprisB_ and agrees to reimburse the Salle tile tax it used or cousum.d �.0 Unlawful se of this ce,tfffcale subje4 f persons to the.penaities pi the sales tax aof- 4`! t: 300;, pl)r'-! FF', L.;1.t{( „le -1trl, <e,•,;i'•r U.., a t NORTH DAKOTA, SOUTH DAKOTA: TM1a purchases made herein o i are subloct to the reducetl rate of sales tax and are not 111ellti fro)nlsu-tax., iy.,L�j.7!!1! t .(�<{i'f fti, r,l NEBRASKA: The reverse signed certifies the intended use of the items purchased renders rl exempt under Reg. -060, t -061 Or 1 -003. TEXAS CERTIFICATION OF EXEMPTION Purchaser's name SEE REVERSE SIDF_ t r rr� •l'r l? [t:!”. i. f" ritY. y Street Address SEE REVERSE SIDE City, stale, zip Code SEE REVERSE SIDE it f claim an exemption tram payment of sales and us. taxes for the purchase of taxable items dasc below or on the attached SEE REVERSE SIDE i t i ::i ?f; ,1� f i•�f�(iih Description at items for an anached order or invoices) to be purchased: SEE REVERSE SIDE claim this ...mption for the following reason: t"d� t,) yy;, f( 'SE-E. REVERSE SIDE tr 1 understand That I will be liable for payment o1 sales fax which may become due for failure to comply with the provisionsjtll iaftrax Code: Limited Sales. Excise, and L,get7fix Act, Municipal Sales and Use Tax Act, Sales and {Ise Taxes far Special Purpose Taxing Aulh.lities. County Sales and lase Tarr. Act, [~oyn y li lea{th Services Sales and Use Tax and the Texas Health and Safety Code: Special Provisions Relating to Hospital Oistricts, Emergency Services Districts, and r Sfricts in counties with a population of 125, 000 or less, t_iabi rity for the tax will be determined by the price paid for the taxable items purchased or the fair' market rental va rl for th p d o- -+true ur.D j, i 1! 1 understand that it is a criminal oftenste to give an exemption certificate to the seller for taxable items which I kno al the me o po C will tie ri ed a m j'n �1 otnen than that expressed in this certificate_ 1 Q Seller: SEE REVERSE SIDE Street address: SEE REV F_RSE cu. a City, state. zip code: SEE REVERSE SIDE Purchaser's signature: SEE_ RF_y=RSE SIDE Dat.: Phone: Title: SEE REVERSE SIDE t ii; i:r :i t)r; This certificate does not require a number to be valid. 1(l l t 1:1) Sales and use tax exemption n mbers or tax a mpt n mbers do not exist. This certificate should be I. /shed to the supplier_ Do not Send the competed Certificate to the Contptrolfer of Public Accounts Effective Date' September 10, 1991 Rule 3.287 NEW YORK STATE DEPARTMENT.OF TAXATION AND FINANCE NEW YORK. STATE AND LOCAL SAL'ES:ANb{USE TAX, rlW? FARMER'S EXEMPTION CERTIFICATE t To purchasers and sellers: To be completed by the formal, given to and retained by the seller, To have a valid certificate, all entries llruat r bJ pl.I.d. �'1 Read all instructions carefully before completing or accepting this certificate. f 1 t .t t t!rtf1 131; ,r t To sellers: You may not accept this cemacate as the basis for selling exempt from tax the property or ter vices fisted below. fa. rte cu {IHGtad'<in sucri's'aiSS This cerfificafe may not be users fo claim exemption for the felnowingf ^t' IeL f!MG0 4 R(-. t1C 7G? t. u ;ilifieS, fuel oil, motor fuel or di...I fuel: 2. labor charges in connec:tiOn with repair', rnaintanan Ce of or service to real property: 3- langible personal p ols-ty incorporated i to a buildia structure, silo foundation or other capital improvements to real property (excluding grape licenses and the e, ing portions of a silif):Iy)ntl., vehirjll�* i> property Eisilai7,a5 {tip. elite. Name of salter R TACTO SU COMPANY AFFILIATES A ttn: Tax Name of Farmer SEE REVERSE SIDE Street address 200 Powell place street address SEF Rf�VF_RS SIDE 53 S ci It F L City Brentwood _State TN ZIP Code 3T02T___ City_,_„. Slz f- RCVERSC SIDC_ state 9o ,ry r Check appltcabte box- M Single Purchase Certificate 0 R�lanket Certificate P I, the reverse signed hereby certify that 1 am a.6-pt from payment of the Sales and use tax on tangible personal property purchased,U 6 you bee the property is'td be ,usoQ�lbr exempt purpose and that certain sorer... are also exempt when performed on an exempt property. (Check applicable box. or bO�es L7 (a) Tangible personal property, except property incorporated Into a building o structure, for use or consumption dir'etdtl t y Erd:p ;y an tNc -pr uctlon of tangible personal property for sale by farming, including stock, dairy, poultry, fruit, fur bearing animal, and truck farming. The term farming also includes ranching, operating nurseries, greenhouses or other similar structures used primarily for the raising of agricultural, horticultural or floricultural commodities, and operating orchards or vineyards- {'y T r As l� {fj'r I CI (by Tangible personal property for use in erecting, adding to, altering or improving a site used in farming to mak� antl tofe`siliage ton a farm, provided Such tangible personal property is to become an integral component part of Such site. (This exemption does not apply to fian'gibly in constructing a silo foundation.) ,r) (c) posts and wire for use in constructing or m ntaining vineyard trellises used In growing grapes for sate. EJ (d) Services of installing- repairing, maintaining and servicing exempt tangible personal property. (This exemption is pr vitleQ far bo)h state and local safes and use tax with the ....piton of the tax imposed by or for New York City.) y N Il:l j j* These statements are made with the knowledge that willfully issuing a false or fraudulent certificate Willi the intent to evade a ��p i tl of Und fm) er section 1817 of the New York Slate Tax Law and section 2/0 y .45 of the penal law punishable b a fine of not more than $1 mprisonntont for S o ,000, or i jjl r �V46 t� ol r`ri e•[tian ta'r` •1_4 l f n il.1 L r� Sign elute Of farmer Or farmer's representative (state lisle and relatio nahrp) SEE REVERSE_ SIDE 4 c l i o ip'h ifs i. Seller llae tax exc+m piton toff tarruers is limited to the purchases of an (7) [gi bee personal property used directly and predominantly Fhe r pnotlu cfion phase of farming and (2) 1h. services described in (d) related to that property. Purctleses for use in administration, storage or marketing or purchases of tangible personal property used indirectly in Terming would not qualify. (See Publication 844, Sales T x' Information for Farmers, for a complete explanation of the tax treatment of farmers purchases and sales.) l (,S2ry1 L For you; protection, a farmer must give you this certificate not "for than 90 days after del very aT the property sold or services rendered. II youltra e ndt(i'eEel Cd lb,1 ode Vlicate within 90 days of the date of sale- the sale will be deemed to have been taxable at the trine the transaction took plac. and the burden of provipg it was not; r sl all I3e upo both yo a td (ha purchaser, �l If the blanket certificate box fs checked, you may consider this certificate prim of any order received frorn the purchaser. A blanket certificate gg ns !n fore t o n7yi 1 'criasc+r givc� you written notice of revocation, or until the Tax Department notifies you that file purcl faset may not make exempt purchases. Lf: f. �cl, Pf Uf;ef �II i Purchaser You must pay lax on utilities (telephone, telegraph, electricity or gas service) healing Olt. motor fuel antl diesel motor fuel at the time of purchase and claim a refund for any exempt use. (it you a e purchasing diesel motor fuel for exaluseve consumption in farm machinery used to produce tangible personal property tot sale, you may use Farm FT -1004, Forme 5 Ea-ernlsf'on Cerfi /-ate for Purchas of Oiosi l Motor Fuel to purchase that fuel exempt.) t I er eck If the blanket certificate box is Ched, you may consider this certificate part of any order received from the purchaser. A blanket certificate remains in force until the purchaser give_, you written notice of revocation. or untif the Tax Department notifies you that the purchaser may nor make exempt purchases. r .vim yF'' -,b.c c. x <w... a.. d. �..._.w.. 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 Dept. 30 1202854988 Purchase Order No. 19281 F 306840 Tractor Supply Credit Plan Terms P.O. Box 689020 Date Due Des Moines, IA 50368 -9020 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8121108 603530120285498o Repair parts 581.75 Total 581.75 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 1 20 Clerk- Treasurer Voucher No. Warrant No, Dept. 30 1202854988 306840 Tractor Supply Credit Plan Allowed 20 P.O. Box 689020 Des Moines, lA 50368 -9020 In Sum of 581.75 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT#rTITLE AMOUNT Board Members Dept 1125 603530120285498o 4237000 581.75 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 9 -Sep 2008 Signature 581.75 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 1