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164966 10/16/2008
CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO r, CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $38.04 DES MOINES IA 50368 -9020 CHECK NUMBER: 164966 CHECK DATE: 1011612008 DEPA ACCOUNT PO N INV OICE NUM A MOUNT DESCRIPTION 1125 4237000 PARKS 38.04 6035301202854988 I page 1 of 3 7 sumyco- BUSINESS ACCOUNT OCT 0 9 2008 BY: Previous Balance 581.75 Closing Date 09/29/08 Payments 581.75 Next C losing Date 10/30/08 CARMEL CLAY PARKS REC Credits 0.00 Payment Due Date 10/24/08 ACCOUNTS PAYABLE Purchases 38.04 1411 E 116TH ST Debits 0.00 Current Due 38.04 CARMEL, IN 46032.3466 FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 7,500 Late Fees 0.00 Minimum Payment Due 38.04 Credit Available 7,461 New Balance 38.04 CURRENT ACTIVITY Trat>ISao #ion Locati ©nl E Amotn SEP 3 GOODS AND SERVICES NOBLESVILLE IN 25.56 SEP 3 GOODS AND SERVICES NOBLESVILLE IN 12.48 TOTAL 6035301202854996 $38.04 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS SEP 20 PAYMENT REF P9194COLT09XOT784 581.75 Customer Service and Billing Errors address: PO Box 689161, Des Moines, IA 50368 -9161. FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Baiance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic Billi PERCENTAGE Subject to Periodic Riling PERCENTAGE Finance Charge Rate Per tod RATE Finance Charge Rate Period RATE REGULAR REVOLVE CREDIT PLAN 0.00 00000 ii 0.00 0.00 .00000 29 0.00 This Account by.Citibank (South Dakota), N,A.. .,CUSTOMER SERVICE 1-800-559-8232 FAX NUMBER 1- 801 779 -7425 Notify Us in Case of Errors or Ouestions 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 ton 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: e 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 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. 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 accounf number on the front of your check or money order. Tractor Supply Co. Full Balance S902TV 10/06 902TV5741006 PCT page 2 of 3 IVT iMR SUPPLYCO. BUSINESS ACCOUNT OCT 0 9 2008 CURRENT ACTIVITY $y A t� �Trarr�oti�rr 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." enz Remit To: BIII To: page 3 of 3 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301202854988 IVTRACTOR DEPT.30- 1202854988 TODD SNYDER SUMYC PO BOX 689020 1427 E 116TH ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 Payment Due Date: 10/24/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TO: INVOICE. 431000867195010 624001016080010 Purchase Order: Purchase Order: 19281 2 AMOUNT DUE: 581.75 AMOUNT DUE: 25,56 Store: 574000451 INVOICE DATE: 08/21 108 store: 574000624 INVOICE DATE: 09/03/08 TANK STL 105 GAL L SNAP 0826161 1.00 377.97 377.97 299BC 2 PIPE GATE HGE 2 3505936 1.00 6.99 6.99 FUEL PUMP EZB 3858004 1.00 199.99 199.99 2996C 2 PIPE GATE HGE Z 3505936 1.00 6.99 6.99 BOOSTER CABLE SOAMP CLA 0475247 1.00 3.79 3.79 SCREW HOOK 3/40 IN ZINC 3540871 1.00 5.79 5.79 SCREW HOOK 3/4X61N ZINC 3540871 1.00 5.79 5.79 SUBTOTAL 581.75 TAX 0.00 SUBTOTAL 25.56 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 581.75 TOTAL 25.56 OCT 0 8 2008 SHIP To: INVOICE: 624001015926010 Purchase Order: 2 AMOUNT DUE: 12.48 Store: 574000624 INVOICE DATE: 09103 /08 HITCH PIN 3 /4X4IN 3PT 0268810 1.00 4.79 4.79 LYNCH PIN 7 /16IN 3PT 0268789 10.00 0.29 2.90 HITCH PIN 5 /6X4IN 3PT 0268802 1.00 4.79 4.79 SUBTOTAL 12.46 TAX 0.00 SHIPPING 0.00 TOTAL 12.48 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425 REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: TWTO TRACTOR SUPPLY COMPANY �Y�� P.O. Box 9020 Tractor Supply Company Des Moines, IA 50368 -9020 2375 East Pleasant St. TSC TEAM MEMBER TO COMPLETE Please include 16 Dig Account Number Noh IN 46060 9 (3171 776 -1883 6035 301 NAME CARMEL CLAY PARKS REC. 1427 E 116TH ST ADDRESS CARMEL IN 460323455 (317) 571-2695 CITY STATE ZIP PHONE 624 624000103 1 1 016080 09/03/2008 01:16Pm CUSTOMER TO COMPLETE 3505936 299BC 2 PIPE GATE HG 1100 1? 6. 6.99 N T CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Agencies The undersigned certifies The undersigned party certifies their exemption from 3505136 299BC 2 PIPE GATE HG compliance with the agricultural payment of sales and use tax on tangible personal 1'00 6,99 6.99 NT sales tax exemption law of the state property as indicated below and /or purchaser is Government Asenc ies indicated below and understands engaged in the business of agricultural production of 3540871 SCREW HOOK 3 /4X61N Z and agrees with the General food or fiber, horticulture, a uaculture of floriculture for 1.00 L 5.79 S. 79 N'r Exemption Statement at right and q resale and/or uses the farm machinery, equipment or Government Agencies the applicable statement of the 5540871 SCREW HOOK 3/06IN Z respective state printed on the other agricultural production items purchased free of 1.00 5179 5.79 NT reverse side of this form. tax, as defined by state law, and as indicated below. Government Agencies PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Subtotal 25.56 STATE. understand they may be liable for payment of all taxes 7.00% Tax 0.00 (REQUIRED) due on the purchase price for the goods as allowed by Total Z5.56 (Exceptions: Georgia, New York Kentucky state law should such goods be used or Consumed In T Cara 25.56 COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. Acct tttttttttttt4996 PURCHASER IS ENGAGED IN:(REQUIRED) Au th* 003255 Ref 0312161531 Resale Under penalty of perjury, signee swears the PO *:0 Government information on this statement is true and correct in Chanse 0.00 Exempt organization, every material manner. A willfully false representation Cash Back Agricultural Production of exemption will cause the purchaser to be subject to Dairy Production penalty and /or other provisions as allowed under state l Livestock Production Buyer acknowledses the receipt of a temple Floriculture /Aquaculture Production law' to Other: COPY Of this sales slip and the Purchase o ITEMS PURCHASED WILL BE USED FOR:(REQUIRED) the described merchandise shall be in Farm Machinery/Repair Parts Government Agency (Entity# accordance with the Cardholder Asreement. Livestock Injestibles or Injestibles Exempt Organization (Entity f p Fertilizer /Ag rich emicals NC: only DOT and US Government are exempt Sisnature: Consumed in Production (KS) Resale (Sales Tax Permit ingredient or Component Parts (KS) Other: tt>; ttt :ttss; :xtxtxtttt :tttttttt:tttt CUSTOMER SIqWZ"JRV4EOUI MGR. APPROVAL z X. USE SHA DED CASH CHECK VISA`.. 'M /C DISCOVER TSC CHARGE ACCOUNT N0. CHG: EXCH., DATE J a o ,o5 o :a a e. QUANTITY !,ITEM NUMBEFI_ DESCRIPTION' I V (1 PF T r: S E P 6 20os Bud LUMP Form No. 99 -00401 (12105) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: T1C�R TRACTOR SUPPLY COMPANY )W. SV"I,YCO P.O. Box 9020 Tractor Supply Company Des Moines, IA 50368 -9020 2375 East P leasant St TSC TEAM MEMBER TO COMPLETE Nablesvi l le. IN 46060 Please include 16 Digit Account Number (317) 776 -1883 6035 301 NAME CARMEL CLAY PARKS REC 1427 E 116TH ST CARMEL IN 460323455 ADDRESS (317) 571 -2695 CITY STATE ZIP PHONE 624 624000070 1 1015926 09/03/2008 10 :21 am CUSTOMER TO COMPLETE 0268810 HITCH PIN 3/04 3P 1,00 4.79 4.79 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT. Government Asencies The undersigned certifies The undersigned a certifies their exem from 0268789 LYNCH PIN 7/16IN 3PT ers compliance with the agricultural g party 10.00 0.29 2,90 sales tax exemption law of the state payment of sales and use tax on tangible personal Government Asencies indicated below and understands property as indicated below and /or purchaser is 026880'2 HITCH PIN 5 /GX4IN 3P and agrees with the General engaged in the business of agricultural production of 1,00 4.79 4.79 NT Exemption Statement a right and food or fiber, horticulture, aquaculture of floriculture for Government Asencies the applicable statement of the resale and /or uses the farm machinery, equipment or respective state printed on the other agricultural production items purchased free of Subtotal 12.48 reverse side of this f rm. tax, as defined by state law, and as indicated below. 7.00 Tax 0.00 The undersigned art further certifies the Total 1'2.48 PRODUCT ISTO� NTHEFOLLOWING 9 p ar t y Y TSC Card 12.48 STATE: I understand they may be liable for payment of all taxes Acct iii#i#i #:#3:4996 EOUIRED) due on the purchase price for the goods as allowed by Autho :003876 Ref #:0309204872 (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed In PO COMPLETE REVERSE SIDE) a taxable manner as defined b state laws: Y Chanse 0.00 PURCHASER IS ENGAGED IN:(REOUIRED) Cash Back Resale Under penalty of perjury, signee swears the A Government information on this statement is true and correct in Buyer acknowledses the receipt of a comple Exempt organization every material manner. A willfully false representatio d Agricultural Production of exemption will cause the purchaser to be subject to copy of this sales slip and the Purchase o Dairy Production penalty and /or other provisions as allowed under statg Livestock Production law the described merchandise shall be in Floriculture /Aquaculture Production Other: accordance with the Cardholder Asreement. ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity Sisnature: Livestock Injestibles or Injectibles Exempt Organization (Entity E) FertilizedAgrichemicals NC: only DOT and US Government are exempt ,jam J (1C F1 Consumed in Production (KS) E] Resale (Sales Tax Permit r I iti#S3iYiiifii #iit i ti #SYiii3#it Ingredient or Component Parts (KS) Other: Call 800 968-0734 within 7 days to complete a survey and be entered in a U ER S MGR.APPROVAL L/ X USE AREA ONLY CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE I I ITEM NUMBER NON DESCRIPTIO TAX FRR T Parr tau BY: Airchasw )do Approval/ Form No. 99 -00401 (12/05) CUSTOMER 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 Tractor Supply Co. Purchase Order No. 18090 p 306840 Dept 30- 1202854988 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 9/3/08 624001016080010 Parts for gate at Central Park 2.5.56 9/3/08 624001015926010 Tractor pins 12.48 Total 38.04 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 T 1 20 Clerk Treasurer 5 Voucher No. Warrant No. Tractor Supply Co. 306840 Dept 30- 1202854988 Allowed 20 P.O. Box 689020 Des Moines, IA 50368 -9020 In Sum of 38.04 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #[TITL AMOUNT Dept Board Members 1125 624001016080010 4237000 25.56 1 hereby certify that the attached invoice(s), or 1 125 6 240010 1592 6010 4237000 12.48 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 8 -Oct 2008 Signature 38.04 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund