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164967 10/16/2008
CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $181.01 DES MOINES IA 50368 -9020 CHECK NUMBER: 164967 CHECK DATE: 10/16/2008 DEPARTMENT T ACCOUNT PO NUMBER INVOICE NUMB AM DESCRIPTION 2201 4238900 STREET 181.01 6035301200050860 page I of 4 TX 7 D 130ift MTOK go-M. vsumyco- BUSINESS ACCOUNT 0000487 m i g i t wtv WEBB> m -WNW -W! 0 Tr.X=A'- Previous Balance 1,441.01 Closing Date 09/18/08 Payments 1,519.77 Next Closing Date 10/21/08 CARMEL STREET DEPT Credits 65.29 Payment Due Date 10/13/08 CINDY Purchases 246.30 3400 W 13 1 ST ST Debits 0.00 Current Due 102.25 WESTFIELD, IN 46074-8267 FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 5,250 Late Fees 0.00 Minimum Payment Due 102.25 Credit Available 5,147 New Balance 102.25 CURRENT ACTIVITY W ag wg— OF INS NOW AUG 26 GOODS AND SERVICES WESTFIELD IN CREDIT 44.68 SEP 12 GOODS AND SERVICES WESTFIELD IN 73.98 TOTAL 6035301200074803 $29.30 SEP 5 GOODS AND SERVICES WESTFIELD IN 11.99 TOTAL 6035301202895932 $11.99 AUG 25 GOODS AND SERVICES NOBLESVILLE IN 44.68 SEP 3 GOODS AND SERVICES NOBLESVILLE IN 115.65 SEP 9 GOODS AND SERVICES WESTFIELD IN CREDIT 20.61 TOTAL 6035301202896013 $139.72 FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance D ly Days in ANNUAL Per Por S I PERCENTAGE i dic Bill PERCENTAGE Fina2 Rate P RATE Fina Rate P.r RATE REGULAR REVOLVE CREDIT PLAN 0. 00 00000 so 0. 00 0.00 .00000 29 0.00 This Account Issued bv Citibank (South Dakota). N.A. CUSTOMER SERVICE-1-800-559-8232 FAX NUMBER I-BOl-779-7425 Information About Your Account applicable daily periodic- rate, and add those two figures together, the result is the periodic finance charges assessed for that balance, except for minor variations Grace Period for Purchases: The grace period for our is at least 20 days. caused by rounding. Therefore, to avoid periodic finance charges on purchases that appear on this If a periodic rate is a monthly periodic rate, we use the following calculation statement, you must (1) have paid the New Balance, plus the minimum monthly method. We take the beginning balance for each balance every day (including payments required for your No Interest and 0% balances, on the last statement by that periodic finance charges imposed in previous' billing periods) add any new statement's payment due date and (2) pay the New Balance, plus the minimum monthly charges, subtract any credits or payments credited as of that day, and make other payments required for your No Interest and 0% balances, on this statement by this adjustments. A credit balance is treated as a balance of zero. This gives us the statement's payment due date; but (3) you may take advantage of the following daily balance. We add up all the daily balances for the billing period (including the exceptions (the "Promotional Balance Exceptions for No Interest or 0% balances: balances on the Closing Date) and divide by the total number of days in the billing First, you can subtract from the New Balance any No Interest or 0% balances that period. This gives us the Balance Subject to Finance Charge for that balance. We do not expire by the Next Closing Date shown on the statement. figure the periodic finance charge by multiplying the Balance Subject to Finance Second, you can pay any No Interest or 0% balances that do expire by the Next Charge for that balance by the applicable monthly periodic rate. In addition, for Closing Date shown on the statement on the later of the promotion's expiration date each purchase balance, we multiply the Balance Subject to Finance Charge for or the statement's payment due date, that balance for the previous billing period by the applicable monthly periodic rate, unless your account was credited for the full New Balance, plus the minimum Balance Subject to Finance Charge: We calculate periodic finance charges separately monthly payments required for your No Interest and 0% balances, on your for each balance subject to different terms (e.g. purchases made pursuant to previous billing statement by that statement's payment due date (subject to the promotional offers and regular revolve credit plan purchases). Charges include Promotional Balance Exceptions described above in the Grace Period for Purchases, fees, and any minimum finance charge. Purchases) or a periodic finance charge was already billed on that balance. Two-cycle Average Daily Balance (Including New Transactions): If a periodic rate is a daily periodic rate, we use the following Calculation method. Notify Us in Case of Errors or Questions About Your Bill For each balance, we multiply the daily balance by the applicable daily periodic rate. We do this for each day in the billing period, including the Closing Date. In If you think your billing statement is wrong, or if you need more information about a addition, for each purchase balance, we multiply the daily balance for each day of transaction on your billing statement, write to us (on a separate sheet) as soon as the previous billing period by the applicable daily periodic rate, unless your possible at the billing error address on the front of your statement. We must hear from account was credited for the full New Balance, plus the minimum monthly you in writing no later than 60 days after we sent you the first statement on which the payments required for your No Interest and 0% balances, on your previous billing error or problem appeai ed. statement by that statement's payment due date (subject to the Promotional Balance Exceptions described above in the Grace Period for Purchases) or a In your letter, give us the following information. periodic finance charge was already billed on that balance. To get the daily Your narne and account number. balance, we take the beginning balance for each balance every day, add any new The dollar amount of the suspected error. charges and any periodic finance charge on the previous day's balance, subtract Describe the error and explain, if you can, why you believe there is an error. If you any credits or payments credited as of that day, and make other adjustments. A need more information, describe the item you are unsure about. credit balance is treated as a balance of zero. For each balance, the Balance Subject to Finance Charge is the average of the daily balances during the applicable billing period. For each purchase balance, if you multiply the current billing period Balance Subject to Finance Charge by the number of days in the billing period and by the applicable daily periodic rate, and you multiply the previous billing period Balance Subject to Finance Charge (if currently subject to a finance charge) by the number of days in that billing period and by the Important Payment Instructions Payment Options Other Than Regular Mail: Crediting Payments: Payment must be received in proper form at our processing Pay by Phone. You may make your payment by phone by using the Pay by Phone facility by 5 p.m. local time there to be credited as of that day. A payment received at Service. You will be charged $14.95 to use this payment service. Call by 5 p.m. the processing facility in proper form after that time will be credited as of the next day. Eastern time to have your payment credited as of that day. If you call after that Please allow 5 -7 days for payments by regular mail to reach us. There may be a delay time, your payment will be credited as of the next day. We may process your of up to 5 days in crediting a payment sent by mail if it is not in proper form or is payment electronically upon verification of your identity. addressed to a location other than the address listed on the return envelope or on the o Send payment by courier or express mail to the Express Payments address: front of the payment coupon, or, for courier or express mail payments, to the Express Customer Service Center, Dept. CCS 922, 4740121st Street, Urbandale, IA 50323. Payments Address set forth below. Payment must be received in proper form, at the proper address, by 5 p.m. Central time in order to be credited as of that day. All payments received in proper form, at Proper Form: For a payment sent by mail or courier to be in proper form, you must: the proper address, after that tirne will be credited as of the next day. Enclose a valid check or money order. No cash, gift cards, or foreign currency please. Report a Lost or Stolen Card Immediately: Customer Service is available 24 hours a Include your name and account number on the front of your check or money order. day, 7 days a week. Copy Fee: On any matter unrelated to a billing error or disputed purchase, we charge a 55.00 fee for each duplicate statement for a hillinq period that is more than 3 months prior to your request. We add this fee to your regular revolve credit plan balance. Tractor Supply CRC S602TV Rev. 10/06 6027V571006 PCT page 2 of 4 TX 7 D 13000 IrTRUM BUSINESS ACCOUNT 0000488 CURRENT ACTIVITY TrSr> action �C:ftaliottl, W rr K f ..v..... ..."Sliu_ ._.may �.rk X&`.. PAYMENTS, CREDITS, FEES, and ADJUSTMENTS AUG 21 PAYMENT REF P91940OKS09SHXN95 1,379.89 SEP 18 PAYMENT REF P9194COLN09VRXHLT 139.88 Customer Service and Billing Errors address: PO Box 689161, Des Moines, IA 50368 -9161. 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." F emit To: Bill To: page 4 or 4 RACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 T `TOR EPT.30 1200050860 MATT HIGGINBOTHAM SU Y02 O BOX 689020 3400 W 131 ST ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000490 Payment Due Date: 10/13/08 Please make checks Payable to TRACTOR SUPPLY CREDIT PLAN iSMIP TO: INVOICE: SHIP TO: INVOICE: 624001012023010 624001016163010 Purchase Order: Purchase Order: 82508 90308 AMOUNT DUE: 44.68 AMOUNT DUE: 115.65 Store: 574000624 INVOICE DATE: 08/25 /08 Stare: 574000624 INVOICE DATE: 09/03 /08 SPRAY GUN COMMERCIAL OR 2107044 1100 44.68 44.68 SPRAY LANCE NYLON 2107060 1.00 16.79 16.79 PUMP 12Y 3.6GPM QUAD 2102222 1.00 98.86 98.86 SUBTOTAL 44.68 TAX 0.00 SUBTOTAL 115.65 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 44.66 TOTAL 115.65 s V V SHIP' TO: INVOICE: 431000871734010 AMOUNT DUE: 20.61 Store: 574000431 INVOICE DATE: 09/09 rob PUMP 12V 5.6GPM QUAD 2102222 1.00 98.86 98.86 PUMP 12Y 2.1GPM CONT FL 2111956 1.00 78.25 78.25 SUBTOTAL 177.11 TAX 0.00 SHIPPING 0.00 TOTAL 20.61 a Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801 -779 -7425 i Remit To: Bill To: Page 3 or 4 TRACTOR SUPPLY CREDIT PLAN ACCOUNT; 6035301200050860 DEPT.30 1200050860 JEFF STEWART 77pimir SUMYCO- PO BOX 689026 211 2ND ST SW BUSINESS ACCOUNT DES. MOINES IA 50368 -9020 0000489 Payment Due Date: 10/13/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TO: INVOICE: eEMNON 431000863307010 431000868475010 Purchase Order: SHOP AMOUNT DUE: 12.44 AMOUNT DUE: 44.68 Store: 574000431 INVOICE DATE: 08/05/08 Store: 574000431 INVOICE DATE: 08/26/08 SHV METAL NEW LAN STYLE 2830037 1.00 12.44 12.44 SPRAY GUN COMMERCIAL OR 2107044 1.00 44.68 44.68 SUBTOTAL 12.44 SUBTOTAL 44.68 TAX 0.00 TAX 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 12.44 TOTAL 44.68 SHIP TO: INVOICE: SHIP TO: INVOICE: 431000872443010 431000870858010 Purchase Order: Purchase Order: SHOP CITYHALL AMOUNT DUE: 73.98 AMOUNT DUE: 11.99 Store: 574000451 INVOICE DATE: 09/12 /08 Store: 574000431 INVOICE DATE: 09/05 /08 PARTS WASHER CLEANER SG 3893915 1.00 36.99 36.99 FEED NUTRISOURCE FARM P 5060063 1.00 11.99 11.99 PARTS WASHER CLEANER SG 3893915 1.00 36.99 36.99 SUBTOTAL 11.99 SUBTOTAL 73.98 TAX 0.00 TAN 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 11.99 TOTAL 73.98 J Please Direct Inquiries to: Phone: 800 -559 -8232 Fax: 801 -779 -7425 REMITTSC BUSINESS ACCOUN I� TRACTOR SUPPLY COMPANY C�YC® P.O. Box 9020 Tractor Supply Company a Des Moines, IA 50368 -9020 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 CARMEL STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 571 -2141 CITY STATE ZIP PHONE 431 431000179 2 871734 09/09/2008 09 :22am CUSTOMER TO COMPLETE 2102222 PUMP 12V 3.8GPM QUAD -1.00 98.86 -98,86 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies The undersigned certifies The undersigned party certifies their exemption from 21.11938 PUMP 12Y 2,16PM CONT compliance with the agricultural payment of sales and use tax on tangible personal 1.00 78.25 78.25 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 -20,61 food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or 7,00i Tax 0.00 the applicable statement of the Total -20.61 respective state printed on the other agricultural production items purchased free of TSC Card -20.61 reverse side of this form. tax, as defined by state law, and as indicated below. Acct#: YYYYEYEEEEYY6013 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they AU th# Ref STATE: understand they may be liable for payment of all taxes Chan 0.00 (REQUIRED) due on the purchase price for the goods as allowed by (Exceptions: Georgia, New York Kentucky State law should such goods be used or consumed In COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. Buyer acknowledses the receipt Of a Comple PURCHASER IS ENGAGED IN: (REQUIRED) t d Resale Under penalty of perjury, signee swears the copy of this sales slip and the purchase o Government information on this statement is true and correct ih Exempt organization every material manner. A willfully false representation the described merchandise shall be in Agricultural Production of exemption will cause the purchaser to be subject to accordance with the Cardholder Asreemen t Dairy Production penalty and /or other provisions as allowed under state Livestock Production Floriculture /Acluaculture Production law' Sisnature: Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity Livestock Injestibles or Injectibles Exempt Organization (Entity Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Resale Call 800 968 -0734 within 7 days to Consumed in Production (KS) complete a survey and be entered in a Ingredient or Component Parts (KS) monthly drawins for a chance to Win a 82500 5 spree. E) Other: (Awarded as Gift Card) NO PURCHASE OR SURVEY NECESSARY, Ends 9/30/08, CUSTOMER SIGNATURE: (REQUIRED)) AL IN USE SHADED AREA ONLY, WHEN REGISTER IS CASH CHECK A M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE DESCRIPTIO Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: TRACTOR SUPPLY COMPANY SUPPLY CO P.O. Box 9020 Tractor Supply Company Des Moines, IA 50368 -9020 2375 East Pleasant St, TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Noblesville,IN 46060 (317) 776 -1083 6035 301 NAME CARMEL STREET DEPT 3400 W 1316T ST ADDRESS WESTFIELD IN 460748267 (317) 571 -2141 CITY STATE ZIP PHONE 624 624000070 1 1016163 09 ✓03/2()08 03:14pm CUSTOMER TO COMPLETE 210x060 SPRAY LANCE NYLON 1,00 16,74 16,74 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies The undersigned certifies The undersigned a certifies their exemption from 2102222 PUMP 12V 3.5GPM GiUAD compliance with. the agricultural payment of sales and use tax on tangible personal 1,00 98.66 98.86 NT sales tax exemption law of the state Government Asencies P property as indicated below and /or purchaser is indicated below and understands engaged in the business of agricultural production of Subtotal and agrees with t e General food or fiber, horticulture, aquaculture of floriculture for 115,65 bt o Tax 0.00 Exemption Statement at right and resale and /or uses the farm machinery, equipment or Total 115.65 the applicable state ent of the other a ricultural roduction items purchased free of respective state pr ted on the g p p 1'SC Card 115.65 l d t reverse side of this f rm. tax, as defined by state law, an as indicated below. Acct J#6013 The undersigned further certifies the Auth #:003608 Ref *:0314141547 PRODUCT IST e undersi art THE FOLLOWING 9 party Y P© #;090306 STATE: understand they may be liable for payment of all taxes Chanse 0.00 /IMEOIRRED) due on the purchase price for the goods as allowed by Cash Back (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed In COMPLETE REVERSE SIDE) a taxable manner as defined b state laws. Y Surer acknawled9e5 the receipt of a coml'1e PURCHASER IS ENGAGED IN:(REOU1RED) E] Resale Under penalty of perjury, signee swears the copy of this sales slie and the purchase o .Government information on this statement is true and correct ip Exempt organization every material manner. A willfully false representation F Agricultural described merchandise shall be in se in Agricultural Production of exemption will cause the purchaser to be subject to the described with the C a Cardholder steal A nt [I hairy Production penalty and /or other provisions as allowed under state Livestock Production Floriculture /Acivaculture Production law' Other: Sisnatiire: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) V Farm Machinery/Repair Parts Government Agency (Entity Livestock Injestibles or Injectibles Exempt Organization (Entity NC: only DOT and US Government are exempt E] FertilizerlAgrichemicals Consumed in Production (KS) Resale (Sales Tax Permit# Call 800- 968 -0734 within 7 days t0 Ingredient or Component Parts (KS) complete a survey and be entered in a monthly drawins for a chance to win a O r: $2500 shoppins spree, c (Awarded as Gift Card) NO PURCHASE C T ME SIGNATURE:(REQUIR D) MGR. PPROVAL s6 X USE A SHADED AREA O NLY CASH CHECK. VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. 7H EXCH, DATE m. C1. Ll ITEM NUMBER NON UNIT,PRICE, r TAX Form No. 99 -00401 (12105) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT FTRACTOR PAYMENTS TO: TRACTOR SUPPLY COMPANY Su"LYC2 P.O. Box 9020 Tractor Supply Company Des Moines, IA 50368 -9020 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 CARMEL STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 571 -2141 CITY STATE ZIP PHONE 431 431000068 2 872443 09/12/2008 02:28pm CUSTOMER TO COMPLETE 3893915 PARTS WASHER CLEANER 1.00 36.99 36.99 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT Government Asencies The undersigned certifies The undersigned party certifies their exemption from 3893915 PARTS WASHER CLEANER compliance with the agricultural payment of sales and use tax on tangible personal 1.00 36.99 36.99 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 73.98 food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or 7.00• Tax 0.00 the applicable statement of the Total 73.98 respective state printed on the other agricultural production items purchased free of TSC Card 73.98 reverse side of this form. tax, as defined by state law, and as indicated below. Acc to t i i t i i i i t i E E 4803 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Auth *:012161 Ref #:1213280881 STATE: understand the y ma y p ayment be liable for of all taxes PO shop (REQUIRED) due on the purchase price for the goods as allowed by Chanse 0.00 Cash Back (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. PURCHASER IS ENGAGED IN: (REQUIRED) Buyer acknowledses the receipt of a comple Resale Under penalty of perjury, signee swears the d Government information on this statement is true and correct in copy of this sales slip and the purchase o Exempt organization every material manner. A willfully false representatioA Agricultural Production of exemption will cause the purchaser- -to -be subject to the described merchandise shall be in Dairy Production penalty and /or other provisions as allowed under state accordance with the Cardholder Asreemen t Livestock Production Floriculture /Aquaculture Production law. Other: Sisnature: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity Livestock Injestibles or Injectibles Exempt Organization (Entity Fertilizer /Ag rich emicals NC: only DOT and US Government are exempt Consumed in Production (KS) Resale (Sales Tax Permit Call 800- 968-0734 within 7 days to Ingredient or Component Parts (KS) complete a survey and be entered in a monthly drawins for a chance to win a other: $2500 shoppins spree. L (Awarded as Gift Card) NO PURCHASE ST MER IGNA7 E: REQUIRED) MGR. APPROVAL 1 X AREA tONLY CAS CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE DESCRIPTIO 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10/01/08 $181.01 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 20 Clerk- Treasurer VOUCHER ,NO. WARRANT NO. ALLOWED 20 Tractor Supply IN SUM OF P. O. Box 9020 Des Moines, IA 50368 -9020 $181.01 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department 0 03c dvb ll!: b 86 0 PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 42- 389.00 $181.01 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 Friday, October 10, 2008 Stree ommissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund