HomeMy WebLinkAbout160602 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
CHECK AMOUNT: $636.40
PO BOX 689020
CARMEL, INDIANA 46032
DES MOINES IA 50368 -9020 CHECK NUMBER: 160602
0
CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 636.40 6035301200182572
I
page 1 of 4 Tx 7 DI 3 0
sumyC�
BUSINESS ACCOUNT
0001763
-ACGOUNT SUMMARY£ 603530120018 2572 T F,
Previous Balance 1,157.80 Closing Date 05/19/08
Payments 676.28 Next Closing Date 06/18/08 CARMEL UTILITIES
Credits 0.00 Payment Due Date 06/13/08 ACCOUNTS PAYABLE
Purchases 636.40 3450 W 131 ST ST
Debits 0.00 Current Due 636.40 WESTFIELD, IN 46074 -8267
FINANCE CHARGES 0.00 Past Due Amount 481.52 Credit Line 5,000
Late Fees 0.00 Minimum Payment Due 1,117.92 Credit Available 3,882
New Balance 1,117.92
CURRENT ACTIVITY
Transaction �LocatloN
F s Amounts,
M
DescrlPUOng t. r F,. AM 7'K. M.
MAY 16 GOODS AND SERVICES NOBLESVILLE IN 124.99
TOTAL 6035301200201083 $124.99
APR 29 GOODS AND SERVICES WESTFIELD, IN 104.86
TOTAL 6035301202814974 $104.86
MAY 16 GOODS AND SERVICES WESTFIELD IN 59.48
MAY 16 GOODS AND SERVICES WESTFIELD IN 125.00
MAY 16 GOODS AND SERVICES NOBLESVILLE IN 59.48
TOTAL 6035301202814990 $243.96
FINANCE CHARGE SUMMARY
Current Billing Period Previous Billing Period
Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL
Subject to Periodic &Ilug PERCENTAGE Subject to Periodic Billing PERCENTAGE
F Hance Charge Rate Period RATE Finance Charge Rate Period RATE
REGULAR REVOLVE CREDIT PLAN 0. Do .00000 31 0.00 0.00 .00000 30 0.00
This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1-800-559-8232 FAX NUMBER 1 -BO1- 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 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 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 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 10/06
902TV5741006 PCT
page 2 of 4 Tx 7 D1130
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S VV
BUSINESS ACCOUNT
0001764
-X.
CURRENT ACTIVITY
Transaction LocatEOnl Amount
.Description
MAY 13 GOODS AND SERVICES WESTFIELD IN 162.59
TOTAL 6035301202905582 $162.59
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
APR 24 PAYMENT REF P919400G309DR9HEV 676.28
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."
Did you overlook your payment to us? If
so, please send the amount due today. If
payment is in the mail thank you!
I
i
Remit To: Bill To: Page 3 or a oao
TRACTOR-SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572
IJEPT.30 1200182572 SEAN WHITLOW
PO BOX 689020 130 1 ST AVE SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020 0001765
Payment Due Date: 06/13/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP T0: INVOICE: SHIP To: INVOICE:
431000829276010 624000962194020
Purchase Order:
40608
AMOUNT DUE: 104.86 AMOUNT DUE: 124.99
Store: 574000431 INVOICE DATE: 04107 /08 Store: 574000624 INVOICE DATE: 05/16/08
GW SOLD NORTH BG QUICK 6854009 1.00 52.43 52.43 SHOE LTHR 8 BN ST PECOS 7087972 1.00 129.99 129.99
GW SOLD NORTH BG QUICK 6854009 1.00 52.43 52.43
SUBTOTAL 129.99
SUBTOTAL 104.86 TAX 0.00
TAX 0.00 SHIPPING 0.00
SHIPPING 0.00
TOTAL 124.99
TOTAL 104.86
SHIP TO: INVOICE: SHIP To: INVOICE:
431000835955010 624000962197010
Purchase Order:
42908
AMOUNT DUE: 104.86 AMOUNT DUE: 59.48
Store: 574000431 INVOICE DATE: 04/29 /08 Store: 574000624 INVOICE DATE: 05/16 /08
GW SOLD NORTH BO QUICK 6854009 1.00 52.43 52.43 BED MAT 8FT FORD 250 35 0184901 1.00 59.48 59.48
GW SOLD NORTH BG QUICK 6854009 1.00 52.43 52.43
SUBTOTAL 59.48
SUBTOTAL 104.86 TAX 0.00
TAX 0.00 SHIPPING 0.00
SHIPPING 0.00
TOTAL 59.48
TOTAL 104.86
Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425
Remit To: Bill To: page a of a t
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572
DEPT.30 1200182572 JERRY SMITH SUMY
PO BOX 689020 760 3RD AVE SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020 000n66
ME Payment Due Date: 06/13/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP TO: INVOICE:
eerm
431000840713010 431000840711010
Purchase Order: Purchase Order:
NONE NONE
AMOUNT DUE: 59.48 AMOUNT DUE: 125.00
Stare: 574000431 INVOICE DATE: 05 /16 /08 Store: 574000431 INVOICE DATE: 05/16 /08
BED MAT 8FT FORD 250 35 0184901 1.00 59.48 59.48 W2 WEATHERPRFER 2.502 T 7377589 1.00 2.99 2.99
SHOE LTHR 10 ON ST PECO 7068017 1.00 129.99 129.99
SUBTOTAL 59.48
TAX 0.00 SUBTOTAL 132.98
SHIPPING 0.00 TAX 0.00
SHIPPING 0.00
TOTAL 59.48
TOTAL 125.00
SHIP TO: INVOICE:
431000839950010
Purchase Order:
5132008
AMOUNT DUE: 162.59
Stare: 574000431 INVOICE DATE: 05/13 /08
F8R MULTIFIT TRUCK HTCH 1890602 1.00 119.92 119.92
FOR PINSCLIP 518IN BKPV 1891137 1.00 4.15 4.15
FBR 2X11N BALL INTERLOC 1891420 1.00 8.54 8 -54
FSR 3 1 /4IN DROP BALL M 1e91519 1.00 29.98 29 -98
SUBTOTAL 162.59
TAX 0.00
SHIPPING 0.00
TOTAL 162.59
Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801 -779 -7425
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
on P.O. Box 9020
Des Moines, i!A 50368 -9020
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
6035 301
NAME
ADDRESS
CITY STATE I ZIP PHONE
CUSTOMER TO COMPLETE
CERTIFICATE OF EXEMPTION:_' GENERAL EXEMPTION STATEMENT:
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agrlculturaF' .payment'of sales and use tax on tangible personal`
sales tax exemption law of the state 1
property as ',indicated, below and /or purchaser is
indicated below. and' understands engaged. in the business. of agricultural, production of ant,iU,,;I
and agrees with the General'" food or fiber, horticulture, aquacuIture of floriculture for t}; I Oc
Exemption Statement at rig and resale and /or' use's the' farm machine rY a Q p F uj rrlent or T _r t
the applicable- statement- of .the resale
respective state prinfe'd,' on the .other agricultural. production items purchased free of 6
reverse side of this form. tax, as defined by state law, and as indicated below.
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
,(REQUIRED) due .the-purchase price for the goods as allowed by
(Ex6pt{ons Georgia;.New York Kentucky .state l a w COMPLETE REVERSE'S IDEp:' g
shDUld SUCK clods'be used. or consumed in
a taxable: rrianner.as defined by state laws: t
PURCHASER IS ENGAGED IN: (REQUIRED) r
p "Iaesaie Under: .penalty of perjury, signee swears the
Government ;information- 'on'this statement is true and correct in
Exempt organization eve r aterial A willfully p .false representation.
A g ncultural Production of, exemption wili.cause,the purchaser to be- subject to w r
E] Dairy! Production x
Livestock Production penalty and /or provisions as,allowed,under.state
Fior iculturelAquaculture:Production law
Y L2
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machin@ryep
lRair Pan s E] Government Agency (Entity# 1
Livestock lnjestibles oi'Injectibles 0 Exempt brganization (Lntity y a z. t a s a ..i t i S r r t
FertilizerlA richemicals NC: only DOT and US Government are exempt
9 t. ir4.;:1;d;:: <bay
Resale sales Tax }?ermit 1 i .i ui+ F r t,', v,
El Consumed in Production (KS)-
U J
Ingredient "or Component Pans (KS)
C7 Other:
CUSTOMER IGNATURE (REQUtFiFA) MGR:APPROVAL
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PAYMENTS TO'.
TRACTOR SUPPLY COMPANY
Su"Ly P.O. Box 9020
t Des Moines, IA 50368 -9020
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number u4'„
6035 301
NAME 4 'hi{ J!
ADDRESS
CITY STATE ZIP PHONE
CUSTOM ERTO COMPLETE (OHM-, yt411 i Ti4k i1 ito i P!
t� t,• .v,
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
the state as indicated below and /or purchaser is
sales tax exemption law of
indicated below and understands property p (01 i
engaged in the business of agricultural production of
and 'agrees 'with t e General fo Las
od or fiber, horticulture, aquaculture of floriculture for
Exemption Statement t right and t: ISC Cart! i. t...
resale and /or uses the farm machinery, equiptnent or
the applicable_ state ent of the.
respective state pri ed. on the other .agricultural production items purchased free of Apt t h* X116MO kv l 4 1 c: i 4't 1
tax, as defined by state law •and as indicated below.
reversesideof hi for Chan "IF
(ash 1 ic�r. i•.
PRODUCT IS-TO US T E FOLLO The undersigned party further certifies they
sure: 'understand they may be liable far payment of all °taxes
REQUIRED) 1 due on the purchase price for allowed by r I t
(Exceptions: G orgia, York a Kentuc.ky State law should such goods•b`e` "used or•'consUirned in
COMPLETE REVERSE. fit d fili 1 t' S 7 t :I 1'1 C'+ ht- v tuj ha t,t.
a taxable.manner as defined-by state'laws. 1
PURCHASER IS`ENGAGEUIN:(REQUIRED) ll, rl: r ,F,, C -F,. p C „rd t ,t
p Resale Under-- of perjury, signee swears the
fig. Government information on this statement is true and correct in
O Exempt organization_ every, material manner..A willfully false. representation.
F-1 Agricultural Production of exemption will cause the to be subject to.
Dairy Production penalty and /or other provisions as allowed understate
Livestock Production
Fl. Floricultureiki aculture Production law.
Other:'!y
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) xYYt. i ifF7dSrYi$Y ;iXr32l71s &t>:t:;%
Farm Machinery/Repair Parts Government Agency (Entity
ri' jectibl t.rti' 1 €1' 4'hF' ^[)I S$ Uil tf�tfl i ?.'ktiY., Iv
171 Livestock Inlestibles or ines Exempt Organization (Entity
FertilizedAgrichemibals:
NC: only DOT and US Government are exempt t1 p t' I is Y h I cI l.,i ii i P l ed if,
eltthly Crawinc-, for dance 10 ;.ti,;
71 Consumed in Production (KS) Resale (Sales. Tax Permit I i:'StiCt s,ft;Ir a li rw a
Ingredient mponentP arts (KS) (Awarded hs bii.it 'Twd) iii! f'rtk�HAa
91' 5URVIEY N CHSARY. EI,ds ;'<W.
ether. tstf3t3Y :dTtEXii #iYxa>iELS:Id:Cai,;tfitt
S EH S{G NAT URE (RE I H MGR. APPROVAL
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CASH GHI CK y VISA M!C DISCOVER• ,TSC CHAFiGEACCOUNT NQ r t kA a CiiG EXCIi' DATE r s ''3 t;
V yy A .n ion"
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Form No. 9e -00401 (tzos) CUSTOMER ORIGINAL
REMI TSC BUSINESS ACCOUNT
R PAYMENTS TO:
TRACTOR SUPPLY COMPANY
.su" Lyco P.O. Box 9020
Des Moines, IA 50368 -9020 I
TSC TEAM MEMBER TO COMPLETE please include 16 Digit Account Number
6035 301
NAME
ADDRESS
CITY STATE ZIP PHONE
Sr
CUSTOMER TO COMPLETE HI (lPll 60
CERTIFICATE OF- EXEMPTION: GENERAL EXEMPTION STATEMENT:
The undersigned certifies The undersigned party 'certlfles -their exemption from
compliance. with the agricultural payment of'sales and use talc on tangible .personal
sales tax exemption w of the state Property .'as.` indicated. below and /or purchaser .is "1'0."
indicated below: and understands
engaged in the business .of._agricultural.production of
and agrees 'with he General
Exemption Statemen at' right and food or fiber, horticulture, amuaculture of floriculture, for
the applicable stat ent' of the resale and /or uses the farm machinery, equipment or ,��r t lIw I fs57,' k t d1
`respective state pr, ted on the other agricultural production items purchased free of Ll I f n
reverse side of t 's f rrr taz,.as defined by state faw and as indicated below. Ca <111 ra
PRODUCT BE E _I THE FOLLOWING The undersigned party further certifies they
STATE: understand they may be liable for of all taxes, 4i
IRED due on the purchase price for goods -as allowed by I u ti k�. ti t.+ .f
(EX*IJions:.Georg4 York Kentucky State law should such goods be used Orconsu in
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws: Ult. I c. si4tl J t: _h.lil t t i u
PURCHASER IS ENGAGED IN: (REQUIRED)
Resale Under penalty of perjury, signee swears the
1r- Government information -on this statement is true and correct in
Exempt organization every material rhanner. A willfully false representation
Agricultural Production of .exemption, will cause. the,purchaser.td-be.subject to e
Dairy Production penalty and /or other, provisions as allowed understate
Livestock Production
Floriculture /AquacuHure_Productio'n
law. (_I
1
i]. Other:,
ITEMS PURCHASED WILL,BE USED FOR:(REQUIRED)
a
Farm Machinery /Repair Parts E] Government Agency (Entity of f:} I; ri; +S I n
Livestock In estibles or I'n ectibles c 1 c' F Slrr ey wid ba
D 1. 1 Exempt Organization {Entity 1;;;, u r; 7 y 6, ti w 1 3 f cm a c (I: n r C 10
FertilizerlAgrichemioals k 1 a
NC: only DOT and US Government are exempt
415C�Ct'whct> >;:n3
consumed in Production (KS) Resale (Sakes Tax Permit f f ksrdec9 �s (sift Ci+r d) 341 PURCH
Ing'redientor Component Parts '(KS) LIP SURV€:Y O>`t:irSSARY, (,,nrj 9!Ri /Oo,
tY# i# S1�Sii7li 'i:ti$F #«Y «i +a't'Y #t'P:tiSs
Other:
.CUSTOMER SIGNATURE: (REQUIRED) `r MGR. APPROVAL.
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0 0 0
ti
'CHECK 4 `VISA WC DISCpVER TSC CHARGE ACCOUNT NO c5 r "iCHG a T FJtCH DATE
cAs
h. �.r "t h yr' i's
Form No. 99 (12105) CUSTOMER ORIGINAL
ria..lneo o c.w Ivvaar e•ovvv�Utl D
x' PAYMENTS TO
TRACTOR SUPPLY COMPANY
C O P.O. Box 9020
IIII! Tractor SUFFIY C01111'anY
Des Moines, IA 50368 -9020 101 U. S. 31 North
TSC TEAM MEMBER TO COMPLETE please include 16 Digit Account Number We<_ ield. IN 46074
6035 301 317) 867 3505
NAME CARMEL UTILITIES
3450 U 131ST ST
ADDRESS WESTFIELD IN 460748267
(317) 733 -2855
CITY STATE ZIP PHONE
431 431000155 1 840713
05/16/2008 11:26art
CUSTOMER TO COMPLETE 0184901 BED MAT 8FT FORD 250
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 1 44 a 59 59 NT
utility
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural payment of sales and use tax on tangible personal Subtotal 59.48
sales tax exemption law of the state property as indicated below and /or purchaser is 7.00% Tax 0,00
indicated below and understands engaged in the business of agricultural production of Total 59.48
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for TSC Card 59.48
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Acct i i E E 2 E J i i 4990
the applicable statement of the other agricultural production items purchased free of Autho :016032 Re4#:1614263762
respective state printed on the tax, as defined by state law, and as indicated below. 80 nD"
reverse side of this form. Chanee 0.00
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Cash }Sack
STATE: understand they may be liable for payment of all taxes
(REQUIRED) due on the purchase price for the goods as allowed b }y� Buyer acknowledse5 the receipt of a cnatp e
.(Exceptions: Georgia. New York Kentucky state law should such goods be used or consumed ITT
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. copy of this 5ale5 slip and the Purchase t
PURCHASER IS ENGAGED IN: (REQUIRED) f
Resale Under penalty of perjury, signee swears the the described merchandise shall be in
Government information on this statement is true and correct in accordance with the Cardholder Agreement.
Exempt organization every material manner. A willfully false representation
Agricultural Production of exemption will cause the purchaser to be subject to
Dairy Production Sisnature:
C) Livestock Production penalty and/or other provisions as allowed under state
Floriculture /Aquaculture Production law.
F1 Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity Ei# i# iiEE #tJ#tiIE# #EJJEEEEIEEIJii#3is
Livestock lnjestiblesorinjectibles Exempt Organization (Entity Call 800 968 0734 within 7 days to
Fertilizer /Agrichemicals NC: only DOT and US Government are exempt complete a survey and be entered in a
Resale (Sales Tax Permit# worithly drawing for a chance to win a
F Consumed in Production (KS) $2540 shOFPin9 5Free.
Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE
Other:
OR SURVEY NECESSARY. Ends 9/30/08,
i# tiiE ##2E2# #EiiEiiiii# #ifi #i3# #E #J
CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL
s- s. X
CAS?/ CHECK VISAy" ^M /C DISCOVER .TSC CHARGE; ACCOUNT NO .ah''+ C CHG F "EXCH' r 3 _ti %DATE
z ��cT' >m x'1...77 F f ?:•5 x'! ,1 .c .��Y� N. xw ta���,�. 4�.rr*�,s af, „fi s 724 }3:: s'Tx .'F
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Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
Mr.wem 1 a 0 0 .0 0U011vte%_)0 i1L�+l�l�t�9 0
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
P.O. Box 9020 Tractor Supply CoiiiFany
SUMU Des Moines, IA 50368 -9020 18160 U.S. 31 North
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number We5if ield, IN 46074
6035 301# (317) 867 -3505
NAME CARMFL UTILITIES
3450 W 131ST ST
ADDRESS WESTFIELD IN 460748267
(317) 733 -2855
CITY STATE ZIP PHONE 431 431000155 1 840711
05/16/20$8 11:25ani
CUSTOMER TO COMPLETE 7377569 WZ WEATHERPRFER 2,50
1100 2,99 2,99 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility
The undersigned certifies The undersigned party certifies their exemption from 7088017 SHOE LTHR 10 RN ST P
compliance with the agricultural payment of sales and use tax on tangible personal 1. A 129,99 129,99 N7
sales tax exemption law of the state property as indicated below and /or purchaser is Utility
indicated below and understands engaged in the business of agricultural production of
and agrees with the. General Subtotal 132.98
Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for 7 00%: Tax 0.00
the applicable statement of the resale and /or uses the farm machinery, equipment or Total 132.98
respective state printed on the other agricultural production items purchased free of TSC Card 125.00
reverse side of this form. tax, as defined by state law, and as indicated below. p t i i t i i i i i i i i i 4990
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they
AUth #:016373 Ref #:1610244032
understand the may be liable for payment of all taxes PO none
STATE: y y p y
REO due on the purchase price for the goods as allowed by Debit 7.98 Acct a i i i i i i i i i 20923
(Exceptions: Georgia, New York 8 Kentucky state law should such goods be used or consumed In AU t s Ref 600$15543625
COMPLETE REVERSE SIDE)
PURCHASER IS ENGAGED IN: (REQUIRED) a taxable manner as defined by state laws.
Change 0.00 Resale Under penalty of perjury, signee swears the Cash Back 0.00
Government information on this statement is true and correct in
Exempt organization every material manner. A willfully false representation d Bayer acknolwledse5 the receirt of a coma -I
Agricultural Production of exemption will cause the purchaser to be subject t
E) Dairy Production copy of this sales 51.ir and the Furchase
Livestock Production penalty and /or other provisions as allowed under stag
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 1 Si5nature:
Livestock Iniestibles or Injectibles Exempt Organization (Entity
FertilizerlAgrichemicala NC: only DOT and US Government are exempt
Consumed in Production (KS) Resale (Sales Tax Permit V
Ingredient or Component Paris (KS)
Other: Call 800-968 -0734 within 7 days to
conlwlete a survey and be entered in a
CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL
X
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GASH CHECK` W. ",VISA n MICY DISCOVER TSCCHARGEACCOUNTNO y e� t,, z r., "a) EXCH:3^
s w.A its 9r su.Al y^^-�t.,tt 5 r r i n 4:':tw
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dam ,y �`�r ❑J'' ®t 1 )'x ),;'r,� ,r •c r i i #F ;yr t d,� 4. z S i �rxY v.
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
2=T PAYMENTS TO:
TRACTOR SUPPLY COMPANY
SUMLYCO RO: Box 9020
Des Moines, IA 50368 -9020
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
6035 301#
NAME
ADDRESS
GITY STATE ZIP PHONE
.CUSTOMER TO (COMPLETE
CERTIFICATE OF EXEMPTION: GENERAL.EXEMPTION STATEMENT:
The;" ..undersigned certifies The .undersigned party oertifies their exemption from
compliance with the agricultural Payirient of sales and use tax .on tangible personal
sales tax exemption law of the state p roperty as indicated below and/or purchaser, is
indicated below and understands e P y P
and agrees with the General engaged in the business of agricultural production of
Exemption Statement: a# right and food or fiber, horticulture, aquaculture of tloricult -ure for
the a livable a ent -at nt of the 'resale and /or uses the farm machinery, equipment or
PP„ 'other agricultural production items purchased free of
respective ,,state printed ,on. the fax as•law, and as indicated below.
reverse side ,,defined
.of,thls form.... by state
PRODUCT ISTO BE USED IN THE FOLLOWING The underslgned party further certifies they
sTATE: understand they may be liable for payment of all taxes
(REQUIRED) due on the purchase price forahe goods as allowed by I
Ex cepfionS ;Georgia;,NewYprk&- Kentucky- state law should s
uch goods.be used: or consumed in
coM ?Care REVERSE stoEj a talc ble manner. as.defined by -state laws.
PURCHASER IS ENGAGED IN: (REQUIRED)
El laesale Under. penalty of- perjury, signee swears the I
Q Government information on this statement is and correct in
Exempt,organizatlon every, material manner. representation
f. Agricultural Production of exerimption_will cause the _p rchaser_to be subject to
Dairy. Production penalty'and /or other,provistons,as allowed under „state
F Livestock Production
FloiiculiurelAquaculture ,Froducticn law
Other
ITEMS PURCHASED WILL BE USED'FOR: (REQUIRED)
Farm Machinery /Repair, Paris Government Agency. (Entity
Livestock` Injestibles or`Inlect i:As 'Exempt Organization (Entity
FertiliierlA nehemicals NC: only DOT and US Government are exempt
r io Resale'(Sales Tax Permit
CansumedinProduction {KS)
p Ingredient or'Component Parts (KS)
OtheF:'
,CUSTO SIGNATURE (REQUIRED) MGR_ APPROVAL
Ar a X IIJL}JC
ALT
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CASH CHECK,- <M/C a j DISCOVER TSC GHAflGE ACCOUNT NO
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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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
306840
TRACTOR SUPPLY CO Purchase Order No.
P.O. Box 689020 Terms
Des Moines, IA 50368 -9020 Due Date 6/2/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/2/2008 6240009621 $124.99
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
r 1 1.1
Date Officer
VOUCHER 081949 WARRANT ALLOWED
306840 IN SUM OF
TRACTOR SUPPLY CO IER
P.O. Box 689020 20 z
Des Moines, IA 50368-90
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
&6 �5 301 Z) 66 L? oZ 5 7
PO INV ACCT AMOUNT Audit Trail Code
62400096219 01- 6200 -06 $124.99
g31 L)W1'39SS- ol (Ocuc -oS 112.51
bz L
O i f ay blo �S
Voucher Tota �99
Cost distribution ledger classification if
claim paid under vehicle highway fund