HomeMy WebLinkAbout165987 11/12/2008 F CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
o CHECK AMOUNT: $834.82
CARMEL INDIANA 46032 Po BOX 689020
'tidor -�o $c DES MOINES IA 50368 -9020 CHECK NUMBER: 165987
CHECK DATE: 1111212008
D EPARTMENT ACCOU PO NUMBER INVOICE N UMB ER AMOUNT DESCRIPTION
2201 4237000 STREET 175.59 6035301200050860
2201 4238000 STREET 256.76 6035301200050860
2201 4356001 STREET 402.47 6035301200050860.:
a
page 1 of 5 Tx 7 DI130000000
®SUPPLY
BUSINESS ACCOUNT
0000475
l
ALr�T ;SUMMARY s f 6� >h��J$�
55
Previous Balance 102.25 Closing Date 10/21/08
Payments 0.00 Next Closing Date 11/19/08 CARMEL STREET DEPT
Credits 0.00 Payment Due Date 11/15/08 CINDY
Purchases 834.82 3400 w 131ST ST
Debits 0.00 Current Due 834.82 WESTFIELD, IN 46074 8267
FINANCE CHARGES 0.00 Past Due Amount 102.25 Credit Line 5,250
Late Fees 0.00 Minimum Payment Due 937.07 Credit Available 4,312
New Balance 937.07
CURRENT ACTIVITY
Transaction L•ocatl7onf
a r AmoRlnl3
OCT 8 GOODS AND SERVICES NOBLESVILLE IN 322.47
OCT 16 GOODS AND SERVICES NOBLESVILLE IN 80.00
TOTAL 6035301200074795 $402.47
SEP 24 GOODS AND SERVICES WESTFIELD IN 7.99
OCT 20 GOODS AND SERVICES WESTFIELD IN 59.99
TOTAL 6035301200074803 $67.98
OCT 9 GOODS AND SERVICES WESTFIELD IN 256.76
OCT 13 GOODS AND SERVICES NOBLESVILLE IN 98.86
TOTAL 6035301202896013 $355.62
FINANCE CHARGE SUMMARY
Current Billing Period Previous Billing Period
Balance Daily Days in ANNUAL Balance Daly Days in ANNUAL
Subject to Periodic Bilking PERCENTAGE Subject to Periodic Biking PERCENTAGE
Finance Charge Rate Per RATE Finance Charge Rate Penod RATE
REGULAR REVOLVE CREDIT PLAN 0.00 00000 33 0.00 0.00 .00000 so 0.00
13�o
ao 6. 0 8 34,��
This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERy
Information About Your Account. purchases and an average daily balance method (including new transactions)
Grace Period on Purchases. You can avoid periodic finance charges on for cash advances. If your account is subject To a daily °periodic rate we figure
purchases, but not on cash advances. This is called a grace period on the periodic finance charge by multiplying the daily balance by its daily
purchases. You can get a grace period of at least 20 days. To do so, pay the periodic rate. We do this for each day in the billing period. In addition, for each
following amounts by the due date every billing period: the New Balance purchase balance, we multiply the daily balance for each clay of the previous
(subject to the Promotional Balance Exceptions), plus the minimum monthly billing period by its daily periodic rate. If your account is subject to a daily
payments required for your No Interest and 0% balances. If you do not, you periodic rate we figure the periodic finance charge by multiplying each
will not get a grace period unless you pay those amounts by the due date for Balance Subject to Finance Charge by its monthly periodic rate. In addition, we
two billing periods in a row. The two Promotional Balance Exceptions are: (1) multiply the Balance Subject to Finance Charge for each purchase balance for
You do not have to pay any No Interest or 0% balances that do not expire by the previous billing period by its monthly periodic rate. Whether your account
the Next Closing Date shown on the billing statement. (2) You can pay any No is subject to a daily or a monthly rate, for each balance, we add up all the daily
Interest or 0 0 /b balances that do expire by the Next Closing Date shown on the balances for the billing period and divide by the number of days in the billing
statement by the later of the promotion's expiration date or the statement's period. This gives us the Balance Subject to Finance Charge for that balance
payment due date. for that billing period. We do not calculate periodic finance charges for the
previous billing period if your account was credited for the full New Balance,
Certain promotional offers may take away the grace period on purchases. plus the minimum monthly payments required for your No Interest and O%
Other promotional offers may allow you to have a grace period on purchases balances, on your previous billing statement by that statement's payment due
without having to pay all or a portion of the promotional balance by the due date (subject to the Promotional Balance Exceptions described above in the
date. If either is the case, the promotional offer will describe what happens. Grace Period on Purchases) or a periodic finance charge was already billed on
that balance. If your account is subject to a daily periodic rate, for each cash
Balance Subject to Finance Charge. We calculate periodic finance charges advance balance, multiply the Balance Subject to Finance Charge by the
separately for each balance. Balances include regular purchases, regular cash number of days in the billing period and f the applicable daily periodic rate.
The result is the periodic finance charges for that balance. For each purchase
advances, and different promotional balances.
balance, multiply the Balance Subject to Finance Charge for the current billing
To get a daily balance, we start with the balance as of the end of the period by its daily periodic rate and by the number of days in the billing
previous day. We add any new charges. We then subtract any new credits or period. Then do the same thing for the Balance Subject to Finance Change for
payments and make other adjustments. A credit balance is treated as a the previous billing period (if there is one) using the daily periodic rate and
balance of zero. If the rate on a balance is a dairy rate we include in the daily number of days in that billing period. Add the two results and you will have
balance any periodic finance charge on the previous day's balance. (This the total periodic finance charge for that balance. Rounding may cause a small
results in daily compounding of finance charges.) difference.
If the rate on a balance is a daily rate we use an average daily balance
method (including new transactions). We figure the periodic finance charge by Notify Us in Case of Errors or Questions About Your Bill, If you think your
multiplyinq the daily balance by its daily periodic rate. We do this for each day bill is wrong, or if you need more information about a transaction on our bill,
in the bluing period. The Balance Subject to Finance Charge is the average of write us (on a separate sheet) at the Billing Errors address on this sta>e€nent
the daily balances during the billing period. If you multiply this figure for each as soon as possible. We must hear from you in writing no later than 60 days
balance by its daily periodic rate and by the number of days in the billing after we send you the first bill on which the error or problem appeared. In
period, the result is the total periodic finance charge on that balance. your letter, give us the following information:
Rounding may cause a small difference.
Your name and account number.
Alternate Balance Sub to Finance Charge Calculation Method. If the The dollar amount of the suspected error,
front of your statement has a message stating this account is subject to the Describe the error and explain, if you can, why you believe there is an
Alternate Balance Subject to Finance Charge Calculation Method we use a error. If you need more information, describe the item you are unsure
two -cycle average daily balance method (including new transactions) for about.
Important Payment Instructions. Copy Fee. We charge $5 for each copy of a billing statement that dates back 3
Crediting Payments. We must receive your payment in proper form at our months or more. We add the fee to the regular revolve credit plan balance. We
processing facility by 5 p.m. local time there. If we do, it will be credited as of waive the fee If your request for the copy relates to a billing error or disputed
that day. A payment received at the processingg facility in proper form after purchase.
that time will be credited as of the next day. Allow 5 to 7 days for payments by Payment Options Other Than Regular Mail.
regular mail to reach us. There may be a delay of up to 5 days in crediting a Pay by Phone Service, You may use this service any time to make a
payment we receive that is not in proper form or is not sent to the correct payment by phone. You will be charged $14.95 to use this service. Call by 5
address. The correct address for a payment sent by regular mail is the address p.m. Eastern time to have your payment credited as of that day. If you call
listed on the return envelope or on the front of the payment coupon. A after that time, your payment will be credited as of the next day. We may
payment made in-store is not sent to the correct address. The correct address process your payment electronically after we verify your identity.
for a payment sent by courier or express mail is the Express Payments
Address shown below. Express Payments. You can send payment by courier or express mail to
Proper Form. For a payment sent by mail or courier to be in proper form, you the Express Payments Address: Customer Service Center, Dept CCS 911,
must: 4740 121st Street, Urbandale, IA 50323. Payment must be received rn proper
form at the proper address by 5 p.m. Central time to be credited as of that
Enclose a valid check or money order. No cash, gift cards, or foreign day. All payments received in proper form at the proper address after that
currency please. time will be credited as of the next day.
Include your name and account number on the front of your check or Report a Lost or Stolen Card Immediately, You may call Customer Service
money order. 24 hours a day, 7 days a week.
If you send an eligible check with this payment coupon, you authorize us
to complete your payment by electronic debit. If we do, the checking
account will be debited in the amount on the check. We may do this as Tractor Supply CRC 56O3TV Rev. 07/08
soon as the day we receive the check. Also, the check will be destroyed. 603TV5740708 -Cit
page 2 of 5 TX 7 D1130000000
®SU YCo
BUSINESS ACCOUNT
0000476
CURRENT ACTIVITY
mars (8I1S8GtlOn s Ll1C0tip11/ F f F y,; 2 �T7 �a�
Date :E u SB
Oki Amount
OCT 3 GOODS AND SERVICES WESTFIELD IN 4.17
OCT 17 GOODS AND SERVICES WESTFIELD IN 4.58
TOTAL 6035301202896161 $8.75
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!
This account is subject to the Alternate Balance Subject to Finance
Charge Calculation Method. See back for details.
L
Remit To: Bill To: Page 3 or s 277
=ro TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 TRACTOR
DEPT.30 1200050860 RON WILLIAMS ®SU"LYCO-
PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020 0000477
Payment Due Date: 11/15108 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP TO: INVOICE:
a®
624001031088010 624001034555010
Purchase Order: Purchase Order:
100808 SCOTT
AMOUNT DUE: 322.47 AMOUNT DUE: 80.00
Store: 574000624 INVOICE DATE: 10/08 /08 Store: 574000624 INVOICE DATE: 10/16 /08
BIB SNDSTN LNO 40X32 OL 7306732 1.00 84.99 84.99 SPECIAL ORDER PAYMENT 624052612 1..00 80.00 80.00
JKT THRML HO LG NOS CT6 7061516 1.00 72.50 72.50
BIB SNDSTN LN 40X32 ON 7048033 1.00 84.99 84.99 SUBTOTAL 80.00
SHOE CHORE HI BK 10 SN6 7015137 1.00 79.99 79.99 TAX 0.00
SHIPPING 0.00
SUBTOTAL 322.47
TAX 0.00 TOTAL 80.00
SHIPPING 0.00
TOTAL 322.47
SHIP TG: INVOICE: SHIP TO: INVOICE:
431000872443010 431000875190010
Purchase Order: Purchase Order:
SHOP SHOP
AMOUNT DUE: 73.98 AMOUNT DUE: 7.99
Store: 57400043/ INVOICE DATE: 09/12 108 Store: 574000431 INVOICE DATE: 09/24/08
PARTS MASHER CLEANER SG 3893915 1.00 36.99 36.99 MARKING FLAG 21IN 100CT 4028474 1100 7.99 7.99
PARTS WASHER CLEANER 56 3893915 1.00 36.99 56.99
SUBTOTAL 7.99
SUBTOTAL 75.98 TAX 0.00
TAX 0.00 SHIPPING 0.00
SHIPPING 0.00
TOTAL 7.99
TOTAL 73.98
V
Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801- 779 -7425
Remit To: Bill To: Page 4 or s 278
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 R J
DEPT.30 1200050860'' JEFF STEWART IV sumyc
=o PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020 0000478
Payment Due Date: 11/15/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP To: INVOICE: SHIP To: INVOICE:
431000881314010 431000871734010
Purchase Order:
TRUCK8
AMOUNT DUE: 59.99 AMOUNT DUE: 20.61
Store: 574000431 INVOICE DATE: 10/20 /08 Store: 574000431 INVOICE DATE: 09/09 /08
BED MAT 8FT FORD 250 35 0184901 1.00 59.99 59.99 PUMP 12V 3.8GPM QUAD 2102222 1.00 98.86 98.86
PUMP 12V 2.1GPM CONT FL 2111938 1.00 78.25 78.25
SUBTOTAL 59.99
TAN 0.00 SUBTOTAL 177.11
SHIPPING 0.00 TAN 0.00
SHIPPING 0.00
TOTAL 59.99
TOTAL 20.61
SHIP To: INVOICE: SHIP TO: INVOICE:
431000878736010 624001033190010
Purchase Order: Purchase Order:
100908 101308
AMOUNT DUE: 256.76 AMOUNT DUE: 98.86
Store: 574000431 INVOICE DATE: 10/09 /08 Store: 574000624 INVOICE DATE: 10/13/08
PELLETS 40LB VW SURE SO 2189761 65.00 4.08 257.04 PUMP 12V 3.SGPM QUAD 2102222 1.00 98.86 98.86
SUBTOTAL 257.04 SUBTOTAL 98.86
TAN 0.00 TAX 0.00
SHIPPING 0.00 SHIPPING 0.00
TOTAL 256.76 TOTAL 98.86
J
J
Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425
Remit To: Bill To: Page s of s 279
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860MR
DEPT.30 1200050860 SHAUN PRIVETT ®SLTMYCO-
=o PO BOX 689020 3400 W 131 ST ST BUSINESS ACCOUNT
DES MOINES IA 50368 -9020 0000479
Payment Due Date: 11/15/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP TO: INVOICE:
431000877371010 431000880446010
Purchase Order: Purchase Order:
100308 101608
AMOUNT DUE: 4.17 AMOUNT DUE: 4.58
Store: 574000431 INVOICE DATE: 10/03 /08 Store: 574000431 INVOICE DATE: 10/17 /08
PVC ELBOW 90DEG 3/4IN 3183394 1.00 1.29 1.29 2 POLE FLAT 47965 0143523 1.00 2.29 2.29
PVC COUPLING 3/4 3183019 1.00 0.49 0.49 2 POLE FLAT 47965 0143523 1.00 2.29 2.29
ADAPTER MALE TPT HB 1 1 2108888 1.00 2.39 2.39
SUBTOTAL 4.58
SUBTOTAL 4.17 TAX 0.00
TAX 0.00 SHIPPING 0.00
SHIPPING 0.00
TOTAL 4.58
TOTAL 4.17
J
Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801 779 -7425
I
REMIT TSC BUSINESS ACCOUNT
1�C��® PAYMENTS TO:
T
TRACTOR SUPPLY COMPANY
SU "LY Co P.O. Box 9020 I
Des Moines, IA 50368 -9020 radar U.S. 31 Supp C
18160 U.S. N ort h
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 881314
10/20/2008 02:48Fm
CUSTOMER TO COMPLETE 0184901 BED MAT 8FT FORD 250
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: t .00 5 59.99 N1' Gove Gov Agen sencies
The undersigned certifies The undersigned party certifies their exemption from
I compliance with the agricultural payment of sales and use tax on tangible personal &tbtotal 59.99
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 59.99
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for TSC Card 59.99
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Ac c't# I; Y Y;;;; I;; 4803
the applicable statement of the other agricultural production items purchased free of Alttht:020042 Ref$:2013483746
respective state printed on the tax, as defined by state law, and as indicated below. PO #:TRUCE; 8
reverse side of this form. Change 0.00
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Cash Back
STATE: understand they may be liable for payment of all taxes
(REQUIRED) due on the purchase price for the goods as allowed by Buyer acknowledges the receipt of a comp le
(Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed Int d
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. Cory of this sales slip and the purchase. o
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 Asreement.
Exempt organization every material manner. A willfully false representation
Agricultural Production of exemption will cause the purchaser to be subject to
Dairy Production penalty and /or other provisions as allowed under state' Sisnature:
Livestock Production
Floriculture /Aquaculture Production law.
Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts. Government Agency (Entity
Livestock Injestibles or Injectibles 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(SalesTax Permit InonthlY drawing for a chance to win a
Consumed in Production (KS) 82500 shopping spree,
Ingredient or Component Parts (KS) i (Awarded as Gift Card) NO PURCHASE
OR SURVEY NECESSARY, Ends 9 /30/09,
Other:
t l
C ST ER SIGNATURE:(REQUIRED) MGR, APPROVAL
X
USE.SHADED AREA ONLY WHEN REGISTER IS
CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. 7 7H G EXCH. DATE
I
ITEM NUMBER DESCRIPTIO
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
OPT
REMIT TSC BUSINESS ACCOUNT
TT01 PAYMENTS TO:
NERW TRACTOR SUPPLY COMPANY
P.O. Box 9020
Su"LYCO Des Moines IA 50368 9020 Tractor S UPPLY Company
1816U U.S. 31 .North
TSC TEAM MEMBER TO COMPLETE
Please include 16 Digit Account Number Westfield, IN 46074
6035 301 317) 867 -3505
NAME
CARMEL STREET DEPT
ADDRESS 3400 W 131ST ST
WESTFIELD IN 460748267
(317) 571 -2141
CITY STATE ZIP PHONE
431 623000089 2 880446
10/17/2008 10:34am
CUSTOMER TO COMPLETE 0143523 2 POLE FLAT 47965
00 CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 1 Go a A5e 2.2 NT
Government Agencies
The undersigned certifies The undersigned party certifies their exemption from 0143523 2 POLE FLAT 47965
compliance with the agricultural payment of sales and use tax on tangible personal 1.00 2 2.29 2.29 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 food or fiber, horticulture, aquaculture of floriculture for Subtotal 4.58
Exemption Statement at right and resale and /or uses the farm machinery, equipment or 7.00% Tax 0.40
the applicable statement of the other agricultural production items purchased free of Total. 4,58
respective state printed on the tax, as defined by state law, and as indicated below. TSC Card 4.59
reverse side of this form. Acct*: sstssttsstts6161
PRODUCT IS TOW THE FOLLOWING The undersigned party further certifies they Autht:017534 Ref #:1709342569
STATE: understand they may be liable for payment of all taxes PO #:101608
(REQUIRED) due on the purchase price for the goods as allowed by Change 0.00
(Exceptions: Geor New York a Kentucky state law should such goods be used or consumed in Cash Back
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws.
PURCHASE S ENGAGED IN: (REQUIRED) Buyer acknowledses the receipt of a comple
ale Under penalty of perjury, signee swears thet ,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 representation`
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 Asreement
Livestock Production
Floriculture /Acluaculture Production law.
Other:
Signature:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
F1 Farm Machinery/Repair Parts Government Agency (Entity
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 fissitititttttitttttttisssiisttt2Sitt
Call 800 -968 -0734 within 7 days to
Q In edientor Component Parts (KS) complete a survey and be entered in a
J� r Other: monthly drawins for a chance to win a
82500 shoppins spree.
(Awarded as Gift Card).NO PURCHASE
CUSTOMER SIGNATURE: (RE MGR. APPROVAL
V
USE AREA ONLY INOP ERATIVE.
CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
ITEM NUMBER NON DESCRIPTION PRICE
TAX
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
T R PAYMENTS TO:
TRACTOR SUPPLY COMPANY
S lyp�nyrO P.O. Box 9020 Tractor SUPPLY Company
2375 East Pleasant St,
Des Moines, IA 50368 -9020 Noblesville, IN 46060
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number (317) 776 -1883
6035 301
624 624000081 2 1034555
NAME 10/16/2008 03:16pm
ADDRESS $22 SPECIAL ORDER CONTRACT s ss
Special Order 624052612
CITY STATE ZIP PHONE CARMEL STREET DEPT
3400 W 131ST ST
WESTFIELD IN 460748267
CUSTOMER TO COMPLETE (317) 571 -2141
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 0222220 JACKET
1,00 a 80.00 80,00 NT
The undersigned certifies The undersigned party certifies their exemption from Government Asencies
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 Subtotal
indicated below and understands engaged in the business of agricultural production of 7,00% Tax 0,00
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for Total 80.00
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Deposit 80.00
the applicable statement of the other agricultural production items purchased free of TSC Card 80.00
respective state printed on the tax, as defined by state law, and as indicated below. Acct# s s s s s s s s i s s s 4795
reverse side of this form. Auth #:016203 Ref #:1614154129
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they PO scot t
STATE: understand they may be liable for payment of all taxes Chanse 0,00--+
(REQUIRED) 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 by state laws. BALANCE DUE 0. 00
PURCHASER IS ENGAGED IN: (REQUIRED) Buyer acknowledses the receipt Of a comple
Resale Under penalty of perjury, signee swears theted
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 representationf
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
F Floriculture /Aquaculture Production law'
Other:
S19ndtUre:
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
Consumed in Production (KS) Resale (Sales Tax Permit sIf222iissttstt2itsistsi22s2i2222is2t
Cali 800 -968 -0734 within 7 days to
Ingredient or Component Parts (KS) complete a survey and be entered in a
Other: monthly drawins for a chance to win a
$2500 s spree,
(Awarded as Gift Card) NO PURCHASE
CUS70MER SIGNATURE: (REQUIRED) MGR. APPROVAL OR SURVEY NECESSARY Ends 9/30/09.
2 e /y x
USE SHADED AREA ONLYWHEN REGISTER IS INOPERATIVE.
_=AM CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
v
J Ll L3 LJ Ll
ITEM NUMBER DESCRIPTION
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT L
T�f® PAYMENTS TO:
TRACTOR SUPPLY COMPANY
WOU m l0WVJ%YC0 P.O. Box 9020 Tractor Supply Comeany
Des Moines, IA 50368 -9020 18160 U.S. 31 North
TSC TEAM MEMBER TO COMPLETE Westf ield, IN 46074
Please include 16 Digit Account Number (317) 867 -3505
6035 301
NAME CARMEL STREET DEPT
3400 W 131ST ST
IN 460748267
(317) 571
ADDRESS (317) 571 -2141
CITY STATE ZIP PHONE 431,•431000179 2 878736 /d
J- 0/09/2008 02:28pm
CUSTOMER TO COMPLETE 1,/ 2189761 y ELLETS 40LB YW SURE
1 .63.00 2 4.08 256,76 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: es Price: 4.29
The undersigned certifies The undersigned party certifies their exemption from Government Asencies
compliance with the agricultural payment of sales and use tax on tangible personal Subtotal 256.76
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 7.00% Tax 0.00
and. agrees with the General Total 256.76
Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for TSC Card 256.76
resale and /or uses the farm machinery, equipment or
the applicable statement of the Acct *:33sit9Y3i3YY6013
tax
respective state printed on the other agricultural production items purchased free Auth *:009292 Ref *:0913275556
reverse side of this form. as defined by state law, and as indicated below. PO *:100908
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Chasse 0.00 Cash Back
STATE: understand they may be liable for payment of all taxes 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, Buyer acknowled5e5 the receipt of a comp le
COMPLETE REVERSE SIDE) 1 id
PURCHASER IS ENGAGED IN: (REQUIRED)
a taxable manner as defined by state laws. copy of this sales slip and the Purchase o
Resale Under penalty of perjury, signee swears the
Government information on this statement is true and correct in the described merchandise shall be in
Exempt organization every material manner. A willfully false representation accordance with the Cardholder Asreemeni
Agricultural Production of exemption will cause the purchaser to be subject to
Dairy Production penalty and /or other provisions as allowed under state
Livestock Production Sisnature:
Floriculture /Acluaculture Production law.
Other: t
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity Yii222YEfYYtiititiiYYi2fiYiYiiitiiY23
Livestock Injestibles or Injectibles Exempt Organization (Entity
Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Call 800 96B 0734 within 7 days to
complete a survey and be entered in a
Consumed in Production (KS) Resale (Sales Tax Permit monthly drawins for a chance to win a
$2500 shoppins spree, Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE
Other: OR SURVEY NECESSARY. Ends 9130109,
YYiiiiiiiiYiiYY2YiYtY2YiYfiYiYYtYiYYY
CUSTOMER SIGNATURE:( UIRED) MGR. APPROVAL
X
uSE.SHADE AREA ONLY
CASH CHECK .VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH... DATE
ITEM NUMB
DESCRIPTIO
EE j
Form No. 99 -00401 (12105) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
0tJPnyC0 P.O. Box 9020 frar.tor supply Company
Des Moines, IA 50368-9020 2375 East Pleasant St.
Noblesville, IN 46060
TSC TEAM MEMBER TO COMPLETE
Please include 16 Digit Account Number (317) 776 -1883
6035 301
NAME CARMEL STREET DEPT
3400 W 131ST ST
ADDRESS WESTFIELD Iti 460748267
(317) 571 -2141
CITY STATE ZIP PHONE 624 624000070 1 1031088
10/08/2008 02:38pm
CUSTOMER TO COMPLETE 7306732 BIB SNDSTN LND 40X32
1.00 84.99 84.99 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Agencies
The undersigned certifies The undersigned party certifies their exemption from 7067516 JKT THRML HD LG MOS
compliance with the agricultural 1.00 72.50 72.50 NT
p g payment of sales and use tax on tangible personal
sales tax exemption law of the state property as indicated below and /or purchaser is Government Agencies
indicated below and un erstands engaged in the business of agricultural production of 7048033 BIB SNDSTN LN 40X32
and agrees with the General g p 1.00 84.99 84.99 NT
Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for Government Agencies
the applicable statem t of the resale and /or uses the farm machinery, equipment or 7015137 SHOE CHORE HI HK 10
respective state print d on the other agricultural production items purchased free of 1100 79.99 79,99 NT
reverse side of this Or tax, as defined by state law, and as indicated below. Government Agencies
PRODUCT IS USE T E FOLLOWING The undersigned party further certifies they Subtotal 322.47
STATE: understand they may be liable for payment of all taxes 7.00: Tax 0.00
uIR D) due on the purchase price for the goods as allowed by Total 322.47
(Exceptions: e?g New York a Kentucky state law should such goods be used or consumed in TSC Card 322.47
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. Acc t t Y Y Y Y i i Y Y t Y Y 4795
PURCHASER IS ENGAGED IN: (REQUIRED) All th# 008944 Ref 0813382924
Resale Under penalty of perjury, signee swears the PO #:100808
Government information on this statement is true and correct in
Exempt organization eve material manner. A willful) false representation Change 0.00
Agricultural Production every y p Cash Back
of exemption will cause the purchaser to be subject to
Dairy Production penalty and /or other provisions as allowed under state
Livestock Production Buyer acknowledges the receipt of a COIOPIP_
C] Floriculture /Acluaculture Production law' t''d
other: copy of this sales slip and the Purchase o
r
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) the described merchandise shall be in
Farm Machinery/Repair Parts Government Agency (Entity# accordance Wwithe ar• holder greement
Livestock Injestibles or Injectibles E) Exempt Organization (Entity
Fertilizer /A 9ichemicals
r NC: only DOT and US Government are exempt
Signature:
Consumed in Production (KS) E] Resale (Sales Tax Permit
Ingredient or C pon n arts (KS)
Other: G
iYYYYiiYitEiiYiiYYiYiYifYiYitiYi2ii2Y
U OM SIGN ATURE:
(REQUIRED) MGR. APPROVAL
USE SHADED AREA X
ONLY
CASH CHECK VISA M/C DISCOVER -TSC CHARGE ACCOUNT NO. CHG. E DATE
L3
DESCRIPTION
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
W T BIM PAYMENTS TO:
TRACTOR SUPPLY COMPANY
SuffLycom P.O. Box 9020 Tractor Supply Co,iieanY
Des Moines, IA 50368 -9020 375 East Pleasant St.
TSC TEAM MEMBER TO COMPLETE Nable5ville,IN 46060
Please include 16 Digit Account Number (317) 776 1863
6035 301
NAME CARMEL STREET DEFT
3400 W 13157 ST
ADDRESS WESTFIELD IN 460746267
(317) 571 -2141
CITY STATE ZIP PHONE 674 624000070 1 1033190
10/1,is200a 02 r 44em
CUSTOMER TO COMPLETE .2102222 PUMP 12V 3.6GPM QUAD
1.00 90,86 x'8,66 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural payment of sales and use tax on tangible personal Subtotal ,8.86
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 lot`'1 98.86
and agrees wi g th he General p TSC Card 98.86
Exemption Statemen at right and food or fiber, horticulture, aquaculture of floriculture for Acct#; ##1 #16013
the applicable stat r of the resale and /or uses the farm machinery, equipment or Auth ;013489 Ref ,1313443554
respective state p nted on the other agricultural production items purchased free of PIP
reverse side of t is f rm. tax, as defined by state law, and as indicated below. Change 0,00
PRODUCT
The undersigned p arty ned art further certifies the y Cash Back
IS T U
STATE: understand they may be liable for payment of all taxes B uyer acknuwledses the receirt o f a c'tle
Et] IRE THE FOLLOWING due on the purchase price for the goods as allowed byt
(Exceptions: eorgia,NewYorkBKentucky- state law sh ould such goods be used or consumed In COPY of this Sales slip and the Purchase G
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws. f
PURCHASER IS ENGAGED IN: (REQUIRED) the described nierchandise shall be in
Resale Under penalty of perjury, signee swears the accordance with the Cardholder Agreement.
W 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 5isnature;
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)
M Farm Machinery/Repair Paris 0 Government Agency (Entity #F_)
Livestock Injestibles or Injectibles Exempt Organization (Entity Ca 800468 0734 within 7 days to
NC: onlyDOT andUS Government are exempt complete a survey and be entered in a
Fertilizer /Agrichemicals monthly drawins for a chance to win a
Consumed in Production (KS) Resale (Sales Tax Permit# $2500 Shopping Spree.
Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE
pR SURVEY NECESSARY. Ends 4130109.
Other
fsb
CU SI ATURE: REQUIRE MGR. APPROVAL
4 V
A W ADED AREA
CASH CHECK VISA'. DISCOVER TSC CHARGE'ACCOUNT NO. CHG EXCH. DATE
D ESCRIPTI O N ITEM NUMB
Form No. 99 -00401 (12105) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
ri� y C® P.O. Box 9020 Tractor Supply Company
Des Moines, IA 50368 -9020 18160 U .S. 31 N or t h
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westf ield, IN 46074
6035 301 317) 867-3505
NAME CARMEL STREET DEFT
3400 W 131ST Sf
ADDRESS WESTFIELD IN 460745267
(317) 571-2141
CITY STATE ZIP PHONE 431 431000179 2 877371
10/03/2008 02:27pm
CUSTOMER TO COMPLETE 3183394 PVC ELBOW 90DEG 3/41
1 ,00 2 1.29 1.29 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies
The undersigned certifies The undersigned party certifies their exemption from 3183019 PVC COUPLING 3/4
compliance with the agricultural payment of sales and use tax on tangible personal 1.00 0.49 0.49 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 2105888 ADAPTER MALE TPT HB
and agrees with the General 1.00 2.39 2.39 NT
food or fiber, horticulture, aquaculture of floriculture for
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Government Asencies
the applicable statement of the other agricultural production items purchased free of
respective state printed on the Subtotal 4, i7
reverse side of this form. tax, as defined by state law, and as indicated below. 7 'fax 0.00
The ned art further certifies they Total 4.17
W e unders
PRODUCT IS TO BE USED THE FOLLOWING g party TSC Card 4.1'7
STATE: understand they may be liable for' payment of all taxes Acc t i s s t 16161
(REQUIRED) due on the purchase price for the goods as allowed by
(Exceptions: Georgia, New York Kentuck state law should such goods be used or consumed in Auth*:003700 Ref 0313273966
COMPLETE REVERSE SIDE) PO 0: 1 00306
a taxable manner as defined by state laws. Change 0.00
PURCHASER IS ENGAGED IN: (REQUIRED) Cash Be[h
Resale Under penalty of perjury, signee swears the
Government Information on this statement is true and correct in
0 Exempt organization every material manner. A willfully false representation Buyer acknowledses the receipt of a temple
Agricultural Production of exemption will cause the purchaser to be subject to i
Dairy Production copy of this sales slip and the purchase o
Livestock Production' penalty and /or other provisions as allowed under staff
Florioultu /Aquaculture Production law'
the described merchandise shall be in
Other: accordance with the Cardholder Agreement,
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity Sisnature t
Livestock Injestibles or Injectibles Exempt Organization (Entity
T-
Fertilizer /Agrichemicals NC: only DOT and US Government are exempt
Consumed in Production (KS) Resale (Sales Tax Permit
ingredient or Component Paris (KS)
1 #tii#Ii #3262 #i #it #t #ilii#
Other: Call 600- 968 -0734 within 7 da ys to
complete a survey and be entered in a
CUSTOMER SlGNATURE:(REQUIRED MGR. APPROVAL
X
USE SHADED AREA ONLY WMEN-REGISTER IS,
CASH CHECK VISA M(C DISCOVER TSC CHARGE ACCOUNT N0. CHG: EXCH; DATE
a
FJ
"DESCRIPTION `UNITPRICE
ITEM NUMBER
Form No. 99 -00401 (12105) CUSTOMER ORIGINAL
REMIT TSC BUSINESS ACCOUNT
T PAYMENTS TO:
TRACTOR SUPPLY COMPANY
ou "LY C® 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 Westfield, IN 46074
6035 301# (317) 867 -3505
NAME CARMEL STREET DEFT
3400 W 131ST ST
ADDRESS WESTFIELD IN 460748267
(317) 571 -2141
CITY STATE ZIP PHONE 431 431000172 2 875190
09/24/2008 11:20ani
CUSTOMER TO COMPLETE 40 28474 MARKING FLAG 21IN 10
1.00 7.99 7.99 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural Subtotal 7.99
payment of sales and use tax on tangible personal
sales tax exemption law of the state property as indicated below and /or purchaser is 7.00% Tax 0.00
indicated below and understands Total 7.99
engaged in the business of agricultural production of
and agrees with the General TSC Card. 7.99
food or fiber, horticulture, aquaculture of floriculture for
Exemption Statement at right and Acctt: #iiiiYYYYiii4803
resale and /or uses the farm machinery, equipment or
the applicable statement of the Auth #:024148 Ref *:2410203316
respective state printed on the other agricultural production items purchased free of PO e:shoP
reverse side of this form. tax, as defined by state law, and as indicated below. Chanse 0.00
r
The under art further certifies the Cash Back
PRODUCT IS TO BE USED IN THE FOLLOWING g p y y
STATE: understand they may be liable for.payment of all taxes Buyer acknowledses the receipt of a cool e
(REQUIRED) due on the purchase price for the goods as allowed b
(Exceptions: Geor New Y ork a Kentucky state law should such goods be used or consumed X d
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. copy of this sales slip and the Purchase o
PURCHASER IS ENGAGED IN: (REQUIRED) f the described merchandise shall be In
F Resale Under penalty of perjury, signee swears the
Government information on this statement is true and correct in accordance with the Cardholder Asreement.
Exempt organization every material manner. A willfully false representation
Agricultural Production of exemption will cause the purchaser to be subject to
Dairy Production penalty and /or other provisions as allowed under state SisnatLlre:
F1 Livestock Production
Floriculture /Aquaculture Production
law.
Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) ifYYiiiiiYY2YYY2iiiE32Y #iYYYiiYYtii2#
Farm Machinery/Repair Parts Government Agency (Entity Y2YYYYtiY #22ti#YY#YYiti #iiYitiiiiiiii
Livestock In estibles or In ectibles Call 800 968 within 7 days to
F 1 Livestock 1 Exe only DOT US Gov
C] Fertilizer /Agrichemicals NC: only DOT and US Government are exempt complete a survey and be entered in a
monthly drawins for a chance to win a
Consumed in Production (KS) Resale (Sales Tax Permit# `$2500 5hopPins spree.
Ingredient or Component Parts (KS) (Awarded as. Gif t Card) NO PURCHASE
OR SURVEY NECESSARY. Ends 9/30/09.
Other: Y## YiiY #iYi #YiiYLY2Y2YYi#3 ####YYiiYi
C STO E SIGNATURE: (REQUIRED) MGR. APPROVAL
a X
USE AREA ONLY
C CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
DESCRIPTI ITEM NUMBER
Form No. 99 -00401 (12105) 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))
10/31/08 $402.47
10/31/08 $256.76
10/31/08 $175.59
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
20
Clerk- Treasurer
V OUCHER NO. WAR RANT N O.
ALLOWED 20
Tractor Supply
IN SUM OF
P. O. Box 9020
Des Moines, IA 50368 -9020
$834.82
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board MemberE
2201 43- 560.01 $402.47 1 hereby certify that the attached invoice(s), or
2201 42- 380.00 $256.76
bill(s) is (are) true and correct and that the
2201 42- 370.00 $175.59
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, November 07, 2008
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund