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166922 12/10/2008
CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $2,032.69 DES MOINES IA 50368 -9020 CHECK NUMBER: 166922 CHECK DATE: 12/10/2008 DEPARTMENT ACCOUNT PO NU MBER IN VOICE NUMBER AMOUNT DES CRIPTION 601 5023990 182572 2,032.69 6035301200182572 '.1 1 page 1 of 6 TX 7 DI130000�00000 VvCQ BUSINESS ACCOUNT 0001630 �ACC4UIdT SUNIMARY �6Q353Q12 4Q18 2572, Previous Balance 321.27 Closing Dale 11/19/08 Payments 241.95 Next Closing Date 12/18/08 CARMEL UTILITIES Credits 0.00 Payment Due Date 12/14/08 ACCOUNTS PAYABLE Purchases 2,032.69 3450 W 131 ST ST Debits 0.00 Current Due 2,032.69 WESTFIELD, IN 46074 -8267 FINANCE CHARGES 0.00 Past Due Amount 79.32 Credit Line 5,000 Late Fees 0.00 Minimum Payment Due 2,112.01 Credit Available 2,887 New Balance 2,112.01 CURRENT ACTIVITY Trartsaetion' s Location)E f �{IIIQ�ntS s ..pescripitonc w�<.:.«x� w.. OCT 21 GOODS AND SERVICES NOBLESVILLE IN 174.92 OCT 21 GOODS AND SERVICES NOBLESVILLE IN 154.95 OCT 21 GOODS AND SERVICES NOBLESVILLE IN 169.95 TOTAL 6035301200201083 $499.82 OCT 22 GOODS AND SERVICES NOBLESVILLE IN 369.84 TOTAL 6035301200201125 $369.84 OCT 31 GOODS AND SERVICES WESTFIELD IN 28.00 OCT 31 GOODS AND SERVICES WESTFIELD IN 249.99 NOV 7 GOODS AND SERVICES WESTFIELD IN 101.46 FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic Billing PERCENTAGE Sut�ject to Periodic &Ihrg PERCENTAGE Finance Charge Rate Period RATE Finance Charge Rate Penod RATE REGULAR REVOLVE CREDIT PLAN 0.00 .00000 29 0.00 0.00 .00000 33 0.00 This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1- 800 -559 -8232 FAX NUMBER 1- 801 779 -7425 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 it`; 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 day 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% 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 0% 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 or 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 u 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 Charge 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 daily 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 multiplying the dally 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 your bill, in the billing period. The Balance Subject to Finance Charge is the average of write us (on a separate sheet) at the Billing Errors address on this statement 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. o Your name and account number. Alternate Balance Sub to Finance Char Calculation Method. If the a The dollar amount of the suspected error. front of your statement has a message stating this account is subject to the a 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 rnethod (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 processing 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 o 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: 4740121st Street, Urbandale, IA 50323. Payment must be received in 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 5603TV Rev. 07/08 soon as the day we receive the check. Also, the check will be destroyed. 603TV5740708 -Cit page 2 of 6 TX 7 D1130000000 ®C'i TRA N SUMYCO- BUSINESS ACCOUNT 0001631 CURRENT ACTIVITY Tansacti on 3� L LOW Ohl x oun r k �Oute �pescn tiara M E i NOV 12 GOODS AND SERVICES WESTFIELD IN 376.10 NOV 12 GOODS AND SERVICES WESTFIELD IN 259.99 TOTAL 6035301202814941 $1,015.54 OCT 30 GOODS AND SERVICES WESTFIELD IN 74.99 TOTAL 6035301202814958 $74.99 OCT 30 GOODS AND SERVICES WESTFIELD IN 72.50 TOTAL 6035301202815039 $72.50 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS OCT 23 PAYMENT REF P91940OMTOA15JFLH 241.95 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. 956 Remit To: Bill To: Page 3 or 6 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 'DEPT.3C 1200182572 SEAN WHITLOW lvsumy(;O- PO BOX 689020 130 1ST AVE SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0001632 Payment Due Date: 12/14/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP To: INVOICE: SHIP TO: INVOICE: 624001033978010 431000880041010 Purchase Order: Purchase Order: SEAN 10152008 AMOUNT DUE: 21.98 AMOUNT DUE: 57.34 Store: 574000624\ INVOICE DATE: 10/15 /08 Store: 574000451 INVOICE DATE: 10/15 /08 WHEEL 1OX1.7S RUB 3550127 1.00 10.99 10.99 FASTENER TIP BIN 2.29 3771993 1.00 2.29 2.29 WHEEL 10X1.75 RUB 3550127 1.00 10.99 10.99 FASTENER TIP BIN 2.29 3771993 1.00 2.29 2.29 FASTENER TIP BIN 2.29 3771993 1.00 2.29 2.29 SUBTOTAL 21.98 FASTENER TIP BIN 2.29 3771993 1.00 2.29 2.29 TAX 0.00 FASTENER BLISTER PK 4.1 3773995 1.00 4.79 4.79 SHIPPING 0.00 ROD 1 /21NX36IN RND 3504558` 1.00 5.29 5.29 ROD 1 /2INX36IN RND 3504558 1.00 5.29 5.29 TOTAL 21.98 CLIP WIRE ROPE 5 /8IN 3551539 4.00 2.49 9.96 WHEEL 10X1 \.00 10. 10. WHEEL 10X1.75 RUB .75 RUB 355 0]27 3550127 99 99 1.00 10.99 10.99 GB GALV AND COTTERPIN B 3568887 25 3.49 0.87 '�i UBTOTAL 57.34 AX 0.00 SHIPPING 0.00 TOTAL 57.34 SHIP To: INVOICE: SHIP To: INVOICE: 624001036885010 624001036884010 AMOUNT DUE: 169.95 AMOUNT DUE: 154.95 Store: 574000624 INVOICE DATE: 10/21 /08 Store: 574000624 INVOICE DATE: 10/21 /08 JKT DCK CLTLD 2X RD CT6 7067370 1.00 74.99 74.99 JKT DCK OLTLD 2X BK CT6 7067299 1.00 74.99 74.99 BIB CRHT ARCTIC 38X32 6409749 1.00 94.96 94.96 BIB CRHT 1NSLTD BR 46X3 6311645 1.00 79.96 79.96 SUBTOTAL 169.95 SUBTOTAL 154.95 TAX 0. 00. TAX 0. 00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 169.95 TOTAL 154.95 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425 Remit To: Bill To: Page 4 or s 957 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 DEPT.30 1200182572 SEAN WHITLOW ®SZ1MYCO2 PO BOX 689020 130 1ST AVE SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0001633 Payment Due Date: 12/14/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN e SHIP T0: INVOICE: SHIP TO: INVOICE: 624001036883010 624001037119010 AMOUNT DUE: 174.92 AMOUNT DUE: 369.84 Store: 574000624 INVOICE DATE: 10/21 /08 Store: 574000624 INVOICE DATE: 10/22 /08 JKT INS SNDSTN LG BN CT 7047184 1.00 79.96 79.96 BIB CRHT ARCTIC 40X30 6409757 1.00 94.96 94.96 BIB CRHT ARCTIC 34X30 6409715 1.00 94.96 94.96 JKT ARCTIC BLK 42 6420389 1.00 89.96 89.96 BIB CRHT ARCTIC 38X30 6409731 1.00 94.96 94.96 SUBTOTAL 174.92 JACKET CRHT ARCTIC 44 6310128 1.00 89.96 89.96 TAX 0.00 SHIPPING 0.00 SUBTOTAL 369.84 TAX 0.00 TOTAL 174.92 SHIPPING 0.00 TOTAL 369.84 i SHIP TO: INVOICE: SHIP TO: INVOICE: 431000883756010 431000883760010 Purchase Order: Purchase Order: DAN DAN AMOUNT DUE: 249.99 AMOUNT DUE: 28.00 Store: 574000431 INVOICE DATE: 10/31 /08 store: 574000431 INVOICE DATE: 10/31 /08 TBX SPEC ALUM 60IN INNE 1099531 1.00 249.99 249.99 SPECIAL ORDER PAYMENT 431052024 1.00 28.00 28.00 SUBTOTAL 249.99 SUBTOTAL 28.00 TAX 0.00 TAX 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 249.99 TOTAL 28.00 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425 II I Remit To: Bill To: Page 5 of s 958 =ro TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 DEPT.30 1200182572 DANIEL JENKINS Wsumyco- PO BOX 689020 760 3RD AVE SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0001634 Payment Due Date: 12/14/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TO: INVOICE: 431000885356010 431000886688010 Purchase Order: Purchase Order: 110708 DAN AMOUNT DUE: 101.46 AMOUNT DUE: 376.10 Store: 574000431 INVOICE DATE: 11/07 /08 Store: 574000431 INVOICE DATE: 11/12 /08 SPECIAL ORDER ARTICLE 0222220 1.00 24.00 24.00 STEEL THREADED ROD 3/41 3501364 1.00 17.49 17.49 SCO FREIGHT 8601004 1.00 4.00 4.00 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 BAG MEGA MOUTH 4049438 1.00 19.99 19.99 LOCKPIN SW 5/16 X 1 3/4 1833561 1.00 2.29 2.29 SLEDGE 3LB 16IN F/G 4000573 1.00 16.99 16.99 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 CHISEL COLD SPC ST 3821374 1.00 17.99 17.99 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 ALUM ANGLE 1.SIN X1.8IN 3501322 1.00 18.49 18.49 LOCKPIN SW I/4 X 1 3/4 1833545 1.00 2.29 2.29 LOCKPIN SW 5/16 X 1 3/4 1833561 1.00 2.29 2.29 SUBTOTAL 101.46 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 TAX 0.00 LOCKPIN SW 5/16 X 1 3/4 1833561 1.00 2.29 2.29 SHIPPING 0.00 LOCKPIN SW 5/16 X 1 3/4 1833561 1.00 2.29 2.29 LOCKPIN SW 5/16 X 1 3/4 1833561 1.00 2.29 2.29 TOTAL 101.46 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 LOCKPIN SW 1/4 X 1 3/4 1833545 1.00 2.29 2.29 JKT INS SNDSTN 2K BU CT 7047249 1.00 79.96 79.96 BIB CRHT INSLTD BR 44X3 6311637 1.00 79.96 79.96 JKT SNDSTN LG CHOC CT 3 7135050 1.00 79.96 79.96 BIB SNDSTN 38X32 CHOC C 7136315 1.00 84.99 84.99 SAFETY SNAPS 3/8IN 3550915 1.00 2.29 2.29 SAFETY SNAPS 5/8IN 3550915 1.00 2.29 2.29 CHAIN 16 SINGLE JACK BR 3510622 12.00 0.14 1.68 SUBTOTAL 376.10 TAX 0.00 SHIPPING 0.00 TOTAL 376.10 SHIP TO: INVOICE: SHIP TO: INVOICE: 431000886681010 431000883602010 J Purchase Order: 103008 AMOUNT DUE: 259.99 AMOUNT DUE: 74.99 store: 574000431 INVOICE DATE: 11/12 /08 Store: 574000431 INVOICE DATE: 10/30 /08 TBX SPEC ALUM 601N INNE 1099531 1.00 259.99 259.99 JKT DCK QLTLD XL BN CT6 7067320 1.00 74.99 74.99 SUBTOTAL 259.99 SUBTOTAL 74.99 TAX 0.00 TAX 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 259.99 TOTAL 74.99 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425 I eoe Remit To: Bill To: page 6 of 6 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 TS WTOR DEPT.3(1- 1200182572 CHAD ZAPF ®SUMYCO- PO BOX 689020 760 3RD AVE SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0001635 M E Payment Due Date: 12/14/08 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: 431000883603010 Purchase Order: J 103008 AMOUNT DUE: 72.50 Store: 574000431 INVOICE DATE: 10/30 /08 JKT THRML HD XL MOS CT6 7067524 1.00 72.50 72.50 SUBTOTAL 72.50 TAX 0.00 SHIPPING 0.00 TOTAL 72.50 Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801- 779 -7425 KLM I I 15Q: dUbINEbb AlL;lL; RUNT N PAYMENTS TO: TRACTOR SUPPLY COMPANY muMY� P.O. Box 9020 Tractor 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 UTILITIES 3450 N 131ST ST MESTFIELD IN 460748267 ADDRESS (317) 733 -2855 CITY STATE ZIP PHONE 624 624000103 1 1036865 10/21/2008 02:35pm CUSTOMER TO COMPLETE 7067370 JKT DICK 9LTLD 2X RD 1.00 74.99 74.99 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility The undersigned certifies The undersigned party certifies their exemption from 6409749 BIB CRHT ARCTIC 38X3 compliance with the agricultural 1 94.96 94.96 NT sales tax exemption law of the state payment of sales and use tax on tangible personal Utility indicated below and understands property as indicated below and /or purchaser is and agrees with the General engaged in the business of agricultural production of Subtotal 169.95 Exemption Statement a 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 169.95 respective state printed on the other agricultural production items purchased free of TSC Card 169.95 reverse side of this form. tax, as defined by state law, and as indicated below. Acc to: i:: i i i i s i i s i 1083 Auth +:021297 Refo:2113350135 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Change 0.00 STATE: understand they may be liable for payment of all taxes Cash Back —4> (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 Buyer acknoaledses the receipt of a coalple COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. t d PURCHASER IS ENGAGED IN: (REQUIRED) COPY Of this sales slip and the Purchase D Resale Under penalty of perjury, signee swears thl 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 Asreement 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 Floriculture /Aquaculture Production law. Sisnature Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity U! Livestock Injestibles or Injectibles Exempt Organization (Entity Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Call 800- 968 -0734 within 7 days to Consumed in Production (KS) Resale (Sales Tax Permit complete a survey and be entered in a monthly drawins for a chance to win a Ingredient or Component Parts (KS) $2500 shoPPins spree other: (Awarded as Gift Card) NO PURCHASE OR SURVEY NECESSARY. Ends 9130109. GNATURE:(R£OUIRED) MGR. APPROVAL X USE AREA ONLY CASH. CHECK VISA,.M/G ..DISCOVER .TSC.CHARGEAQCOUNTIVO.'" CHG.v• :EXCH. DATE OUANTITY ITEM NUMBER )ESCRIPTIO Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL REMIT 'r5C: 5U5IN11=55 XXOUNT PAYMENTS TO: TRACTOR SUPPLY COMPANY SU PIPLY "'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 6035 301# (317) 776 -1883 NAME CARMEL UTILITIES 3450 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2655 CITY STATE ZIP PHONE 624 624000103 1 1036884 10/21/2006 02:33pm CUSTOMER TO COMPLETE 7067299 JKT DICK NLTLD 2X BK 1.00 74.99 74,99 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility The undersigned cert ifies The undersigned party certifies their exemption from 6311645 BIB CRHT INSLTD BR 4 compliance with the agricultural 1.00 79,96 79.96 NT payment of sales and use tax on tangible personal sales tax exemption law of the state property as indicated below and /or purchaser is Utili indicated below and understands engaged in the business of agricultural production of and agrees with the General Subtotal 154,95 Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for 7 OOx Tax 0.00 resale and /or uses the farm machinery, equipment or the applicable statement of the Total 154,95 respective state printed on the other agricultural production items purchased free of TSC Card 154.95 reverse side of this form. tax, as defined by state law, and as indicated below. Acct# i i i t i i i i i i i i 1083 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Auth# t 021493 Ref E: 2113331442 understand the may be liable for payment of all taxes Change 0.00 STATE: y y p y (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. t d Buyer acknowledses the receipt of a compl PURCHASER IS ENGAGED IN: (REQUIRED) COpY Of this sales 9 1iP and the Purchase Resale Under penalty of perjury, signee swears the F-1 Government information on this statement is true and correct iri the described merchandise shall be in Exempt organization every material manner. A willfully false representation Agricultural Production of exemption will cause the purchaser to be subject to accordance with the Cardholder Asreement Dairy Production penalty and /or other provisions as allowed under state Livestock Production Floriculture /Aquaculture Production law. Sisnature Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity I lt (J Livestock lnjestiblesorinjectibles Exempt Organization (Entity# Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Call 800- 968-0734 within 7 days to C] Consumed in Production (KS) Resale (Sales Tax Permit complete a survey and be entered in a .Ingredient or Component Parts (KS) monthly drawing for a chance to win a $2500 shoppins spree. other: (Awarded as Gift Card) NO PURCHASE OR SURVEY NECESSARY. Ends 9/30/09, CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL X CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG: EXCH. DATE ITEM NUMBER NON TAX Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL Kt111daQ o 1 btr t%Ub1Ntbb AC;1;;UUN I PAYMENTS TO: W TTO TRACTOR SUPPLY COMPANY su" P.O. Box 9020 Tractor Supply Company Des Moines, IA 50368 -9020 2375 East Pleasant St. TSC TEAM MEMBER TO COMPLETE Noblesvi l le, IN 46060 Please include 16 Digit Account Number (317) 776 6035 301 NAME CARMEL UTILITIES 3450 1tl 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2655 CITY STATE ZIP PHONE 624 624000103 1 1036883 10/21/2008 02:31pm CUSTOMER TO COMPLETE 7047184 JKT INS SNDSTN LG BN 1,00 79.96 79.96 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility The undersigned certifies The undersigned party certifies their exemption from 6409715 BIB CRHT ARCTIC 303 compliance with the agricultural 1.00 94.96 94.96 NT payment of sales and use tax on tangible personal 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 food or fiber, horticulture, a uaculture of floriculture for Subtotal 174.92 Exemption Statement at right and resale and /or uses the farm machine equipment or Total Tax 4.92 the applicable statement of the 'total 174.92 respective state printed on the other agricultural production items purchased free of TSC Card 174,92 reverse side of this form. tax, as defined by state law, and as indicated below. Acc to t t i t t t t i t t t t 1083 The under art further certifies the Auth0:021830 Re4a:2113311039 PRODUCT IS TO BE USED IN THE FOLLOWING 9 p ar t y y Chasse 0.00 STATE, understand they may be liable for payment of all taxes Cash Back (REQUIRED) due on the purchase price for the goods as allowed by (Exceptions: Georgia, New York Kentucky State law Should such oods be used or consumed in COMPLETE REVERSE SIDE) g Buyer acknowledses the receipt Of a complE a taxable manner as defined by state laws. t d PURCHASER IS ENGAGEDIN:(REQUIRED) COPY 04 this sales s lip and the Purchase C Resale Under penalty of perjury, signee swears th? Government information on this statement is true and correct in [3 Exempt in the described merchandise shall Exempt organization every material manner. A willfully false representation accordance with the Cardholder A in F1 Agricultural Production of exemption will cause the purchaser to be subject to nt Dairy Production penalty and /or other provisions as allowed under state Livestock Production Floriculture /Aquaculture Production law. Sisnature Other: ITEMS PURCHASED WILL BE USED FOR:(REQUIRED) �•��1 Farm Machinery/Repair Parts Government Agency (Entity Livestock Injestibles or Injectibles Exempt Organization (Entity NC: onIyDOT and US Government are exempt F1 Fertilizer /Agrichemicals Call 800- 968 -0734 within 7 days to Consumed in Production (KS) Resale (Sales Tax Permit complete a survey and be entered in a Ingredient or Component Parts (KS) monthly drawins for a chance to win a $2500 shoppins spree, other: (Awarded as Gift Card) NO PURCHASE OR SURVEY NECESSARY, Ends 9130109, CUSTOMER SIGNATURE:(REOUMED) 7 MGR. APPROVAL 7( X USE SHADED AREA. ONLY W HEN REGISTER IS INOP ERATIVE. CASH CHECK VISA ;M/C' •DISCOVER' TSC CHARGE ACCOUNT NO'' -CHG." EXCH. DATE Q UANTITY Ll Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL HEMIT TSC OU51NESS ACCOUNT PAYMENTS TO: �&ITRAC709 TRACTOR SUPPLY COMPANY MU 011111111111111' Y JrL CO P.O. Box 9020 FFL Des Moines, IA 50368-9020 73 TSC TEAM MEMBER TO COMPLETE W:25 If i;., N 4t. Please include 16 Digit Account Number 'J (6035 301 (31") N AME I-ARMEL UTILI'r'L:' *'450 W 131ST ST ADDRESS A'Sli-ILLD IN 4604826r (31 7) 733-2K.5 CITY STATE ZIP PHONE 431 431000147 -1 883756 10/"SI/2008 09:46aiii CUSTOMER TO COMPLETE 109P '_31 'IBX SPEC r).LUM 60fN I 00 247,99 24 �5' K'1' 2 CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT. PiiLe: 9.VQI The undersigned certifies The undersigned party certifies their exemption from Utility 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 S;Abtot,Ai 21q. 99 indicated below and understands engaged in the business of agricultural production of 7-00"1 T'ax 0. 0:� and agrees with the General food or fiber, horticulture, aquaculture of floriculture for Tu tal 24Y. 95 Exemption Statement at right and resale and/or uses the farm machinery, equipment or 1"'SC Car 2 .4 9, 5'!) the applicable statement of the Acct other agricultural production items purchased free of 0.:33t'zt23ts3%49A,1 respective state printed on the tax, as defined by state law, and as indicated below. I'lutht: 131616 1 Ref t: reverse side of this form. PO 0: ;an PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they ch'111ge 0,C'0 STATE: (REQUIRED) understand they may be liable for payment of all taxes Cash Back 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 Bu) aLknowl?_J5e5 the receipt 2 cv;,i-, COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. to d PURCHASER IS ENGAGED IN: (REQUIRED) c Of thi 5eile s), i r arld th-- Resale Under penalty of perjury, signee swears thg Government information on this statement is true and correct in the described w.-chenidise shall be iz! Exempt organization every material manner. A willfully false representation accardwice with ihe Cardho f 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 5i Sn R I r15• e: Floriculture/Aquacullure Production law. Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity t t i't t Z 1 i 3 4 1 14.0 T., A t 44 vt I,* Livestock Injestibles or Injectibles Exempt Organization (Entity t i t t 4 1 Fertilize r/Agriche micals NC: only DOT and US Government are exempt Ca 11 ��oo 960 0 e34 !J i 11 i (I i di4 t C] Consumed in Production (KS) F Resale (Sales Tax Permit a 5I.It'wc- awl be eltc-Ved if: ca 140tithly L.1'1'.AWirl'3 loi- '1 61dliCe !0 wj,rl a Ingredient or Component Parts (KS) $25 5liorr.;.119 5vree' F1 Other: (Awarded .95 Gift (::;,rd) NO POW'HASt" OR "URVEY NECEKARY, F r, d 5 L/ 7 0 9 t I ii4 t t4 it2 2 ttt�t ttS c MER S IGNATUR QUI MGR. APPROVAL X WHEN REGISTERISINERATIVE. USE SHADED AREA OP CASH C EC NLY VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE Ll LJ J _LJ DEScIRIPTION RECE11t,7ED Byi:L4-y— DATE 10 2 o PO# uSr_, Form No. 99-00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: TRACTOR SUPPLY COMPANY P.O. Box 9020 Des Moines, IA 50368-9020 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number (6035 301 J `'6 1 5 f NAME 413w00!47 '2 88 76 �-J' 10/31/2008 09:%7w ADDRESS Is$ SPECIAL Rf 'DER COWP(�"T tis CITY STATE ZIP PHONE Special Order a: 431052024 CARMEL WILITILS -,450 W 131 S'( S1 (3 F IN 46074826 CUSTOMER TO COMPLETE (31 M-�81S� CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 6;' KEYS The undersigned certifies The undersigned party certifies their exemption from 1.00 24,00 24. NT compliance with the agricultural payment of sales and use tax on tangible personal t3u1, As-;TiCieS sales tax exemption law of the state property as indicated below and/or purchaser is 8601004 Kft FREIGHT indicated below and understands and agrees with the General engaged in the business of agricultural production of 1.00 4. 4. CO NT food or fiber, horticulture, aquaculture of floriculture for Governfifent Agencies Statement at right and the applicable statement of the resale and/or uses the farm machinery, equipment or 11 respective state printed on the other agricultural production items purchased free of oUbtot-01 tax, as defined by state law, and as indicated below. 7.00% 1': 0.!)0 reverse side of this form. Total 2F 00 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Devos i t 'Z J o0 STATE: (REQUIRED) understand they may be liable for payment of all taxes TSC Lard 2.8 00 due on the purchase price for the goods as allowed by a c t;&: t 3 t 14 3 1 t s- 9 4V4 I (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in H;u I hO 17'S 1866 Ref 6: 31 01047401 COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. 1`0 S:daii PURCHASER IS ENGAGED IN: (REQUIRED) Chanse 0 00 Resale Under penalty of perjury, signee swears the L Back Government information on this statement is true and correct in Exempt organization every material manner. A willfully false representation BALANCL DUE: 0 Q F Agricultural Production of exemption will cause the purchaser to be subject to P!.; iclkTjowlt.&j�5 the PeLCIT OF 6 Dairy Production penalty and/or other provisions as allowed under statd E] Livestock Production F Floriculture/Aquaculture Production law. �-Ll- of AM 1,ales 57J.-- and fizz 11 Other: 'he ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) acordrifice W the t Farm Machinery/Repair Parts Government Agency (Entity F Livestock Injestibles or Injectibles Exempt Organization (Entity t- F e Fertilizer/Agrichemicals NC: only DOT and US Government are exempt Consumed in Production (KS) Resale (Sales Tax Permit Ingredient or Component Parts (KS) Other: t.t t 4 4 t 4.4 k;! t.4 ;.t Calf -oithi.lf i to CUSTO IGNATURE:( E MGR. APPROVAL CnItirl;fle a 5i.tT-vf,-7 and be iT. 77 0/ o it r I it f 131 '1 a Chance io U. I 2ASTC X USE sHAbED AREA ONLYWHEN REGISTER IS INOPERATIVE. CASH C CK VISA C DISCOV TSC CHARGE ACCOUNT NO. CHG. EXCH: DATE QUANTITY J ITEM NUMBER DESCRIPTION. P F- G, E i VED Byp DATE /0 0# /".Ccl Form No. 99-00401 (12/05) CUSTOMER ORIGINAL P R T 10/31/08 9: 4 AM 431 WESTFIELD, IN. Page 1 of 1 SO# 431052024 CUSTOMER CARMEL UTILITIES SHIP TO SHIP TO STORE 3450 W 131ST ST WESTFIELD, IN 460748267 (317)733 -2855 VENDOR PO# 8666933 VENDOR 510289 DELTA CONSOLIDATED INDUSTRIES INC CREATE DATE 10/31/08 STATUS Pending STATUS DATE 10/31/08 OPERATOR 431000120 MICHAEL NIEMANN EXTENDED SKU DESCRIPTION PART QTY PRICE DISC AMOUNT 0222220 KEYS REPL 1 24.00 0.00 24.00 8601004 SCO FREIGHT 1 4.00 0. 4.00 SUBTOTAL 28.00 TAX 0.00 TOTAL 28.00 PAID AMOUNT 0.00 BALANCE DUE 28.00 PAYMENT HISTORY D PAYMENT TYPE AMOUNT I a to-evil I a Vv L.V%J% PAYMENTS TO: TRACTOR TRACTOR SUPPLY COMPANY Su "LYC® P.O. Box 9020 Des Moines, IA 50368-9020 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number r 16,1 ,C -16 0':` (6035 301 867 NAME CAR'MEL. lJT*--'LJ1HFS 3450 W t: -15i S[ 4 Q ADDRESS I..'Esum-D (M) 733 -'Ki!! 'CITY STATE ZIP PHONE H6.14,. Z2008 08: 44�lni CUSTOMER TO COMPLETE 109?'-"31 1,00 ZI-I'P, 99 2 "'i CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT* utili!, The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal 'a Lib 10 t aL sales tax exemption law of the state property as indicated below and/or purchaser is 00% 1'av, 0,00 indicated below and understands engaged in the business of agricultural production of Tuta.1 259-3111 and agrees with the General food or fiber, horticulture, aquaculture of floriculture for T,6L C Exemption Statement at right and resale and/or uses the farm machinery, equipment or the applicable statement of the other agricultural production items purchased free of i-)uth4:012.',A81 K'e -F respective state printed on the tax, as defined by state law, and as indicated below. Ulan5e 0100 reverse side of this form. Cash Par. k PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they T, STATE: understand they may be liable for payment of all taxes �.Uyel' ur ci Cie (REQUIRED) due on the purchase price for the goods as allowed b y" (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in ckj!,y (if --tir and -ihe rul-chase C COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. 4 PURCHASER IS ENGAGED IN: (REQUIRED) the C% ,Crity,' b le in Resale Under penalty of perjury, signee swears the accor wi th the C e� ho 1. de r A r Ti t F Government information on this statement is true and correct in F Exempt organization every material manner. A willfully false representation Agricultural Production of exemption will cause the purchaser to be subject to -3 ivot t I.;. I e; Dairy Production penalty and/or other provisions as allowed under state I n Livestock Production Floriculture/Aquaculture Production law. Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Mach inery/Repair Parts Government Agency (Entity Cell 800-968-07''4 within 7 day-_ to Livestock Injestibles or Injectibles Exempt Organization (Entity G alf I is fc :a and lbe en tC- -,cd i.fi a E] Ferlilizer/Agrichemicals NC: only DOT and US Government are exempt fr, 0 n ti I I d T a W i t f or a Chi:''. ti I o W 3, 1) a Consumed in Production (KS) Resale (Sales Tax Permit 2t 0 0 1 F i ri er e (Awavde(3 tl, G-141 (",ird) NO F Ingredient or Component Parts (KS) 0 SURVEY L'ods 9/30/09. F Other: Enter Sture >4 u4- i CuSR SIGNATURE: (RE MGR. APPROVAL SIGNATURE:( X ZZ t�2 ::Z�l USE SHADED AREA ONLY WHEN'REGISTER 1S.1NOPERATIVE., VISA CAS C M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE ITEM NUMBER- DESCRIPT16N UNIT PRICE RECEIVED DATE IL' P()# AC-Cl# USE 7(- Form No. 99-00401 (12/05) CUSTOMER ORIGINAL sp ORDWMPORT 10 09:34 AM 431 WESTFIELD, IN. Page 1 of 1 SO# 431052024 CUSTOMER CARMEL UTILITIES SHIP TO SHIP TO STORE 3450 W 131ST ST WESTFIELD, IN 460748267 (317)733 -2855 VENDOR PO# 8666933 VENDOR 510289 DELTA CONSOLIDATED INDUSTRIES INC CREATE DATE 10/31/08 STATUS Pending STATUS DATE 10/31/08 OPERATOR 431000120 MICHAEL NIEMANN EXTENDED SKU DESCRIPTION PART QTY PRICE DISC AMOUNT 0222220 KEYS REPL 1 24.00 0.00 24.00 8601004 SCO FREIGHT 1 4.00 O.^^ 4.00 SUBTOTAL 28.00 TAX 0.00 TOTAL 28.00 PAID AMOUNT 0.00 BALANCE DUE 28.00 PAYMENT HISTORY DATE PAYMENT TYPE AMOUNT •�..((.q{.((JJ. a vv r.vv •vvv v.a T RACTO R PAYItl1ENTS T TRACTOR SUPPLY COMPANY SULYC® P.O. Box 9020 Tractor Sur- Ply ColoPn•r Des Moines, IA 50368 -9020 18 160 U.S 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Wes if ield. IN 46074 6035 301 (31 7) 867 NAME CARMEL UTILITIES 3450 W 13151 S7 ADDRESS WESTFIELD IN 460743267 (31'(') 733 -2855 CITY STATE ZIP PHONE 431 623000069 2 885356 11/07/2003 08:53am CUSTOMER TO COMPLETE 0222220 SPECIAL ORDER ARTICL 1,00 '24,00 24,00 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility The undersigned certifies The undersigned party certifies their exemption from 8601004 52'0 FREIGH'f compliance with the agricultural payment of sales and use tax on tangible personal 1.00 (J 4,00 4,00 NT 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 4049430 BAG MEGA MOUTH and agrees with the General 1.00 19.99 19.99 NT food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or F'es• Price: 27.99 the applicable statement of the other agricultural production items purchased free of Utility respective state printed on the tax, as defined by state law, and as indicated below. 4000573 SLEDGE 3LB 16IN F/G reverse side of this form. 1.00 L 16.99 16.99 NT PRODUCT IS TO BE USED N THE FOLLOWING The undersigned party further certifies they Utility STATE: y y payment understand the may be liable for a ment of all taxes 3821 374 CHISEL COLD SFIC S1 1 .00 17.99 17,9V NT Eo IRED) due on the purchase price for the goods as allowed by (Exceptions: Georgia, New York a Kentucky state law should such goods be used or consumed in U t i 1 i t Y COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. 3501322 ALUM ANGLE 1 51N X11 PURCHASER IS ENGAGED IN: (REQUIRED) 1 .00 18.45 18,49 NT D 50<ale Under penalty of perjury, signee swears the Utility /Government information on this statement is true and correct in Exempt organization every material manner. A willfully false representation Subtotal 101 46 Agricultural Production of exemption will cause the purchaser to be subject to 00 Tax 0.00 Dairy Production penalty and /or other provisions as allowed under state Total 101-46 Livestock Production TSC C ard 101 .46 Floriculture /Aquaculture Production law' Acct#:a't2sas4a31s4941 Other: Autho:007231 Ref4:0707530003 PO x:110708 ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Chan 9e 0.00 E] Farm Machinery/Repair Parts Government Agency (Entity Cash Kick Livestock Injestibles or Injectibles Exempt Organization (Entity Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Buyer acknowle the receip of a CunlNl ,.d Consumed in Production KS Resale (Sales Tax Permit CUPY of this 5ale5 slip and the Pl.archase Ingredient or Component Parts (KS) f the describi=d merchandise shall be in Other: accordance with the Cardholder A9reemen CUS ER SIGNATURE: (RE 1 MGR. APPROVAL X r Jl9natL11'f': X UlSEi.SHA AREA ONLYWHEN REGISTER IS INOP ERATIVE. CASH C VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE Q UANTITY PRICE REeE1),"ED B"!A"V If �c DAIE 7� PO# ACCT# Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL P'EC(F/Bi o o ®u�nvta� aat.�,vcatd t NT PAYMENTS TO: TRACTOR SUPPLY COMPANY slim o P.O. BOX 9020 Tractor SUPPlY r DidP r3n'Y Des Moines, IA 50368 -9020 18160 U.S. 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westfield IN 460 °4 6035 301# (317) 867 -3505 NAME CARMEL UTILITIES 3450 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733-2855 CITY STATE ZIP PHONE 431 431000179 2 883602 10/30/2608 01 :59pM CUSTOMER TO COMPLETE 7067320 JKT DICK QLTLD XL BN 1,00 74,99 7439 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT Utility The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural Subtotal 74, 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 engaged in the business of agricultural production of Totel 74,99 and agrees with the General TSC Card ?4,99 Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for Acc to i i i a i a a a a a a i 4958 resale and /or uses the farm machinery, equipment or the applicable statement of the Autho:030205 Refe:3012583844 respective state printed on the other agricultural production items purchased free of PO a :103008 reverse side of this form. tax, as defined by state law, and as indicated below. 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 99 BttyeT' acknowledses the rec.eirt of a COMP] (Exceptions: Georgia, New York Kentucky state law should Such goods be used or consumed In d COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. copy Of 1'hi5 sales slip and the Purchase PURCHASER IS ENGAGED IN: (REQUIRED) f file described olercFlandise shall be in 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 isnature Livestock Production Floriculture /Aquaculture Production law. Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) E1Ez ttEEEYiY22fE2tYYEtYYiEiiiitaEi2ai Farm Machinery/Repair Parts Government Agency (Entity EitiYE3ia 2aEiEEEfalYiYitEiYititiziiYa Livestock Injestibles or Injectibles Exempt Organization (Entity Cal 900 0734 within 7 days to Fertilizer /Agrichemicals NC: only DOT and US Government are exempt c UI+:P lete a survey and be entered in a Consumed in Production (KS) E] Resale (Sales Tax Permit Monthly drawin chance, to win a Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE Other: OR SURVEY NECESSARY. Ends 9/30/09. ifYtEaEEEiiE tEE 8EEf r 3Y t aiiiitaifiYEYEa CUSTO SIGN RE:(R UIRED) MGR. APPROVAL X CVVTtJtVJJ `"111 SHADE USE AFIfEA ONLY CASH CHECK" VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE QUANTITY ITEM NUMBER. DESCRIPTION Farm No. 99 -00401 (12/05) CUSTOMER ORIGINAL nV-11Voe e a fit. WT T T0: TRACTOR SUPPLY COMPANY S� P.O. Box 9020 Des Moines, IA 50368 Tractor Supply Company TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number 18160 U.S. 31 North 9 WestfielJ,IN 46079 6035 301 317) 867-3505 NAME CARMEL UTILITIES ADDRESS 3450 W 131ST ST WESTFIELD IN 460748267 (317) 733 -2855 CITY STATE ZIP PHONE 431 431000179 2 883603 10/30/2008 02:00rm CUSTOMER TO COMPLETE 7067524 JKT THRML HD XL MOS CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: 1 00 e 72.50 72.50 N The undersigned certifies Utility g The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal Subtotal 72.50 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 72,50 and agrees with the General food or fiber, horticulture, aquaculture of floriculture for TSC Card ?2,50 Exemption Statement at right and resale and /or uses the farm machinery, equipment or Acc to t s t s E s a a s a a 35039 the applicable statement of the other agricultural production items purchased free of Auths:030363 Ref ;:3013002993 respective state printed on the tax, as defined by state law, and as indicated below. PO 4:103008 reverse side of this form. Chanse 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 ac knowledses the receip of a col. v 1; (Exceptions: Georgia, New York Kentucky state law Should such goods be used Or Consumed t COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. copy of this sales slip and the Purchase 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 Asreemen t 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 Sisna tore: Livestock Production Floriculture /Aquaculture Production law' Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) 2233 33E It t2E3It 3332t3t181t33Et3t3tEtt:t Farm Machinery/Repair Parts Government Agency (Entity 3 E 3 E 3 3 3 a s 3 2 3 3 a E E 3 3 3 E t 3 3 E t 3 3113 t 11 It 3 E Livestock Iniestibles or Iniectibles 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 Consumed in Production (KS) Resale (Sales Tax Permit# monthly drawins for a chance to win a 82500 shopPins spree. Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE Other: OR SURVEY NECESSARY, Ends 9/30/09. ss oat :a:: :asaE3s:a:aa: :tsE::3asss :3 CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL X SHADED e INOP ERATIVE. CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE TE NN. TAX Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT TWW PAYMENTS TO: TRACTOR SUPPLY COMPANY U"Ly P.O. Box 9020 Des Moines, IA 50368-9020 S TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number (6035 301# NAME 1 3 450 L. 3 IsI ADDRESS WLSTF 1 2 r:.L' 1) CITY STATE ZIP �PHONE 1 7,3600-0101 09:12a.11I CUSTOMER TO COMPLETE THRFADi_. R.'61D 3 1.00 C_ CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT. U!"! j. The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural pa�ment of sales and use tax on tangible personal C 2, 2 2 N17 sales tax exemption law of the state property as indicated below and/or purchaser is i, li: indicated below and understands engaged in* the business of agricultural production of M X and agrees with the General food or fiber, horticulture, aquaculture of floriculture for I 00 Exemption Statement at right and !.;'iiii ty resale and/or uses the farm machinery, equipment or the applicable statement of the other agricultural production items purchased free of LOCKT-P! v respective state printed on the tax, as defined by state law, and as indicated below. 00 ri 2. 2 2 reverse side of this form. U t 2" 11 i nr!' PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they 4' "j" '1 4 X I STATE: understand they may be liable for payment of all taxes 00 2 2.2T NJ (REQUIRED) due on the purchase price for the goods as allowed by (Exceptions: Georgia, New York Kentucky i ji, X I state law should such goods be used or consumed in COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. 2 2P N PURCHASER IS ENGAGED IN: (REQUIRED) i.1 i t Resale Under penalty of perjury, signee swears the J Government information on this statement is true and correct in 0 2. 29 W! Exempt organization every material manner. A willfully false representation U 11 j. 1. Agricultural Production of exemption will cause the purchaser to be subject to Dairy Production penalty and/or other provisions as allowed under state 0 0 '2 2T N T Livestock Production f Floriculture/Aquaculture Production law. 1 UK P1, Other: 0 U L' i'. 1 r y ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) :i.` I I LOCKPf N 'S I.: X I Farm Machinery/Repair Parts Government Agency (Entity 2.9 N1 Livestock Iniestibles or Injectibles Exempt Organization (Entity i. t y Fertilizer/Agrichemicals NC: only DOT and US Government are exempt X I 2. ;�v N C] Consumed in Production (KS) Resale (Sales Tax Permit F Ingredient or Component Parts (KS) L 0. *:"'Yl til x 'I 1 5" 2' 2� NT 0 Other: r.)0 C 2 I J -1 i 'Y 1 3 C 4US ER SIGNATURE: (RE MGR. APPROVAL 1 013 A 2. U ii I i. X CASH CH CK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. ;CHG. EXCH. DATE I J_ ITEM NUMBER-. NION DESCRIPTION TAX AMP"` DATR PO# ACCT# Form No. 99-00401 (12/05) CUSTOMER ORIGINAL I •L-rv o vv uv'7eltl L-%J a %J VV•a PAY T TRACTOR SUPPLY COMPANY ,��•�T f T �s G�2 7- sly Co P.O. Box 9020 Des Moines, IA 50368 -9020 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number 6035 301 NAME ADDRESS r 1 Ste: 3 i.: CITY STATE ZIP PHONE CUSTOMER TO COMPLETE 1 CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: The undersigned certifies The undersigned party certifies their exemption from r: compliance with the agricultural sales tax exemption law of the state payment of sales and use tax on tangible personal J property as indicated below and /or purchaser is i indicated below and understands engaged in the business of agricultural production of and agrees with the General Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for resale and /or uses the farm machinery, equipment or the applicable statement of the respective state printed on the other agricultural production items purchased free of 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 on the purchase price for the goods as allowed by r'' `'�'r'• (Exceptions: Georgia, New York Kentucky state law Should such goods be used Or consumed In o COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. PURCHASER IS ENGAGED IN: (REQUIRED) r s Resale Under penalty of perjury, signee swears the Government information on this statement is true and correct in Exempt organization every material manner. A willfully false representation' 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 r i I [D Floriculture /Aquaculture Production IdW. y 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 Consurrled in• fi gduetion_)(KS);,, 0 Resale (Sales Tax Permit Ingredie'htor 0dfi0oridiit7Pa1ts•(KS) :-iI11 :Ie 1 1 El +,a atlT m0u Other: V1 YY9'Fii It2- 7 YSYYBkY° iiTsE 'SY «iYir:''�bYi: «YbY;'.'eF. P ?:S..;iF;'f'riYc� ;s;;oasi ?�:iiY CU MER SIGNATURE IR�f)j1;1 U Yi D� 1 D MGR. APPROVAL O J 17 .1.�' ...it' X USE SHADED AREA CAS C I A' '•M/C '`DISCOVEFi TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE iYYtY 2i2YY iYY YiYYii SYYYi =SiTY LJ AIAJTO3w0 SI)3 It +)]'Aj.�SJ04 n• Ij O QUANTITY DIESCRIPTIO is f) 3J0" .ID.itil r SlYiiiYi$Yii Y «YYYY �P=YY.'_Yii!T;. «ILYY 35UH3�tId Oil U. t a t 03 1? u r rr n; ;::)a LI :i P n i_ t; Ii r rr r c :o-" ?i.'.. YYYSi4YiYF.S'T >r;ar. ;ia Form No. 99.00401 (12105) CUSTOMER ORIGINAL e asr,eerea e a vv a�a�veeeo_a,yv revvarv.c TRACTOR T PAYMENTS TO: RACTOR SUPPLY COMPANY i ���j� P.O. Box 9020 WOU Tractor SuPPIv (.OmPanY 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 UTILITIES 3450 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2855 CITY STATE ZIP PHONE 624 624000103 2 1037119 10/22/2008 10:16am CUSTOMER TO COMPLETE 6409757 BIB CRHT ARCTIC 40X3 1.00 94,76 94.96 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Uti The undersigned certifies The undersigned party certifies their exemption from 6420389 JKT ARCTIC BLK 42 compliance with the agricultural 1100 89.96 89,96 NT sales tax exemption law of the state payment of sales and use tax on tangible personal Ut i 1 i tv indicated below and understands property as indicated below and /or purchaser is 6409731 BIB CRHT ARCTIC 38X3 and agrees with the General engaged in the business of agricultural production of 1100 94,96 94,96 NT Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for Utility the applicable statement of the resale and/or uses the farm machinery, equipment or 6310128 JACKET CRHT ARCTIC 4 respective state printed on the other agricultural production items purchased free of 1.00 89.96 89,96 NT reverse side of this form. tax, as defined by state law, and as indicated below. Ut i I i t y PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Subtotal 369,84 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 369.84 (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in TSC Card 369.84 COMPLETE REVERSE SIDE) a taxable manner as defined b state laws. Y Acctt:EEES#E EY #E1 125 PURCHASER IS ENGAGED IN: (REQUIRED) Au tht 022645 Ref t; 2209163821 Resale Under penalty of perjury, signee swears the Chan -3e 0.00 Government information on this statement is true and correct in Cash Back Exempt organization every material manner. A willfully false representation Agricultural Production. of exemption will cause the purchaser to be subject to Buyer acknowledses the rereit't D# a cone. Dairy Production penalty and /or other provisions as allowed under state ed F Livestock Production F Floriculture /Aquaculture Production law r..ory of this sales slip and the Purchase Other: the described merchandise shall be in ITEMS PURCHASED WILL BE USED FOR :(REQUIRED) accordance With the Cardholder Asreelltent Farm Machinery/Repair Parts Government Agency (Entity Livestock iniestibles or Injectibles Exempt Organization (Entity Fertilizer /Agrichemicals INC: only DOT and US Government are exempt 5i,Snature: Consumed in Production (KS) Resale (Sales Tax Permit Ingredient or Component Parts (KS) Other; t# E# EEEEEEEE #Ef #E#3EEEEY2#222EE #i CUSTO ER SI N TURF: (REQUifIE l MGR. APPROVAL SHA CASH' CHECK' VISA M/C DISCOVER' TSCCHARGE'ACCOUNTNO" CHG 3 ?EXCH.'- DATE 1 a e a UN Form No. 99- 00401 (12105) CUSTOMER ORIGINAL VOUCHER 083772 WARRANT ALLOWED 306840 VXEI IN SUM OF E TRACTOR SUPPLY CO P.O. Box 689020�� Des Moines, IA 50368 -9020 0 .R Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code Ll SS 376 c�• �SUG,�.. 7�•CC> COtq H3io�`c�853s[,"o�o bl.�y�Gb �b► -�ft�. 43100088668 01- 6200 -03 $324.87 r�j� qob 43100088668 01- 6500 -04 $5123 5c% V 9 0�© tp�b ltDl.� 5c« e �Ic MS`S GA V 3( t L A (t)i u 4. ct tact, 14.9' 7- 3c1e ao 1b 3c 4t +3iooc� o b \,i. a�t)' 0qq. Voucher Total �R Cost distribution ledger classification if claim paid under vehicle highway fund 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 12/2/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/2/2008 4310008866E $376.10 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 Date Officer