172584 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $138.99
DES MOINES IA 50368 -9020 CHECK NUMBER: 172584
CHECK DATE: 5/1312009
DEPARTMENT AC PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 603530120018 138.99 6035301200182572
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BUSINESS ACCOUNT
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4t�WTSUMIi�ARY 0035i'4 072Q01$2572
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Previous Balance 0.00 Closing Date 04/20/09
Payments 0.00 Next Closing Date 05/19/09 CARMEL UTILITIES
Credits 0.00 Payment Due Date 05/15/09 ACCOUNTS PAYABLE
Purchases 138.99 3450 W 131ST ST
i Debits 0.00 Current Due 138.99 WESTFIELD, IN 46074 -8267
FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 5,000
Late Fees 0.00 Minimum Payment Due 138.99 Credit Available 4,861
New Balance 138.99
CURRENT ACTIVITY
Transaction Ltio Amount
Iasscr
APR 2 GOODS AND SERVICES WESTFIELD IN 54.99
TOTAL 6035301200201125 $54.99
APR 1 GOODS AND SERVICES WESTFIELD IN 84.00
TOTAL 6035301202814941 $84.00
This account is subject to the Alternate Balance Subject to Finance
Charge Calculation Method. See back for details.
FINANCE CHARGE SUMMARY
Current Billing Period Previous Billing Period
Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL
Subject to Periodic &Ilirg PERCENTAGE Subject to Periodic Billing PERCENTAGE
Finance Charge Rate Period RATE Finance Charge Rate Period RATE
REGULAR REVOLVE CREDIT PLAN 0.00 .00000 32 0.00 0.00 .00000 29 0.00
This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1- 800.559 -8232 FAX NUMBER 1-801-779-7425
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Notify Us in Case of Errors or Questions About Your Bill Copy Fee: On any matter unrelated to a billing error or disputed purchase,
we charge a $5.00 fee for each duplicate statement for a billing period that
If you think your billing statement is wrong, or if you need more information is more than 3 months prior to your request. We add this fee to regu-far
about a transaction on your billing statement, write to us (on a separate revolve credit plan balance.
sheet) as soon as possible at the billing error address on the front of your
statement. We must hear from you in writing no later than 60 days after we Payment Options Other Than Regular Mail:
sent you the first statement on which the error or problem appeared. In your
letter, give us the following information: Pay by Phone. You may make your payment by phone by using the Pay by
Phone Service. You will be charged $14.95 to use this payment service.
Your name and account number. Call by 5 p.m. Eastern time to have your payment credited as of that clay.
The dollar amount of the suspected error. if you call after that time, your payment will be credited as of the next day.
Describe the error and explain, if you can, why you believe there is an We may process your payment electronically upon verification of your
error. If you need more information, describe the item you are unsure identity.
about. Send payment by courier or express mail to the Express Payments
address: Customer Service Center, Dept. CCS 8725 W. Sahara Blvd., Las
Important Payment Instructions Vegas, NV 89117. Payment must be received in proper form, at the proper
address, by 5 p.m. Pacific time in order to be credited as of that day. All
Crediting Payments: Payment must be received in proper form at our payments received in proper form, at the proper address, after that time
processing facility by 5 p.m. local time there to be credited as of that day. A will be credited as of the next day.
payment received at the processing facility in proper form after that time will
be credited as of the next day. Please allow 5 -7 days for payments by Report a Lost or Stolen Card Immediately: Customer Service is available
regular mail to reach us. There may be a delay of up to 5 days in crediting a 24 hours a day, 7 days a week.
payment sent by mail if it is not in proper form or is addressed to a location
other than the address listed on the return envelope or on the front of the Your account is issued by Citibank (South Dakota), N.A.
payment coupon, or, for courier or express mail payments, to the Express
Payments Address set forth below.
Proper Form: For a payment sent by mail or courier to be in proper form,
you must:
Enclose a valid check or money order. No cash, gift cards, or foreign
currency please.
Include your name and account number on the front of your check or
money order.
Tractor Supply Co. Full Balance S902TV 10/06
902TV5741006 PCT
8/0
Remit To: Bill To: page 2 or 2
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 TRAMR'
DEP ,T.30 1200182572 GREG HOLANDER ®SUMYCO.
PO BOX 689020 130 1 ST AVE SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020
Payment Due Date: 05/15109 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP TO: INVOICE:
431000919430010 431000919094010
Purchase Order: Purchase Order:
GREG DAN
AMOUNT DUE: 54.99 AMOUNT DUE: 84.00
Store: 574000431 INVOICE DATE: 04/02 /09 Store: 574000431 INVOICE DATE: 04/01 /09
GW 50LB NORTH BG QUICK 5854009 1.00 54.99 54.99 SPECIAL ORDER ARTICLE 0222220 2.00 40.00 80.00
SPECIAL ORDER ARTICLE 0222220 1.00 4.00 4.00'
SUBTOTAL 54.99
TAX 0 -00 SUBTOTAL 84.00
SHIPPING 0.00 TAX 0.00
SHIPPING 0.00
TOTAL 54.99
TOTAL 84.00
Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801 779 -7425
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IRAC70 PAYMENTS T
TRACTOR SUPPLY COMPANY
A11Y C P.O. Box 9020
Des Moines, IA 50368 -9020
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
6035 301
NAME
ADDRESS
CIYY STATE ZIP PHONE
CUSTOMER TO COMPLETE
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT:
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural payment of sales and use tax on tangible personal
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
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for
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
respective state printed on the
reverse side of this form. tax, as defined by state law, and as indicated below.
1
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
(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.
PURCHASER IS ENGAGED IN: (REQUIRED)
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
E] Livestock Production penalty and /or other provisions as allowed under state
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
f Fertilizer /Agrichemicals NC: only DOT and US Government are exempt
Consumed in Production (KS) Resale (Sales Tax Permit
Ingredient or Component Parts (KS)
Other b.
CUSTOMEgSIGNATURE:(REOUIR y MGR. APPROVAL
X
0 0
CASH CHECK` VISA 1:MWC DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
0"
NON
ITEM N DESCRIPTIO
TAX
DATE
PO#
F i
Form No. 99 -00401 (12105) CUSTOMER ORIGINAL
>t 1 0 ou"J11l1r—CP0 M%'Ft VU0V I
PAYMENTS TO:
TAWNUTOR TRACTOR SUPPLY COMPANY
SLMYCO I N
P.O. Box 9020
Des Moines, IA 50368 -9020
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
6035 301
NAME
ADDRESS
i 3 "v
CIV STATE ZIP PHONE
CUSTOMER TO COMPLETE
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: <'3
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural itvP.i„ a
payment of sales and use tax on tangible personal
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
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for
Exemption Statement at right and
resale and /or uses the farm machinery, equipment or
the applicable statement of the r�.. c:( •+:i I
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.
The under art further certifies the
PRODUCT IS TO BE USED IN THE FOLLOWING 9 party Y
STATE: understand they may be liable for payment of all taxes
(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 cons(lmed
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws.
PURCHASER IS ENGAGED IN: (REQUIRED)
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
Floriculture /Aguaculture Production
law.
Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity
Livestock Injestibles or Injectibles Exempt Organization (Entity
NC: only DOT and US Government are exempt
Fertilizer /Agrichemicals
Consumed in Production (KS) Resale (Sales Tax Permit
Ingredient or Component Parts (KS)
Other:
CUSTQMER SIGNATURE: (REOU RED) MGR. APPROVAL
y X
o 0 0 0•
ASH' CHECK VISA; M/C DISCOVER TSC CHARGE'ACCOUNT NO:'. CHG. EXCH. DATE
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EE
Form No. 99 -00401 (72105) 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 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 5/4/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/4/2009 4310009194< $54.99
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 091729 WARRANT ALLOWED
3^6840 IN SUM OF
TRACTOR SUPPLY CO
P'O. Box 689020
Des Moines, IA 50368 -9020 0�y����L'�
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
43100091943 01- 6200 -06 $54.99
13kr'q1C)b1 DU
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund