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170605 04/01/2009 CITY OF CARMEL INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CHECK AMOUNT: $871.56 CARMEL, INDPANA 46032 PO BOX 689020 'g.owi�'ro DES MOINES IA 50368 -9020 CHECK NUMBER: 170605 CHECK DATE: 4/1/2009 DEPA T ACCO PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION -2201 4237000 361.58 6035301200050860. x'.2201 4467099 509.98 603530120005086,0 E xi page 1 of 1 4 Tx 7 D113000000000000 �Q 06 ®SU i YYV- BUSINESS ACCOUNT 0000416 —4 ACC'QUtdT SUA�MARY�6035301k r Previous Balance 1,059.59 Closing Date 03/19/09 Payments 595.30 Next Closing Date 04/20/09 CARMEL STREET DEPT Credits 0.00 Payment Due Date 04/13/09 CINDY Purchases 871.56 3400 W 131ST ST Debits 0.00 Current Due 871.56 WESTFIELD, IN 46074 -8267 FINANCE CHARGES 0.00 Past Due Amount 464.29 Credit Line 5,250 Late Fees 0.00 Minimum Payment Due 1,335-85 Credit Available 3,832 New Balance 1,335.85 CURRENT ACTIVITY Transaction Location% mount MAR 10 GOODS AND SERVICES NOBLESVILLE IN 15.99 TOTAL 6035301200074803 $15.99 "MAR 17' GOODS AND SERVICES WESTFIELD IN 279.99 MAR 18 GOODS AND SERVICES WESTFIELD IN 229.99 TOTAL 6035301200074837 $509.98 FEB 26 GOODS AND SERVICES WESTFIELD IN 172.48 MAR 18 GOODS AND SERVICES WESTFIELD IN 71.27 TOTAL 6035301202895866 $243.75 FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic all irg PERCENTAGE Sutjec[to Periodic &Ihrg PERCENTAGE Finance Charge Rate Period RATE Finance Charge Rate Period RATE REGULAR REVOLVE CREDIT PLAN 0.00 .00000 29 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 I 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 advance;. 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 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 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 number It days in the billing period and f the applicable daily periodic rate. separately for each balance. Balances include regular purchases, regular cash 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 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 Ouestions About Your Bill. If you think your multiplying 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 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 ou the first bill on which the error or problem a period, the result is the total periodic finance charge on that balance. y p appeared. In Rounding may cause a small difference. your letter, give us the following information: Alternate Balance Subj to Finance Charge Calculation Method. If the a Y name and account number. g 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 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 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 payment we receive that is not in proper form or is not sent to the correct Pay Phone Service. You may use this service any time make a address. The correct address for a payment sent by regular mail is the address payment by phone. You will charged to use this service. Call by 5 listed on the return envelope or on the front of the payment coupon. A after Eastern time to have your payment credited as of that day. If you call a payment made in-store is not sent to the correct address. The correct address after that time, your payment will be credited as of the next day. We may for a payment sent by courier or express mail is the Express Payments process your payment electronically after we verify your identity. Address shown below. o Express Payments. You can send payment by courier or express mail to Proper Farm. For a payment sent by mail or courier to be in proper form, you the Express Payments Address: Customer Service Center, Dept. CCS 911, 4740121st Street, Urbandale, IA 50323. Payment must be received in roper must: 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 S603TV Rev. 07 /08 soon as the day we receive the check. Also, the check will be destroyed. 603TV5740708 -Cit page 2 of 4 Tx 7 D1130000000 VSUMYCO- BUSINESS ACCOUNT 0000417 CURRENT ACTIVITY a Transaction ocationl, �esc�(ptioR� ..0 MAR 12 GOODS AND SERVICES WESTFIELD IN 57.93 TOTAL 6035301202896120 $57.93 MAR 10 GOODS AND SERVICES WESTFIELD IN 43.91 TOTAL 6035301202896161 $43.91 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS FEB 19 PAYMENT REF P9194001J09J091J6 595.30 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. Memll I o: 13111 10: page 3 of 4 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 DEPT.30 1200050860 JEFF STEWART ®SUPPLYC PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000438 Payment Due Date: 04/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP T0: INVOICE: SHIP To: INVOICE: 624001100111010 431000915255010 Purchase Order: Purchase Order: SHOP TRUCK10 AMOUNT DUE: 15.99 AMOUNT DUE: 279.99 Store: 574000624 INVOICE DATE: 03110 /09 store: 574000451 INVOICE DATE: 03/17 /09 TANK CLEANER QT 4201797 1.00 15.99 15.99 TBX BET ALUM FS DUAL LI 1091850 1.00 279.99 279.99 SUBTOTAL 15.99 SUBTOTAL 279.99 TAX 0.00 TAX 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 15.99 TOTAL 279.99 SHIP To: INVOICE: SHIP TO: INVOICE: 431000915449010 431000910940010 Purchase Order: Purchase Order: TRUCK11 SHOP AMOUNT DUE: 229.99 AMOUNT DUE: 172.48 Store: 574000451 INVOICE DATE: 03/18 /09 Store: 574000451 INVOICE DATE: 02/26 /09 TBX GOOD ALUM FS GULL W 1099454 1.00 229.99 229.99 G8 GALV AND COTTERPIN B 5568887 26.50 5.49 92.49 PUMP 1 /5HP UTV SUBM 5125257 1.00 79.99 79.99 SUBTOTAL 229.99 TAX 0.00 SUBTOTAL 172.48 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 229.99 TOTAL 172.48 V Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801- 779 -7425 Remit I o: Bill To: Page 4 or 4 I TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 DEPT.30 1200050860 STEVE JONES ®SUMYC g PO BOX 689020 3400 W 131 ST ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000419 Payment Due Date: 04/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP To: INVOICE: SHIP TO: INVOICE: 431000915538010 431000913957010 Purchase Order: Purchase Order: SHOP 3112009 AMOUNT DUE: 71.27 AMOUNT DUE: 57.93 Store: 574000431 INVOICE DATE: 03/18 /09 store: 574000431 INVOICE DATE: 03/12 /09 SPRAY TIP 15DEG YW 3.5 3823782 1.00 7.29 7.29 WHEEL 7X1 /4X5 /B 11 META 3818363 1.00 8.99 8.99 DISCONNECT 18IN WANDOUI 3807168 1.00 23.99 23.99 WHEEL 7X1/4X5/8 11 META 3818363 1.00 8.99 8.99 SPRAY GUN METRIC W ADAP 3823821 1.00 39.99 39.99 WHEEL 7Xl /4X5/8 11 META 3818363 1.00 8.99 8.99 SAW WHEEL 14X3/32X7/64X 3805653 1.00 6.99 6.99 SUBTOTAL 71.27 SAW WHEEL 14X3/32X7/64X 3805653 1.00 6.99 6.99 TAX 0.00 SAW WHEEL 14XS/32X7/64X 3805653 1.00 6.99 6.99 SHIPPING 0.00 MTL DEPRESSED CTR ABRAS 3811175 1.00 9.99 9.99 TOTAL 71.27 SUBTOTAL 57.93 TAX 0.00 SHIPPING 0.00 TOTAL 57.93 J SHIP TO: INVOICE: 431000913486010 Purchase Order: 3102009 AMOUNT DUE: 43.91 Store: 574000431 INVOICE DATE: 03/10 /09 TANK CLEANER QT 4201797 1.00 15.99 15.99 HITCH PIN 1 /2X4IN 3PT 0268666 8.00 3.49 27.92 SUBTOTAL 43.91 TAX 0.00 SHIPPING 0.00 TOTAL 43.91 J Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801- 779 -7425 REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: TRACTOR TRACTOR SUPPLY COMPANY SU PPLYCa -a P.O. Box 9020 TriActur SUPF[Y collipny Des Moines, IA 50368-9020 18160 U,S, 31 Nut th TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account-Number- Wt:-3tfii`Id. IN 1607 (6035 301 (317) 867-3505 NAME CrIRMEL STREEI DEFT 3400 W 131ST ST ADDRESS JESTFIELD !N 160748267 (317) 7313-2001 CITY STATE ZIP PHONE 431 786000104 2 910910 0212612009 Ml'&oi CUSTOMER TO COMPLETE 31�688K 68 GAL'. AND C0fTE.Pl 26, SO e Z'49 92,49 N CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT Govei•i,wei:t Aqencie5 The undersigned certifies The undersigned party certifies their exemption from 3125257 F01`11" 1/3HP MY SIJDM compliance with the agricultural payment of sales and use tax on tangible personal 1.00 Li 7 9 9'7 7V V9 NT sales tax exemption law of the state property as indicated below and/or purchaser is Gov :Vllmefit Asenci=_s 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 172.48 Exemption Statement at right and resale and/or uses the farm machinery, equipment or 7,00% Tax 0100 the applicable statement of the agricultural production items purchased free of Total 172. respective state printed on the o TSC Card 172. l t d d tax, as defin by state law, an as indicated below. reverse side of this form. Acct1-:3t$A*t*141215966 PRODUCT IS TO BE USkD IN THE FOLLOWING The undersigned party further certifies they Au I r te OZ6906 Re 0 26091330 P0 shoe STATE: understand they may be liable for payment of all taxes (RE G DIRED) due on the purchase price for the goods as allowed by Ci,anse 0.00 (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in C'"'[-1 Back, COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. PURCHASER IS ENGAGED IN: (REQUIRED) Buyer aCkf1Ut41'.:d'JL'1i the feceil't 01 d coliwL-- Resale Under penalty of perjury, signee swears th6cd h� information on this statement is true and correct in ror of thi5 51-- and the furchi5e o Tj 'Exempt or every material manner. A willfully false representation F Agricultural Production of exemption will cause the purchaser to be subject to the described Illerchuridise Shall 6e ill Dairy Production penalty and/or other provisions as allowed under state accordance with IN- Cardholdcr A5reeltient. Livestock Production Floriculture/Aquaculture Production law, Other: !3 isyla tur e ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery /Repair Parts 67�Government Agency (Entity F Livestock Iniestibles or Injectibles Exempt Organization (Entity Fertilizer/Agrichemicals NC: only DOT and US Government are exempt Consumed in Production (KS) Resale (Sales Tax Permit Call 800-960-0734 within 7 days to Ingredient or Component Parts (KS) coraplete 'A st(rvey and be el ter ed in a C] other: wonthly drawint3 for a chance to win a $2500 5haprins spree, (Awarded a5 Gift Czffd) No PURDiASE CUSTOMER SIGNATUORE:AEOUIRED) MGR. APPROVAL X USE SHADED AREA ONLY WHEN REGISTER IS INOPERATIVE. A 'M/C DISCOVER" TSC CHARGE ACCOUNT NO. CHG. -EXCH. DATE J" LJ ITEM NUMBER DESCRIPTION '102 A'4nurrb""1-11 4bl;J/WLI.J A J.1'J)1Ei je.1 1 0 S HT"FlP a-l- 6010216 SP' D ),NQSS3,'J3N VIAZIPIS S1 Form No. 99-00401 (12/05) CUSTOMER ORIGINAL r REMIT TSC BUSINESS ACCOUNT W T BAC PAYMENTS TO. TRACTOR SUPPLY COMPANY S� Ho P.O. Box 9020 Tractor �,tl'fIy 1'.ojde8.riv Des Moines, IA 50368 -9020 23'eS East Pleasant St, TSCTEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Noblesville. IN 46060 6035301 (317) 776 --IBH NAME CARME:L STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2001 CITY STATE ZIP PHONE 624 624000081 2 1100111 03/10/2009 10 ;56am CUSTOMER TO COMPLETE 4201797 TANK CLEANER PT 1.00 P 15.99 153? NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Govert?ntellt Agr.ncies The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal Subtota t 15.99 sales tax exemption law of the state property as indicated below and /or purchaser is 7.00Z Tax 0.00 indicated below and understands engaged in the business of agricultural production of total 15.99 and agrees with the General 'r SC Card 15.99 Exemption Statement at ht ri and food or fiber, horticulture, aquaculture of floriculture for P g resale and /or uses the farm machinery, equipment or Acct# t t t t t t t t t t r! 41303 the applicable statement of the other agricultural production items purchased free of Auth# 010622 Ref #:1009561725 respective state printed on the tax, as defined by state law, and as indicated below. Pe -shoe reverse side of this form. CFlange 0.00 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Cash Bac STATE: understand they may be liable for payment of all taxes (REQUIRED) due on the purchase price for the goods as allowed by PAO'er ac6.now'led5es the receipt of a com le (Exceptions: Georgia, New York Kentucky state law Should such goods be Used or consumed In I d COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. cagy of this sales 51i.e atld the Purchase o PURCHASER IS ENGAGED IN: (REQUIRED) f Resale Under penalty of perjury, signee swears the the described merchandi5e shall be in Government information on this statement is true and correct in accordance with the Cardholder Asreensent. 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 Signature; Livestock Production Floricullure /Aquaculture Production law' Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) #ttat2 111 #tt ##t #t #t #t Farm Machinery/Repair Parts Government Agency (Entity at; axx.taaat #tit #at #tt>.tttttttattttt Livestock Injestibles or Injectibles Exempt Organization (Entity# Call 000 968°07 within 7 days to Fertilizer /Agri6hemicals INC. only DOT and US Government are exempt C Otnp fete a Surve'Y and be en tered in a Consumed in Production (KS) Resale (Sales Tax Permit n;ullthl'r drawing far a dhanrce to win a $1500 slloi spree. Ingredient or Component Parts (KS) (Awarded as Gift Card) NO PURCHASE Other: OR SURVEY NECESSARY. Ends 9130109, x# at# aaaaxa #aaaxaatttttttttttttt# #tt R G AT RE:(REQUIR�D) MGR. APPROVAL 2 d� X 'SHADED AREA ONLY REGISTER IS INOPERATIVE. C H CHECK VISA MIC DISCOVER TSC CHARGE ACCOUNT NO. �GHG. EX H. DATE ITEMNUMBER DESCRIPTION,, UNIT PRICE 4 Form No. 99 00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT PAYMENTS T0: TRACTOR SUPPLY COMPANY burrLy Box 9020 i'r c for 5u =r l r (i3tANiiny Des Moines, IA 50368 -9020 1 0160 U .S. 31 Nor i h TSC TEAM MEMBER TO COMPLETE please include 16 Digit Account Number 'JetiV ie id, 01 460 {'4 6035 301 (317) 8673505 NAME CARM L STREET DEPT 3400 W 131ST S1' ADDRESS W[STFIE.LU IN 46074/3267 (317) 733 -2001 CITY STATE ZIP PHONE 431 4 310001 7? 2 91 486 03/1 012009 10 01 a RI CUSTOMER TO COMPLETE 4201797 AN11( CLEANER Lill' 11.00 4 15. !S.9 Ni CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: O'civernmen t Agencies The undersigned certifies The undersigned party certifies their exemption from 026E666 HITCH PIN 1/2X41N SP compliance with the agricultural payment of sales and use tax on tangible personal h 00 7 27, 92 NT sales tax exemption law of the state property as indicated below and /or purchaser is Govei Agencies indicated below and understands engaged in the business of agricultural production of and agrees with` the General S Dotal 4;1.91 nd Exemption Statement at right ood or fiber, horticulture, aquaculture of floriculture for p g resale and /or uses the farm machinery, equipment or .00% Tax 0.00 the applicable statement of the 'Total 43.91 respective state printed on the other agricultural production items purchased free of TSC Card 43.91 reverse side of this form. tax, as defined by state law, and as indicated below. PRODUCT ISTO BE USED IN THE FOLLOWING The undersigned party further certifies they Au the 010479 Ref e STATE: understand they may be liable for payment of all taxes PO :03102009 (REQUIRED) due on the purchase price for the goods as allowed by Cho n5e 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. PURCHASER IS ENGAGED IN: (REQUIRED) BUye, ackouw 'Nic 'c'Cril t of a caravle Resale Under penalty of perjury, signee swears the' Government information on this statement is true and correct in cupy of this sales slip and the e(.trchnse o Exempt organization every material manner. A willfully false representation Agricultural Production of exemption will cause the purchaser to be subject to the desc e ihed nerchaodi5e ;hall be in Dairy Production penalty and /or other provisions as allowed under state acr..ui datiL. wi ttl be CvT- dholder AgreealL•nt Livestock Production Floriculture /Acluaculture Production law' Other: signat4.lre ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) E] Farm Machinery/Repair Parts Government Agency (Entity Livestock Injestibles or Injectibles Exempt Organization (Entity Fertilizer /Agrichemicals NC: only DOT and US Government are exempt YdY;&$t; 883 :SYx833br;R6 ^.8t:8a$$$$ +$$8$kfit Consumed in Production (KS) Resale (Sales Tax Permit Gall 000- 963-07' 1 4 within 7 days in Ingredient or Component Parts (KS) ci1M fete a SurVCy antj be Entered in a n;onth.lY drawinl t 1w a chance to win :i Other: $2500 short -ins spree.. (Awarded a Gift Cart!) NO PURCHASE CUSTOMER SIGNATURE: (REQUIRED MGR, APPROVAL X USE SHA DE D AREA O NLY CASH CHECK VISA Mic DISCOVER. TSC CHARGE ACCOUNT NO. CHG EXCH. DATE DESCRIPTIO Form No. 99 00401 (12/05) CUSTOMER ORIGINAL REMITTSC BUSINESS ACCOUNT Np T 70B® PAYMENTS T0: TRACTOR SUPPLY COMPANY P.O. Box 9020 Tractor St{PPIY COri1paTiY Des Moines, IA 50368 -9020 18160 U's. 31 North TSC TEAM MEMBER TO COMPLETE please include 16 Digit Account Number Westt ield, IN 4.60 4 6035 301# (31 7) 867 -3505 NAME C'.t1RME L Sl REE'1" 3400 W 131ST ST ADDRESS WESTFIELD IN 4607`18267 (317) 135 -2001 CITY STATE ZIP PHONE 431 4MOOO /i'. 2 91395? 03112�2005` 10:12dn1 CUSTOMER. TO COMPLETE 3818363 WHEEL 7X1/4X5/8 11 ii 1.00 8.95' 3. V9 Nl' CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Gove.rnmen1 Asencie:5 The undersigned certifies The undersigned party certifies their exemption from 3616'63 WHELL 7X 1 fk5r0 11 tt compliance with the agricultural payment of sales and use tax on tangible personal 1, L 8.99 8.99 ;NT sales tax exemption law of the state property as indicated below and /or purchaser is Government Asencies indicated below and understands 3810363 WI"IFEL 7X'I /4X_;/8 11 ti engaged in the business of agricultural production of and agrees with the General 1 00 L 8 Y9 9 99 M food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and Guver A'jeitcie'a resale and /or uses the farm machinery, equipment or the applicable statement of the other agricultural production items purchased free of 3805653 5 U WHEEL 1 403/32X7/ respective state printed on the 1 00 C 6.9, 6.99 NT reverse side of this form. tax, as defined by state law, and as indicated below. GGvernlc nt Asenc:iea PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they 3805653 SOW UP EL J A1X3/3?X7/ understand th m be liable for p ayment of all taxes 1 .00 A5 en 6.99 iI1 h STATE: Y Y p Y Government ARCncie:, (REQUIRED) due on the purchase price for the goods as allowed by 38056:i3 SAW "t1ELI_ 14X3f32}f 7 (Exceptions: Georgia, New York Kentucky State law should such goods be used or Consumed In Dr COMPLETE REVERSE SIDE) 1 00 P 6 6 9 N r a taxable manner as defined by state laws. Ar.cu nra_�nt Go +�Pr, PURCHASER IS ENGAGED IN: (REQUIRED) 381 1 175 M D F t C hi AB F Resale Under penalty of perjury, signee swears the Government information on this statement is true and correct in 1 00 2 9 99 9 NT Exempt organization every material manner. A willfully false representation bdvernmert F13encies Agricultural Production of exemption will cause the purchaser to be subject to Dairy Production penalty and /or other provisions as allowed under state 5ubi utal 57' '3 Livestock Production 7. 00% Tax 0.00 Floriculture /Aquaculture Production law' T„tal 57.93 Other. ors OOC'ti TSC Card 57.(13 .,'d Ar.ct':sss$xss sa:su612U ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) L L (itt t; 1 O 1 2184 fit fi :1209120535 JP "#UITUP,JDL) F`VLr un:) not E] S F s s 8 s 3 s s ^nt s s a s �Parts G Agency (Entity PO 1:03112009 Livestock In estiblestor In edibles Exem _f Or anization (Entity Lh R`..i e 0 .00 Ink I UO I NC= only DOT and US Government are exempt Dish R c k F1 Fertilizei /Agrichemicals`I r 7 I 1-'•V rinD hrd n�sioao�t3; 0 Resale (Sales Tax Permit# Consumed inProduction(KS) I L DL4Yer ttcltnouiledse5 the recexrt of a coniple 41 tZLL-C1p -,.13 li 8 IngredienAor :.'Component arts,.(KSW+•nj In.' t "1 !_ary of t:7i:, sales slir ctnd the Ntlrchase O ❑�OlYie;::yz$� °.':5338& l2Rk3C`;°45d8$$,(•SG F 3i .','t�� ni ;i <i•i Z1 K�lt. 1.3 R:i Jb ;c,�� tan to atIloi 3�H1rr7'.STd..`'1C 10.1X? I the described merchandise. shsll be in CUSTOMER SIG E:' E LIR ,zt.t5?O MMG APPROVAL dCCOV "uta! §C2 �iL'? t (1ST Cat'ri,i]1ca+F (�SPcrftetlt. iXN w X USE SHADED AREA O NLY a• CASH'- 'CHECK v VISA M/C DISOOVER TSC CHARGE ACCOUNT N0. CHG, EXCH. DATE ITEM NUMBER O Ofi� �,O�f` t O t "I�rt Et�a�.� maw D ESCRIPTION e_ UT pa,1a) ua aq P(1 R xaAal)S a ;alaluo.D u� vP 4 KS &88A$4R$2335 ?.Fi:i3dT?8T33 t$& a$ R$;rlSi�aKA$$E8A$$8YA3E8Zi$$bIIF Form No. 99-00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT TRA�C�OR® PAYMENTS TO: TRACTOR SUPPLY COMPANY SUPPLY CO P.O. Box 9020 Des Moines, IA 50368 -9020 rractor Sm r ly Ccrlra;lr TSC TEAM MEMBER TO COMPLETE Please include 16 Dig Account.-Number— 18160 U.S. '1 North 9 WeStf ield.'1N '4G074 6035 301# (317) 867 -350' NAME CARt:1CL STREET DEPT ADDRESS 'S W 131 ST ST WESTFIELD IN 46074626? (317) 733-2001 CITY STATE ZIP PHONE ;�1 431CUU1r5 2 91525b 03/17/2009 01:49rr1 CUSTOMER TO COMPLETE 1 091050 TBk BET XUM FS 0U;,L CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: oo 279 279.99 NT The undersigned certifies Guvermienf A5evcie5 g The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal Subtol.J. 779,99 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 Tutol 279,9; and agrees with the General food or fiber, horticulture, aquaculture of floriculture for 'V C Cat d 279.99 Exemption Statement at right and resale and /or uses the farm machinery, equipment or Acc i sb s> t> ttsst4837 the applicable statement of the other agricultural production items purchased free of Authl 0i 7616 Ref e 171249395'0 respective state printed on the tax, as defined by state law, and as indicated below. PO t:TRUCK 10 reverse side of this form. Change 0.00 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they C:a5i, 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 knowled_:i•:, the recei.r r of a conlple (Exceptions: Georgia, New York Kentucky state law should such goods be used or Consumed •Inc COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. cony Df this ,,lip and 1 0e rurch;i�F: 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 ar.co<<,.tncr_ wir`h t(;F Cardholder Aareeraent. 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 Si ma ture: Livestock Production Floriculture /Aquaculture Production law' Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) E] Farm 9 4d33329144232 1983d888 #t2at33t b. Yd8 Farm Machinery/Repair Parts Government Agency (Entity ntc•; g %o;s8t8i38 %88<388E3. %8 %58% %Y Livestock lniestiblesorinjectibles Exempt Organization (Entity Call 500 witiu.n f das!5 to Fertilizer /Ag rich emicals NC: only DOT and US Government are exempt core lrte a sur. aoci be Lniere -d in a Consumed in Production (KS) Resale (Sales Tax Permit# moa2iilr drawins fur a ChaoLQ TO ?•tin a »2500 511OPP1n5 SPrE`o, Ingredient or Component Parts (KS) (Awarded aj Gift Card) NO PURCHASE Other: OR SURVEY NECESSARY, Ends 9130109. s%% Yaca% .ysn2 %3>zs +,s%a�tg %sattt4::t %st CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL USE SHADED AREA ONLY WHEN REGISTER IS INOPERATIVE. .CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE ITEM NUMBER DESCRIPTIO Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT TRACTOR® PAYMENTS TO: IF TRACTOR SUPPLY COMPANY Su"LYC2 P.O. Box 9020 Tv'Actor SUPPLY ConwanY Des Moines, IA 50368 -9020 18160 U.S. 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westf ield, 46074 6035 301 (317) 867 3505 NA S;ilktiCL ST1'HT DCf'T 3400 W 131ST Si ADDRESS WLSrfIEL IN 46071°267 (317) 733 -2001 CITY STATE ZIP PHONE 431 451000072 2 915538 03/18/2009 03 :19rm CUSTOMER TO COMPLETE M237e2 s1'r; Y TIP 15DEG V 3 1.00 (_i 7.25' 7.29 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Gov:•I r I„ent Rjencies The undersigned certifies The undersigned party certifies their exemption from 3907168 T ISCONNECI' 1910 WAND compliance with the agricultural payment of sales and use tax on tangible personal 1.00 C 23 23.94 NT sales tax exemption law of the state property as indicated below and /or purchaser is Goverct.ten t i;uencie indicated below and understands 13239121 SPRAY GU.1 NCTRIC W A engaged in the business of agricultural production of and agrees with the General 1.00 e 39.99 39•, NT food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or A: =cncic, the applicable statement of the other agricultural production items purchased free of respective state printed on the tax, as defined by state law, and as indicated below. Subt 01` 11 71.27 reverse side of this form. 7.00% Ta:. 0.00 The under art further certifies the Total 71.27 PRODUCT IS TO BE USED IN THE FOLLOWING 9 party y STATE: understand they may be liable for payment of all taxes T „l; Gd r d Y 1 '27 (REQUIRED) due on the purchase price for the goods as allowed by AC L t s s i 2 `$586,1 (Exceptions: Georgia, New York a Kentucky state law should such goods be used or consumed in Au it1 :018815 RL' f 0 101410566 4 COMPLETE REVERSE SIDE) P0 4: L,h� a taxable manner as defined by state laws. C; 1,,111 �e 0'( PURCHASER IS ENGAGED IN: (REQUIRED) Cash Bitc ii Resale Under penalty of perjury, signee swears the Government information on this statement is true and correct in Exempt organization every material manner. Awillfully false representation ti,,_ receipt of a conIPle -Agricultural Production of exemption will cause the purchaser to be subject ee- Dairy Production penalty and /or other provisions as allowed under state cop3' ihis .;ales Iiv ,Id Ni ['Ut Lh: �L• 0 Livestock Production f Floriculture /A uaculture Production law. Hie &.:,rr;bed n;erchandl, shall bo in Other: o.::c 3rdtnce lAth `he Car holdr.r A,rezaient, ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity i Livestock Injestibles or Injectibles Exempt Organization (Entity E) Fertilizer /Ag rich emicals NC: only DOT and US Government are exempt Consumed in Production (KS) Resale (Sales Tax Permit Ingredient or Component Parts (KS) 4$ tY8SE4c8 :iS33t$II$4;'83$Y3822$FyEEsB other: Call 800-96C -0731 within 7 airs `ro LUniPlet:: a ju,•veY <<nd bL e,ltered in t CUSTOMER�SIGNA�TUURRE:(REp RED) MGR. APPROVAL USE SHADED AREA ONLY CASH CHECK 1 VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE L) r: .7 c: ITEM NUMBER DESCRIPTION UNIT PRICE r G a o. u r ao- .a •t rt: ac M u= U1 .«gin ..K cn w n rb��'�vcT�oa G C w7 "=c rrt t•J r- w w ti m as N r. 4. rU a n r_' r-. w m f1 r rD w n J as a. ry •A to G v m Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL ��r1 REMIT TSC BUSINESS ACCOUNT TEW iOR TRACTOR SUPPLY COMPANY S�J g,YCo P.O. Box 9020 Tr actor Saprl.y Conwarir Des Moines, IA 50368 -9020 18160 U S, 3 1 Nul' th TSC TEAM MEMBER TO COMPLETE 41 cat i`ld: IN 4607.1 Please include 16 Digit Account Number 6035 301# (31 7) 867 NAME CARREL S1 REE'T DEPT 3400 w 131ST Sf �fESTFIELD N 460748267 ADDRESS (31 733 2001 CITY STATE ZIP PHONE 431 431 00011 r 2 915445 03/18/2'00c" 10: 51 aoi CUSTOMER TO COMPLETE 1 tO T43-1 TBx 5011) ALUM, r GI_IL I Qt7 LS 229, 99 229.99 N1' CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government: Asencies The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal St t0tRI 229,9Y sales tax exemption law of the state property as indicated below and/or purchaser is 7.00W, 'lax 0.00 indicated below and understands engaged in the business of agricultural production of To to I 229' yg food or fiber, horticulture, aquaculture of floriculture for and agrees with the General TSL Card 7.99 Exemption Statement at right and (�cr..t'$� #ss4837 resale and /or uses the farm machinery, equipment or the applicable statement of the Atztlz0 0181 T7 Ref- 1:1849504955 respective state printed on the other agricultural production items purchased free of 1`8 $;trur_ktt reverse side of this form. tax, as defined by state law, and as Indicated below. Charse 0,0;1 PRODUCT ISTO BE USED IN THE FOLLOWING The undersigned party further certifies they ca: th 1'Ick STATE: understand they may be liable for payment of all taxes Buyer acknowled the receipt of a c0n�1r ll.e (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 Ine g Y ❑f ((I 15 51 Sa COMPLETE REVERSE SIDE) .1 P and the Fail 1_t1s15e O a taxable manner as defined by state laws. i PURCHASER IS ENGAGED IN:(REQUIRED) the d nIe'i' C h1a11cli SP �l kst.)I 't .i,it E] Resale Under penalty of perjury, signee swears the the des nce with tie C:�r -3 ha l A -r ent. 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 IoW' Floriculture /Aquaculture Production Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery /Repair Parts Government Agency (Entity Livestock Injestibles or Injestibles Exempt Organization (Entity Cal: 800- 960 0734 wi fian 7 days to IN only DOT and US Government are exempt coniPlete a 5"rvey and be eti tered lit a F] Fertilizer /Ag riche micals nlr7nth:Y d, at +ins far a chance t0 win s: Consumed in Production (KS) L] Resale (Sales Tax Permit# $2500 5hoPrins 5Free, Ingredient or Component Parts (KS) Awarded as Gif Card) NO PURCHASE DR SURVEY NECESSARY, Ends 9130109, Other: CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL X X USE AREA ONLY CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT N0. CHG. EXCH. DATE ITEM NUMBER DESCRIPTION UNIT PRICE r Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL VO 'N WARR NO. Tractor Supply ALLOWED 20 IN SUM OF P. O. Box 9020 Des Moines, IA 50368 -9020 $871.5 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 2201 -670.9 $509.98 1 hereby certify that the attached invoice(s), or 2201 42- 370.00 $361.58 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Q trid7Y, 27, 2009 Street Commissioner t ::f Strc. ,,o rTtie 8r Cost distribution ledger classification if claim paid motor 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 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)) 03/25/09 $509.98 03/25/09 $361.58 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