168719 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
i CHECK AMOUNT: $268.77
CARMEL, INDIANA 46032 Po aox 669020
DES MOINES IA 50368 -9020 CHECK NUMBER: 168719
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 0622 268.77 6035301202510622
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page 1 of 2 T
"HU MIR
SUPPLY CO2
BUSINESS ACCOUNT
�iss
Previous Balance 68.27 Closing Date 01/20/09
Payments 68.27 Next Closing Date 02/18/09 CARMEL UTILITIES
Credits 0.00 Payment Due Date 02/14/09 TREASURER OFFC
Purchases 268.77 760 3RD AVE SW
Debits 0.00 Current Due 268.77 CARMEL, IN 46032 -2072
FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 10,000
Late Fees 0.00 Minimum Payment Due 268.77 Credit Available 9,731
New Balance 268.77
CURRENT ACTIVITY
Datei f�escn tlor>! IMF w xy.
JAN 15 GOODS AND SERVICES WESTFIELD IN 268.77
TOTAL 6035301202515571 $268.77
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
DEC 20 PAYMENT REF P919400PL09EY0467 68.27
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 Bill PERCENTAGE Subject to Periodic &Ihrg PERCENTAGE
Finance Charge Rate Period RATE Finance Charge Rate Period RATE
REGULAR REVOLVE CREDIT PLAN 0.00 .00000 33 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
Notify Us in Case of Errors or Questions About Your Bill Copy Fee: On any matter unrelated to a billing error or disputed purchase,
we charge a $5.00 fee for each duplicate statement for a billing period that
If you think your billing statement is wrong, or if you need more information is more than 3 months prior to your request. We add this fee to your regular
about a transaction on your billing statement, write to us (on a separate revolve credit plan balance.
sheet) as soon as possible at the billing error address on the front of your
statement. We must hear from you in writing no later than 60 days after we Payment Options Other Than Regular Mail:
sent you the first statement on which the error or problem appeared. In your
letter, give us the following information: o Pay by Phone. You may make your payment by phone by using the Pay by
Phone Service. You will be charged $14.95 to use this payment service.
Your name and account number. Call by 5 p.m. Eastern time to have your payment credited as of that day.
The dollar amount of the suspected error. If you call after that time, your payment will be credited as of the next day.
Describe the error and explain, if you can, why you believe there is an We may process your payment electronically upon verification of your
error. If you need more information, describe the item you are unsure identity.
about. o 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
I
Remit To: Bill To: Page 2 of 2 794 TRACTOR TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301202510622 WSUMYCO2
DEPT'30- 1202510622 JOSEPH FAUCETT
PO BOX 689020 1 CIVIC SO BUSINESS ACCOUNT
DES MOINES IA 50368 -9020
Payment Due Date: 02/14/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE:
431000902478010
Purchase Order:
JOE278
AMOUNT DUE: 268.77
Store: 574000431 INVOICE DATE: 01/15/09
BIB 42X30 INS EX BK CT6 7021227 1.00 83.65 83.65
JKT INS DCK XL BK BNCES 7793531 1.00 27.99 27.99
JKT INS EX HO LT BK CT6 7037341 1.00 69.65 69.65
BIB ART INS LS BK BNCES 7037244 1.00 48.99 48.99
JKT INS HD XT BR BNCES6 7793214 1.00 38.49 38.49
SUBTOTAL 268.77
TAX 0.00
SHIPPING 0.00
TOTAL 268.77
Please Direct Inquiries to: Phone: 800 559 -8232 Fax: 801- 779 -7425
I
REMIT TSC BUSINESS ACCOUNT
i r slum%YCO M PAYMENTS TO:
TRACTOR SUPPLY COMPANY
P.O. Box 9020 Tractor Supply ComranY
Des Moines, IA 50368 -9020 1 B 160 U.S. 31 North
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number vjeskf ield. IN '16V4
6035 301 (317) 667 3505
NAME CARMEL UTILITIES
I civic Jo
ADDRESS
C'�RMCL IN 450322584
(31r) 571 -2428
CITY STATE ZIP PHONE 13 1 43 2 902478
01/15/2009 10:18am
CUSTOMER TO COMPLETE 7021227 Ble 42X30 INS EX V pe
1.00 83.65 83.65 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Res. P rice: 119.50
The undersigned certifies The undersigned party certifies their exemption from n GovernmQnt Asencies
compliance with the agricultural- payment of sales and use tax on tangible personal 77,3531 JKT INS DCK XI_ BK EN
sales tax exemption law of the state property as indicated below and /or purchaser is t .00 Id 2.7, 99 27. V9 NTI O
indicated below and understands engaged in the business of agricultural production of Res. Price: 39.99
and agrees with the General Government Asencies
food or fiber, horticulture, aquaculture of floriculture for ir.
Exemption Statement at right and 7037341 JKT 'INS EX HD LT BK
resale and /or uses the farm machinery, equipment or
the applicable statement of the 1.00 69.65 69, 65 NT,
respective state printed on the other agricultural production items purchased free of Res. Price: 99.50
reverse side of this form. tax, as defined by state law, and as indicated below. Gover Asencies
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they 7037247 BIB riRT 1NS LS BK BN
understand the may be liable for payment of all taxes I 48. d 48.99 N r
STATE: y y p y Re Res, P rice: 69.99
(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 GOver ni tent Asenc
COMPLETE REVERSE SIDE) 779321 4 JKT I i1D XT BF' BNC
a taxable manner as defined by state laws.
PURCHASER IS ENGAGED IN: (REQUIRED) 1 OO 38. 58 49 NT
Resale Under penalty of perjury, signee swears the Res, Pi".ce: 54,99
Government information on this statement is true and correct in Government Asencies
Exempt organization every material manner. A willfully false representation
Agricultural Production of exemption will cause the purchaser to be subject to "tutotal 868, r'7
Dairy Production penalty and /or other provisions as allowed under state 7.00: Tax 0.00
Livestock Production Total 7.68.'17
E] law Floriculture /Acluaculture Production TSC Ca1'd 268.77
Other: Accts:t324t2tt2tt.t5571
Autht:015728 R00;150918331
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) PO 41 j oC 278
Farm Machinery/Repair Parts Government Agency (Entity Cha nse 0,00
Livestock Injestibles or Injectibles Exempt Organization (Entity Ca Bac
NC: only DOT and US Government are exempt
Fertilizer /Agrichemicals Buvt_r acknDwled9L tit:: rr'ceir't of a CantPle
Consumed in Production (KS) Resale (Sales Tax Permit
Ingredient or Component Paris (KS) LOPY of this gales slit= and the PUrchatie o
f
Other: the described tnerchcAiid,_se shall lie ill
accordance with the Cardholder Asreemert,
CUS MER G TU E:(REQUIRED MGR. APPROVAL
w 7 X
USE SHADED AREA ONLY WHEN REGISTER IS INOPERATIVE.
C SH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE
UNIT PRICE
ITEM NUMBER DESCRIPTIO
Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL
prescribed by State Board of Accounts City Form No. 201 (Kev 199b)
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.
Terms
PO BOX 689020 Due Date 1/29/2009
DES MOINES, IA 50368
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/2912009 4310009024; $268.77
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date iff i
TOUCHER 087204 WARRANT ALLOWED
;06840 IN SUM OF
RACTOR SUPPLY CO
'O BOX 689020
)ES MOINES, IA 50368
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
'O INV ACCT AMOUNT Audit Trail Code
43100090247 01- 7202 -06 $268.77
C AI
Voucher Total $268.77
'ost distribution ledger classification if
;lairn paid under vehicle highway fund