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174523 07/08/2009 =R� CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CHECK AMOUNT: $39.27 CARMEL, INDIANA 46032 PO BOX 689020 v y.roN �o DES MOINES IA 50368.9020 CHECK NUMBER: 174523 CHECK DATE: 7/812009 DEPARTMENT ACCOUNT PO NUMBE I NVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 00050860 /3`9.27 6035301200050860 t page 1 of 3 Tx 7 Di130� ®Su"LYC© I BUSINESS ACCOUNT kd� $Ui�IIMAF#Y 535 3a�2 4 Q5 d$6Q Previous Balance 2,351.98 Closing Date 06/18/09 Payments 2,419.58 Next Closing Date 07/21/09 CARMEL STREET DEPT Credits 0.00 Payment Due Date 07/13/09 CINDY Purchases 39.27 3400 W 131ST ST Debits 0.00 Current Due 0.00 WESTFIELD, IN 46074.8267 FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 5,250 Late Fees 0.00 Minimum Payment Due 0.00 Credit Available 5,250 New Balance 28.33 CURRENT ACTIVITY Tret�at tun LoaaiioM e -Arn' Li Mme, I�escrtptlon _r�� JUN 2 GOODS AND SERVICES WESTFIELD IN 27.48 JUN 8 GOODS AND SERVICES WESTFIELD IN 8.37 TOTAL 6035301200074863 $35.85 JUN 2 GOODS AND SERVICES NOBLESVILLE IN 3.42 TOTAL 6035301202896120 $3.42 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS MAY 21 PAYMENT REF P9194004DO9K9RH37 573.74 JUN 18 PAYMENT REF P9194005909RL6969 465.23 JUN 18 PAYMENT REF P9194005909RL6969 516.88 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 biking 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 acid 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 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 marl 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 page 2 of 3 Tx 7 D11300 i ®SU P'PZ.Y�CO2 BUSINESS ACCOUNT CURRENT ACTIVITY Tr�t►sactfon� �LOCa#iaN pia #e Ez op, OR Fh JUN 18 PAYMENT REF P9194005909RL6969 863.73- This account is subject to the Alternate Balance Subject to Finance Charge Calculation Method. See back for details. Blue Books are now available in stores. Be sure to stop by to pickup your free copy packed with product information, planning guides, comparison charts and more. It's even easier to get what you need at Tractor Supply! Now order any item available for sale online and have it shipped to your nearest store for free! Buy in bulk and save! Check out our volume pricing on fencing, feeds, clothing and __ma_ available on purchases as .small as five stems.- See a team member for details. 812 Remit To: Bill To: Page 3 of 3 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 ®S DEPT.30 1200050860 JEFF STEWART PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 Payment Due Date: 07/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TO: INVOICE: 431000930924010 431000936792010 Purchase Order: Purchase Order: SHOP SHOP AMOUNT DUE: 132.96 AMOUNT DUE: 27.48 Store: 574000431 INVOICE DATE: 05/13 /09 Store: 574000431 INVOICE DATE: 06/02 /09 RATCHET 2X27 2PK 3010575 2.00 24.99 49.98 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 002HTS TOWING MAGNETIC 1069332 1.00 52.99 52.99 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 FLOOR JACK 2T 0116479 1.00 29.99 29.99 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 SUBTOTAL 132.96 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 TAX 0.00 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 SHIPPING 0.00 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 TOTAL 132.96 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 2.29 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 _2.29 LOCKPIN SW 1/4 X 2 1/2 1833553 1.00 2.29 SUBTOTAL 27.48 TAX 0.00 SHIPPING 0.00 TOTAL 27.48 SHIP TO: INVOICE: SHIP TO: INVOICE: 431000938446010 624001143042010 Purchase Order: Purchase Order: SHOP 60209 AMOUNT DUE: 8.37 AMOUNT DUE: 3.42 Store: 574000431 INVOICE DATE: 06/08 /09 Store: 574000624 INVOICE DATE: 06/02 /09 CAT PIN 7/8X1 -5 /8IN 1 D 0268420 1.00 2.79 2.79 G2 BULK SELLING SKU 3599993 2.15 1.59 3.42 CAT PIN 7/8X1 -5 /8IN 1 D 0268420 1.00 2.79 2.79 CAT PIN 7/8 -5/81N 1 D 0268420 1.00 2.79 2.79 SUBTOTAL 3.42 TAX 0.00 SUBTOTAL 8.37 SHIPPING 0..00 TAX 0.00 SHIPPING 0.00 TOTAL 3.42 TOTAL 8.37 Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801 779 -7425 -r —T^ 1"{tlVll l 1 �l.r ®V.711�AC.7.� i4\.r4VVltl 1 PAYMENTS TO: T TRACTOR SUPPLY COMPANY i SUFnYCQ P.O. Sox 9020 Tractor Supply Lomeany Des Moines, IA 50368 -9020 18160 U.S. 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westf ield.'IN 46074 6035 301# (317) 867 -3505 NAME CARMEL STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2001 CITY STATE ZIP PHONE 431 431000072 2 938446 06/08/2009 11:22am CUSTOMER TO COMPLETE 0268420 CAT PIN 7/8x1 -5 /8IN 1100 2.79 2,79 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT Government Agencies The undersigned certifies The undersigned party certifies their exemption from 0268420 CAT PIN 7/8X1 -5 /8TN compliance with the agricultural payment of sales and use tax on tangible personal 1.00 2.79 2,79 NT sales tax exemption law of the state property as indicated below and /or purchaser is Government Agencies indicated below and understands engaged in the business of agricultural production of 0268420 CAT Pled 7/8x1 -5/8IN and agrees with the General 1 .00 L 2, 79 2, 79 NT Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for resale and /or uses the farm machinery, equipment or Government Agencies the applicable statement of the respective state printed on the other agricultural production items purchased free of 5ubtatal 8.37 reverse side of this form. tax, as defined by state law, and as indicated below. 7.00: Tax 0.00 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Total 8.37 understand the may be liable for p ayment o all I SC Card 8.37 STATE: y y t f ll t p y CCtY' (REQUIRED) due on the purchase price for the goods as allowed by A AC c 1I :EEE #i #YYYYE34B03 (Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed In Att 0086Se T:ef e 0810Z2Z347 S Shop COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. PO 0,04 PURCHASER IS ENGAGED IN: (REQUIRED) Chance Cash Back 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 representatiopp Buyer ac knowledses the receip of a comp le Agricultural Production of exemption will cause the purchaser to be subject th Dairy Production penalty and /or other provisions as allowed under state copy of this sales slip and the Purchase c Livestock Production Flo riculture/Aq uaculture Production law• the described merchandise shall be in Other accordance with the Cardholder Asreement. ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity# 5isnature: 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 Ingredient or Component Parts (KS) t# ###iii #iii### ##i#iiEiii3 #Y#iE #Efii 3Y2 ##Y## #EiY2E#EEE##i #i #E#tE #i# /iii• (71 Other: Call 800 -968 -0734 within 7 days to complete a survey and be entered in a C T E SI _ATURE: (REQUIRED) MGR. AP L X 7 r S CHECK VISA M/C DISCOVER T CHARGE ACCOUNT N0. K K 9 CHG. K -�XCH. M 7Y D)*E ITEM NUMBER 0 O K Q] u1 K N O a y w EA w "7 K K '7 1f M K K rt K mt Ln O V rJ7 K K ra rri tR W Ct K K O rs n rD CI? O n O r9 n3 --C w t+. u4 «n R r r- K C n w v cs�» oro.... b d -a w r x. rC_ O n as 3 W K 0. C7 0 0 R lD N rt n .mac w n rn rD n o o K» y y K O rf? K K K K N K y Form No. 99. 00401(12/05) CUSTOMER ORIGINAL REWTTSC BUSioVL.,,-, i WSW PAYMENTS ONLY TO: V T TRACTOR SUPPLY COMPANY SV"LYCo P.O. Box 689020 Tractor Supply Company Des Moines, IA 50368 2375 East Pleasant St. TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Noblesville IN 46060 (317) 776 -1883 6035 301 NAME CARMEL STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2001 CITY STATE ZIP PHONE 624 624000051 1 1143042 06/02/2009 10:27am CUSTOMER TO COMPLETE 3599993 62 BULK SELLING SKU 2.15 8 1.59 3.42 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal Subtotal 3.42 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 3.42 and agrees with the General food or fiber, horticulture, aquaculture of floriculture for TSC Card 3.42 Exemption Statement at right and resale and /or uses the farm machinery, equipment or Accta: JJJJJJiiiiii6120 the applicable statement of the other agricultural production items purchased free of Autho:002471 Ref +:0209270520 respective state printed on the g p P PO s :060209 reverse side of this form. tax, as defined by state law, and as Indicated below. Chanse 0.00 Th further certifies they Cash Back The undersigned art PRODUCT IS TO BE USED IN THE FOLLOWING party STATE: understand they may be liable for payment of all taxes Buyer acknowledses the receipt of a c00 (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. copy Of this sales slip and the Purchase O f PURCHASER IS ENGAGED IN: (REQUIRED) the described merchandise 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 Agreement. Exempt organization every material manner. A willfully false representation Agricultural Production of exemption will cause the purchaser to be subject to Dairy Production penalty and /or other provisions as allowed under state Sisnature: Livestock Production law. Floriculture /Acluaculture Production Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) JJJJiiiiJJJJJiJJJJJiJiiiifiitiifSitii Farm Machinery/Repair Parts Government Agency (Entity JJJJJiiJJJfiiJiiJiJJJiiitiiiiiJJitiJi Livestock Injestibles or Injectibles Exempt Organization (Entity Call 800-968 -0734 within 7 days to E] Fertilizer /Agrichemicals NC: only DOT and US Government are exempt complete a survey and be entered in a monthly drawins for a chance to win a Consumed in Production (KS) Resale (Sales Tax Permit 2500 shopping spree. Ingredient or Component P 6 (KS) (Awarded as Gift Card) NO PURCHASE OR SURVEY NECESSARY. Ends 9130109. F1 Other: CUSTU R SIG E4 (R UIRED) MGR. APPROVAL X INOPERATIVE. USE SHADED AREA ONLYWHEN REGISTER IS CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE L) La L3 ITEM NUMBER DESCRIPTION J Form No. 99 -00401 (12108) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT TRACTOR SUPPLY COMPANY Vau "LY levy co P.O. Box'9020 Tractor Supply Company Des Moines, IA 50368 -9020 18160 U.S. 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit-Account Number Westf ield, IN 46074 6035 301 317) 867-3505 NAME CARMEL STREET DEPT 3400 W 131ST ST ADDRESS WESTFIELD IN 460748267 (317) 733 -2001 CITY STATE ZIP PHONE 431 786000104 2 936792 06/02/2009 02:29pm CUSTOMER TO COMPLETE 1833553 LOCKPIN SW 1/4 X 2 1 1.00 2.29 2.29 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT Government Asencies The undersigned certifies The undersigned party certifies their exemption from 1833553 LOCKPIN SW 1/4 X 2 1 compliance with the agricultural payment of sales and use tax on tangible personal 1.00 2.29 2.29 NT sales tax exemption law of the state property as indicated below and /or purchaser is Government Asencies indicated below and understands engaged in the business of agricultural production of 1833553 LOCKPIN SW 1/4 X 2 1 and agrees with the General 1 .00 2.29 2.29 N'T food or fiber, horticulture, aquaculture of floriculture for Exemption Statement at right and resale and /or uses the farm machinery, equipment or Government Asencies the applicable statement of the 1833553 LOCKPIN SW 1/4 X 2 1 e other agricultural production items purchased free of respective a {d n q„jWa fdA, as defined by state law, and as indicated below. 1 .00 2.29 2.29 NT reverse sidg rl10fifHD- AIdanSdO 31? J1 Government Asencies 1p 9 an UU5 11��pp ue Ti ft under art further certifies the 1833553 LOCKPIN SW 1/4 X 2 1 PRODUCT IS TO BE 1�EO IFfTHEFOCLOw11SG n g party y 11 00 2.29 2.29 NT STAT a a a a t a a a a a s a s a a a a a a a a a a a a: UFtEfa? 8ft*'id they may be liable for payment of all taxes Government Asencies a t ft t a a a a a a a a x 1 dtiMm tbg purchase price for the goods as allowed by 1833553 LOCKPIN SW 1 /4 X 2 1 Exceptictgl $eo?§I�&dWgorld&@IMj &b) 110 1 ���ft should such goods be used or consumed in COMPLETE REVERSE ddnsi 3eq a taxable manner as defined by state laws. 1 .00 2.2 2. 29 NT Government Asencies PURCHASER I"N0GE1§g4:II3'fi Uft(JI T InO 1833553 vernmen SW 1/4 X 2 1 F1 Fles512uatutuoo aDTAd@S aamo ;s Wn penalty of perjury, signee swears the 1.00 2.29 2.29 NT ❑c tci�veaur t: a:: a a a a a: "ormt*am on this statement is true and correct in en Governmt Asencies ❑a KE9�D3QfPa�+3atiP ®a a t a t a t i t a t i every material manner. A willfully false representation 1833553 Government n SW 1/4 X 2 1 E] D Dairy airyaltura l{r d t 8smd>r� mo /moo �I aan &Rb Mtption will cause the purchaser to be subject to 1.00 2.29 1.29 NT �or�ITe;ap a;alAwO. p &hAlty and /or other provisions as allowed under state F1 Livestock Production law. Government Asencies Floriculture /A?t$cdltLre %Lttiolb 1833553 LOCKPIN SW 1/4 X 21 Other: 1.00 2.29 2.29 NT Government Asencies ITEM X 6 0 1 E16 s1La a NIUSS 1833553 LOCKPIN SW 1/4 X 2 1 '60/ £/b s `JySS O3N Jl y S X10 1:1 F QW3 r 'UP! P (V 09s t q se p� @'f�fr ment Agency (Entity 1.00 2.29 2.29 NT Livestock I0&0iIJW§oFWJeetR W OOSZ® Exempt Organization(Entity# Government Asencies ''FJh1lI1ePAgrlJ`cR •'il43lse .to} (;UXMP 1p A14PU®Ny DOT and US Government are exempt 1833553 LOCKPIN SW 1/4 X 2 1 1.00 2.29 2.29 NT P uT paa ua a pue �anans E aWsff(� alesTaxPermit# El eg�suglRV LroEil0Pi f -896 -008 TTp3 Government Asencies altaQrlrtliEmtadrioeriitF'1�ta tlf9) a x a a a a t a a x 1833553 LOCKPIN SW 1 /4 X 2 1 1.00 2.29 2.29 NT aa,> aaaaaaaaaaaaaa aaaaaaaaaaasaaaaa Government Asencies Subtotal 27.48 C ST ER S NATURE:(REQUIRED) MGR. APPROVAL 7.00% Tax 0 p .aan;eus X USE SHA DED AREA ONLY S CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT NO. CHG EXCH. DATE Uh3Q JGV as 104 aeO ay; 4{ lm aout? aO3 a aq I e s a ipuujam QTdosu ay; T LJ QUANTITY ITEM NUMBER DESCRIPTION UNIT PRICE 0 a; a 00 asue43 J04s :0 Od LS9S8.£1ZO:sfay 8 LZ to £08r:sataaasataa ::�tooy ae 86' LZ i'etOl Form No. 99 -00401 (12/05) CUSTOMER ORIGINAL Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 06/29/09 $39.27 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 20 Clerk- Treasurer VOU N WARRANT NO. ALLOWED 20 Tractor Supply IN SUM OF P. O. Box 9020 Des Moines, IA 50368 -9020 $39.27 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 42- 370.00 $39.27 1 hereby certify that the attached invoice(s), or 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 I f` p �Wedne9day, J lyl61, 2009 Street Commissi�o ff V LI VrrrL N'l 111 ll4, ty: IF +,I Title Cost distribution ledger classification if claim paid motor vehicle highway fund