174525 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
0 ONE CIVIC SQUARE TRACTOR SUPPLY CO
CARMEL, INDIANA 46032 PO BOX 689020 CHECK AMOUNT: $94.97
DES MOINES IA 50368 -9020 CHECK NUMBER: 174525
CHECK DATE: 7/8/2009
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 603530120018 39.98 5035301200182572
601 5023990 603530120018 54.99 6035301200182572
page 1 of 3 Tx 7 D 13oo 11ii���11/�VV�/ \�1� o
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BUSINESS ACCOUNT
WOO is nG o�41 rG
z
Previous Balance 138.99 Closing Date 06/18/09
Payments 138.99 Next Closing Date 07/21/09 CARMEL UTILITIES
Credits 0.00 Payment Due Date 07/13/09 ACCOUNTS PAYABLE
Purchases 94.97 3450 W 131STST
Debits 0.00 Current Due 94.97 WESTFIELD, IN 46074 -6267
FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 5,000
Later Fees 0.00 Minimum Payment Due 94.97 Credit Available 4,905
New Balance 94.97
CURRENT ACTIVITY
7rartsact�on y Lacati'on/
�a Amount"
MAY 22 GOODS AND SERVICES WESTFIELD IN 54.99
TOTAL 6035301202814974 $54.99
MAY 28 GOODS AND SERVICES WESTFIELD IN 39.98
TOTAL 6035301203045040 $39.98
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
MAY 21 PAYMENT REF P9194004DO9K9RH58 138.99
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 allirg PERCENTAGE Subject to Periodic Bill ng PERCENTAGE
Finance Charge Rate Penod RATE Finance Charge Rate Penod RATE
REGULAR REVOLVE CREDIT PLAN o .00000 so 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 billinq 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 ton a separate revolve credit plan balance.
sheet) as soon as possible at the billing error address on the front of your
statement. We must near 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 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. 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. Ail
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
975
Remit To: Bill To: page 3 or 3
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 ®SQ.
DEPT.30- 1200182572 MICHAEL LUPER
PO BOX 689020 760 3RD AVE 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:
431000933428010 431000935221010
Purchase Order:
52809
AMOUNT DUE: 54.99 AMOUNT DUE: 39.98
Store 574000431 INVOICE DATE: 05/22 /09 Store: 574000431 INVOICE DATE: 05/28 /09
GN SOLB NORTH BG QUICK 6854009 1.00 54.99 54.99 TRAILER LIGHT KIT 0165313 1.00 19.99 19.99
A FRAME JACK 20001-B 1160217 1.00 19.99 19.99
SUBTOTAL 54.99
TAX 0.00 SUBTOTAL 39.98
SHIPPING 0.00 TAX 0.00
SHIPPING 0.00
TOTAL 54.99
TOTAL 39.98
Please Direct Inquiries to: Phone: 800 -559 -8232 Fax: 801 779 -7425
Notify Us in Case of Errors or Questions About Your Sill 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 staterent on which the error or problem appeared. In your
letter, give us the following information: 4 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. 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
6UMM 9 0)
BUSINESS ACCOUNT
REMIT TSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
I 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) 667 -3505
NAME CARMEL UTILITIES
3450 W 131ST ST
ADDRESS WESTFIELD IN 460748267
(317) 733 -2855
CITY STATE ZIP PHONE 431 623000089 2 933428
05/22/2009 09:08am
CUSTOMER TO COMPLETE 6854009 GW 50LB NORTH BG 9UI
1.00 54.99 54.99 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Utility
The undersigned certifies The undersigned party certifies their exemption from
compliance with the agricultural payment of sales and use tax on tangible personal Subtotal 54.99
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 Total 54.P9
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for TSC Card 54.99
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Acct@: asasaa23$ttt4974
the applicable statement of the other agricultural production items purchased free of Autha:022110 Refo:2208080745
respective state printed on the tax, as defined by state law, and as indicated below. Chanse 0.00
reverse side of this form. Cash Back
PRODUCT IS TO BE USES IN THE FOLLOWING The undersigned party further certifies they
IV
STATE: understand the may be liable for payment of all taxes Buyer acknoaledses the receipt of a c
(REQUIRED) due on the purchase b
price for the goods as allowed y
Exceptions: Georgia, New YorkBKentucky state law Should such goods be used or consumed f copy Of this sales slip and the Purchase
COMPLETE REVERSE SIDE)
a taxable manner as defined by state laws.
PURCHASER IS ENGAGED IN: (REQUIRED) the described merchandise shall be in
ale Under penalty of perjury, signee swears the accordance with the Cardholder Asreement.
J/4overnment 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 Sisnature:
Dairy Production penalty and /or other provisions as allowed under state
Livestock Production
Floriculture /Aquaculture Production law'
Other:
EtEEEE8EEi8EE8EEaEEEEEE28EEEiEaEEBtiY
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED)
Farm Machinery/Repair Parts Government Agency (Entity# Call 800- 968 -0734 within 7 days to
Livestock Iniestibles or.lniectibles Exempt Organization (Entity complete a survey and be entered in a
Fertilizer /Agrichemicals NC: only DOT and US Government are exempt mon draains for a chance to win a
V dient ed in Production (KS) Resale (Sales Tax Permit# 32500 shoppins spree.
(Awarded as Gift Card) NO PURCHASE
or Component Parts (KS) OR SURVEY NECESSARY Ends 9/30/09.
tEEYEaEE8EEiEEEtEE8EE8EEEEasBtiitiafE
Enter Store A 0431
CUSTOMER SI NATU E:(REQUIRED) MGR. APPROVAL
G.Sr X
IN
CASH HECK VISA. M/C 'DISCOVER. TSC CHARGE ,ACCOUNT NO,. CHG. EXCH. DATE.
Ll J Ll U Ll I I J I J
Q e DESCRIPTION;' TA
F" No. Q102 CUSTOMER ORIGINAL
REMCTTSC BUSINESS ACCOUNT
PAYMENTS TO:
TRACTOR SUPPLY COMPANY
SUPnYCO W T=70R
P.O. Box 9020 Tractor Supply Company
Des Moines, IA 50368 -902.0 15160 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 UTILITIES
3450 W 131ST ST
ADDRESS WESTFIELD IN 460748267
(317) 733 -2655
CITY STATE ZIP PHONE 431 431000172 2 935221
03/28/2009 10:37am
CUSTOMER TO COMPLETE 0165313 TRAILER LIGHT KIT
1.00 19.y9 19,99 NT
CERTIFICATE OF EXEMPTION: GENERAL. EXEMPTION STATEMENT: Res, Price: 25,99
The undersigned certifies The undersigned party certifies their exemption from Utility
compliance with the agricultural payment of sales and use tax on tangible personal 1160277 A FRAME JAC" 200OLP
sales tax exemption law of the state property as indicated below and /or purchaser is 1.00 0 19,99 19.99 NT
indicated below and understands engaged in the business of agricultural production of Res. Price: 24.99
and agrees with the General Utility
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 Subtotal 39.98
respective state printed on the °ther agricultural production items purchased free of 7,00% Tax 0100
reverse side of this form. tax, as defined by state law, and as indicated below. Total 39,91E
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they TSC Card 39.98
understand they may be liable for payment of all taxes
STATE: Auth #:028782 Refo:2809370017
(REQUIRED) due on the purchase price for the goods as allowed by PO #:052809
(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. Chanse 0.00
Cash Back
PURCHASER IS ENGAGED IN: (REQUIRED)
Resale Under penalty of perjury, signee swears the Buyer acknowledses the TeceiFt of a corupi:
Government information on this statement is true and correct in
Exempt organization every material manner. A willfully false representati
Agricultural Production of exemption will cause the purchaser to be subject to Copy of this sales slip and the Purci,ase
E] Dairy Production penalty and /or other provisions as allowed under stale
Livestock Production law the described merchandise shall be in
E] Floriculture/Aquaculture Production accordant h the Cardholder Asreement.
Other:
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) S is t e:
Farm. Machinery /Repair Parts Government Agency (Entity
Livestock Injestibles or Injectibles Exempt Organization (Entity 9
Fertilizer /Agrichemicals NC: only DOT and US Government are exempt
Consumed in Production (KS) Resale (Sales Tax Permit
Ingredient or Component Parts (KS)
Call 800-968-0734 7 days to
Other: complete a survey and be entered in a
monthly drawins for a chance to win a
CUSTOMER SIGNATURE :(AEQU[RER) MG AP AL
p 0
CASH CHECK .VISA :MICIC DISCOVER TSC CHARGE' ACCOUNT. NO. CHG, 'EXCH.' DATE
Ll
39
PQ#
ACCT# c
l 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 6/29/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/29/2009 4310009334: $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 cer
VOUCHER 092208 WARRANT ALLOWED
306840 IN SUM OF
TRACTOR SUPPLY, CO
P.O. Box 689020 {;�o cn
Des Moines, IA 50368 -9020 0ARN,10�
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
43100093342 01- 6200 -06 $54.99
4 3 I =93saa
Voucher Total 9 `1 4) "Z 9
Cost distribution ledger classification if
claim paid under vehicle highway fund