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HomeMy WebLinkAbout173574 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO 0 CHECK AMOUNT: $863.73 CARMEL, INDIANA 46032 PO BOX 689020 •q off DES MOINES IA 50368 -9020 CHECK NUMBER: 173574 CHECK DATE: 6/10/2009 DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT D 1120 4350100 1214034794 863.73 BUILDING REPAIRS MA REMIT TSC BUSINESS ACCOUNT PAYMENTS TO: TRACTOR SUPPLY COMPANY Su "LY CO P.O. Box 9020 1 Tractor Supply Company Des Moines, IA 50368 -9020 18160 U.S. 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number Westfield, 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 431000179 2 930744 0 /12/2009 03:03pm CUSTOMER TO COMPLETE 22190( TALL MAT 4X6 RUBBER 27.00 31.99 063.73 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Price: 34.99 The undersigned certifies The undersigned party certifies their exemption from Government Asencies 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 Subtotal 863.73 indicated below and understands engaged in the business of agricultural production of 7.00% Tax 0.00 and agrees with the General Total 863, 73 Exemption Statement at right and food or fiber, horticulture, aquaculture of floriculture for TSC Card 863.73 the applicable statement of the resale and/or uses the farm machinery, equipment or Acct0:gss;;s;; ;s; ;6062 respective state printed on the other agricultural production items purchased free Autho:012718 Ref :1214034794 reverse side of this form. tax, as defined by state law, and as indicated below. P[1 #:station 43 PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Chanee 0.00 STATE: understand the y y p ay ment ma be liable for of all taxes Cash Back (REQUIRED) due on the purchase price for the goods as allowed by Buyer acknowled9eg the receipt of a comp le (Exceptions: Georgia, Ne York Kentucky state should such goods be used or consumed COMPLETE REVERSE SIDE) t? a taxable manner as defined by state laws. corn of this sales slip and the Purchase o PURCHASER IS ENGAGED IN: (REQUIRED) Resale Under penalty of perjury, signee swears A Government information on this statement is true and correct in the described merchandise shall be in Exempt organization every material manner. Awillfully false representation accordance with the Cardholder Asreement, 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 Sisnature: Floriculture /Aquaculture Production law' ED Other: ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery/Repair Parts Government Agency (Entity Livestock lniestiblesorinjectibles Exempt Organization(Entity# EaaE; aiiYEtataEaaaYEYad2a $;aaa ;EEEYEE --i] Fertilizer /Agrichemicals NC: only DOT and US Government are exempt Call 800-968 -0734 within 7 days to Resale (Sales Tax Permit# complete a survey and be entered in a Consumed in Production (KS) monthly drawins for a chance to win a Ingredient or Component Parts (KS) $2500 Shope i ns spree, (Awarded as Gift Card) NO PURCHASE F] other: OR SURVEY NECESSARY, Ends 9130109. s ;s; ;sa :sass; ;ssasaas ;aaaats ;sss; CUST ER SI G RE: IEQUIIRFD) M APPROVAL SHADE USE AREA ONLY CASH CHECK °VISA MIC ,DISCOVER TSC CHARGE ACCOUNT NO. CHG. EXCH. DATE IJZ%IiI II�IIIIIIIIIII I DESCRIPTIO ti Form No. 9e -00401 (12 /05) CUSTOMER ORIGINAL ARKANSAS: The customer, as indicated by their signature on the reverse, comities That ho /she is engaged in the business of farming and the farm machinery anti equ;pment purchased will be used exclusively and directly in the agricultural production of food or fiber as a business. Tile reverse signed is aware that any false representation made by therm in an attempt to purchase farm machinery and equipment free from Arkansas Sales Tax is a misdemeanor. GEORGIA.: The reverse signed hereby cenrffes that all targible personal property purchased or leased after the reverse indicated date will be purchased or leased far the purgosE Indicated below, unless otherwise specified on a particular order, and that the purchases are used as a part of a pursuit engaged Ill for profit. This cenifieale shall r main in effect until revoked in writing. Any tangible personal property obtained under this certificate of exemption is subject to this sales arid use tax if it is used or consumed by the leurcf a ser in any nianno, other than indicated on this certificate. (Check proper box.) -FARM MACHINERY AND EOUIPMENT- j t Rubber -tired Farm tractors and attachments which will be used exclusively in tilling, planting. cultivating or harvesting farm crops for sale. Such crops will be planted ano harvested within a twelve -month period. O.C.G -A- 46- 8- 3(29)(I) 2- Machinery and/or equipment which wilt be used on the farm directly in the production of poultry or eggs for sale. O.C.G.A. 48- 6- 3(29)(A) j 3. Machinery and/or equipment which will be used on the farm directly in the production, processing or storage of fluid milk for sale. O.C,G -A. 48- 8- 3(29)(C) 4. Machinery and/or equipment which -ill be used an line farm directly in the production of livestock for sale. O.C.G -A- 48- 8- 3(29)(D) 5. Machinery and;or equipment which will be used On the farm directly in harvcsfing farm crops grown and used on the farm as teed ter poultry Of livestock by a producer falling under the categories 2, 3. or 4 above. O.C.G.A. 48- 8- 3(29)(E) 6. Machinery and/or equipment which will be used in the hatching and brooding of poultry and livestock for sale. O,C.G.A. 48- 8- 3(29)(8) 7. Machinery and /or equipment which will be used in tilling the soil or in animal husbandry. O.C.G.A. 48- 8- 3(29)(F) -(G) (H) 9. Machinery and /or equipment which will be used exclusively for irrigation of farm crops grown for sale including, but not limited to fruit, vegetable and nut Crops. O.C.G -A,§ 46 -8 -3(26) 9. Pecan sprayers, pecan shakers and/or other oquipment used in harvesting pecans. O.C.0 -A. 48- 8- 3(29)(J) j 10. Fun,prnaut which will be used nn the farm exclusively in processing anions. O.C.G.A. 48 -8- 3(29)(1) TIMBER EQUIPMENT AND RELATED ATTACHMENTS- J 11. Off -road equipment and related attachments which wilt bra used exclusively in the -silo preparation, planting, cultivation, or harvesting of timber. This shall include all olf -road cgwpmonl and related attachments used in every forestry procedure staring ith "the severing tree fr. —(he grounc�.,U and including the point at which file tree or its parts in any form has been loaded in the field in or on a truck or other vehicle for transport to the place of use. b.C.G.A. LIVESTOCK, SEED, FERTILIZER, FEED, PACKAGING, ETC: 12, Cartier hogs, sheep, horses, poultry. and bees when sold for breeding purposes. O.C.G -A- 48 -8 -3(28) 13. Seed, seedlings, fertilizers, insecticides, fungicides. rodenticides, herbicides. defoliants, soil fumigants, plant growth regulating chemicals. desiccant. (including shavings and sawdust frorn wood, pearsut hulls. ful €er's esnh, straw and hay) and feed for livestock, fish or poultry when used either directly in tilling the soil air in animal, fish or poultry husbandry: and /or, nonreturnable raterWs used for packing farm products for shipment or sale- O.0 -G.A. 48 -8 -9(25) (35) (A) (iii) -FUELS USED IN POULTRY STRUCTURES ELECTRICITY USED IN IRRIGATION OF FARM CROPS- 14. Tha sofa of el.oIncily for the operation of an irrigation system which is used an a farm exclusively for irrigation of tarn crops when separately metered. O- C -G "A. 48 -8 -3(64) 1 'i 5. Liquefied petroleum gas or other fuel used in a structure in which broilers, pullets. or other poultry arc raised when separately motored. O.C.G.A. 48 -8 -3(49) ILLINOIS: Tha reverse signed hereby certifies that the property purchased will be used primarily in production agriculture or in State or Federal agriculture programs. Any farm chemicals purchased as exempt are such pursuant to Section 130.1955. KENTUCKY: Tha reverse signed hereby certifies that they are a farmer regularly engaged in the occupation of: (farmer must initial appropriate If rugs)) _tilling and cultivating the soil for the production of crops: raising and feeding livestock or poultry the products of which ordinarily constitute food for human consumption; or raising and feeding Ilarnas, alpacas, ratites, buffalo, or aquatic organisms. The reverse signed also certifies that file tangible personal propany purchased as indicated below will be used for the exempt purpose(s) provided for under KRS 130.460. Farmer must fN/TIAf„ appropriate line(s). Baling twine and wire R3'ddlE't SeEl E.fR 17't "t3ilaz ESEtttYt :l Farm chemicals rt Farm machinery, attachments and repaWrefelacement pall. therefor 7tr ('�V_•.,�.t �T.� Ir Farm work stock ll 37d CT t EI- Q VC wliiKEfJttl ?E Feed and feed additives Gasoline, special foals, natural gas or liquefied petroleum gas ,��,3 }If1L•h I lla ?1. o Livestock or poultry the products of which ordinarily constitute food for human consumption q]p (f A QLgdlUd }Oi. if C}1a9Cie: j.'t r" Ratites, Ifamas. alpacas, buffalo, or aquatic organisms Machinerv, equ ahachrrr and cops'Greet. aernant_ pans -:harp for to- bsIoCnrporated into an existing on -la mr&ikirjl oylvean fRdflitytand pdultry,Elivo�i4¢M, Fe(fiie; Jlar;la, alpaca'. or acluacultum facilities' Seed or fertifi la.i T, 8C 'u'�ii �rR }ill) gaAa {o Materials to be incorporated into the renovation or repair of an existing on -farm grain /soybean facilities and poultry, Ily s�oc�C tile,, llama, E a P 0%, agi(aE�lltutre 4T, l t l yi I.; S Water used in the production of crops as a business or in the raising of livestock /poultry, ratites, llamas, alpacas. buf((aa o, sjj i7a'ii tlrga o isms'and daily ca t e- SEE_ REVERSE SIDE SF_F_ REvERSF_ AVE' 441 Rt d t R E tE Zt S l f 1111 Signature Date MICHIGAN: The reverse signed hereby certifies that all items, except as indicated, are purchased for use or consumption in connection with the production of horticultural or agricultural products as a business enterprise, arid agrees to reimburse the seller it,. sales tax if used or consumed otherwise. Unlawful use of this certificate subjects persons to the penalties of the sales in act. NORTH DAKOTA, SOUTH DAKOTA: The purchases made herein are subject to the reduced Kate of .ales tax and are net exempt from such tax NEBRASKA: The reverse signed certifies ih. intended use of the items purchased renders it exempt under Reg. 1 -060. 1 -061 or 1 -063. TEXAS CERTIFICATION OF EXEMPTION Purchaser's name SEE. REVERSE SIDE Street Address SEE REVERSE SIDE City, state, zip code SEE- REVERSE $[OF I claim an exemption from payment of sales and use taxes for the purchase of taxable items described below or on the attached order or invoice: SEE REVERSE SIDE orf ill 17t71T r r1T t1I Tug; f','r 0 ;T',TDf.t W= Description of items (or an attached order or invoice) to be purchased: SEE REVERSE SIDE_ I claim this exemption for the following reason: SEE REVERSE SIDE I understand that I will be liable ter payment of sales tax which may become due for failure to comply with the provisions of Ih ]x a T- Lode: 1 'm tt. xciso nib U Act, •1 Municipal Sales and Use 'fax, Act, Sales and Use Taxes for Special Purpose Taxing Authorities. County Sales and Use 't ax Act, County Health Services halos and Use "f'ax and the Texas Health and Safety Code: Special Provisions Relating to Hospital Districts, Emergency Services Districts. and Emergency Services Oistricis in counties with a population of 125, 000 or less. Liability for the tax will be determined by the price paid for lha taxable items purchased or the fair market rental value for fin period f ti s sod- I understand that it is a criminal offense to give an exemption certificate to tine seller for taxable items which I !!mew at the tiii� p r 'purchase, will be use in manner o_ her itran that expressed in this certificate. Seller: SEE REVERSE SIQi= Street address: SEE REVERSE SIOF f tl 7 J f7 Ltr K City, state, zip Cade: SEE REVERSE SIDE Purchasor's signature: SEF RF-VEHSE SIDE_ Data 1-ho, d. V File SFF REVERSE SIDE t r n r r i'T This certificate does not require a number to be valid. t Sales and use tax exemption numbers or lax exempt numbers do not exist. r, (I 1 .rjF 0 1 l; 1. �,F 'f This certificate should be furnished to the supplier. Do not'liand the completed certificate to the Comptroller of Public Accounts Effective Date: September 10, 1991 :7Cr a 54 8 d t t R 1 i. E E d �i. Rule 3 -297 NEW YORK STATE DEPARTMENT OF TAXATION AND FINANCE NEW YORK STATE AND L ©Ct4L S P�. t S AND USE TA X. FARMER'S EXEMPTION CERTIFICATE .i• To purchasers and sellers: To be completed by the farmer, given to and retained by the seller. To have a valid certificate, all pal triesTr�tust be completed. Real, all instructions carefully before completing or accepting this certificate. .t To sellers: You may not accept this certificate as the basis for selling exempt from tax the property or services listed below, Tay rrilyt�be�Fidllected on such solos. 11r; This cerfificara may not be used to Claim a cmotton for the following: 11 1 uli"lies, fuel oil, motor feet or di.sal fuel; 2. labor charges in connection with, repair, maintenance of or service to real property'I i J'�la ngii9le personal prvperty-ineorporr_tted i a tiullding, structure. silo foundation or other capital' improvements to real property (exclfiding grape trellises and the remaining portions of a silo): 4. motor vehicles; or 5, property listed as taxable. Name of seller TRACTOR SUPPLY COMPANY A.FFILIATES Attn: Tax Name of Farmer SEE RE VERSE SIDE Street address 200 Powell Place Street address SEE REVERSE I�� I tt T ranAfcl of C a r burr rl�a _C l Brent wood TN Zip Code 3_7027 C_T1y SE E_ REV SIDE —State GIP. Cod" check applicabt bb c Single Prjrdhase Cerlifcate. T t]131anket. Certificate J�tr8 I 1, the reverse signed hereby comfy that I am exempt train payment of the sales and use tax an tangible personal property purchajerf you because the property is v Ear a n exe lnpt purpose and that certain services are also exempt who. performed on an exempt property. (Check applicable box or boxesa Fj. j l�) 0 (a) Tangible personal property, except property Incorporated into a building or structure, for use or consumption dfrcctty,and Rrs'dominately in praeugtlon of tangible personal property for sale by farming, including stock, dairy, poultry, fruit, fur bearing animal, and truck farrnirige The terrl'G farmind' also lncivaea•rr3nbhing, Operating nurseries, greenhouses or other similar structures used primarily for the raising of agricultural, horticultural or floricultural commodities, and operating orchards or vineyards_ i (b)'Tanglbte personal property for use in erecting, adding to, altering or Improving a silo used In farming to make ah& 'sutige:oii-aherm, provided such tangible persanal property is to become an integral component part of such she. (This exemption does not apply to tangible personal pr per }y sod in aonslrucUng a silo foundation.) 'Q�i Vi,i J C�.r t,)�+� p (c) Post. and wire for use in constructing or maintaining vineyard trellises used in growing grapes for sale. p (d) Services of installing, repairing, maintaining and servicing exempt tangible personal properly. (This exemption is provided for both state and local safes and use tax with the exception of the tax imposed by or for New York City.) 7I I I 4 ('.(t 1 ThesE slatoments are made with 'lhq knowledge that willfully issuing a false or fraudulent certificate with the intent to evades tax'!is a misdemeanor under section 1917(m) of the New York State Tax Law and section 210.45 of the penal law punishable by a fine of not more than $1,000, or imprisonment for nolIC -ET,, _tqfri h yci'ar oy 6oth� Signature of farmer or farmer's representative (state title and relationship) SEE REVERSE SIDE Seller The tax exemption for farmers is limited to the purchases of (1) tangible personal property used directly and predominarry }rafts proaueiinn p}iast, of farming and (2) the services described in (d) related to that property- Purchases for use in administration, storage or marketing or purchases of tangible personal property used indirectly in fanning would not quality. (See Publication 844, Sales Tax /reformation for Farmers, for a complete explanation of the tax treatment of farmers purchases and sales.) For our protection, a farmer must I 1" y p give you This certificate not later than 90 days after' delivery of the props ny sold or services rendered- 11 you have not s recaivpd 1]il�c`ertiticale within 0 9 days of the date of sate, the sate will be doeraed to have been taxable at the time the transaction took place and the burden of proving it was not, 4)t a ll]tie 6por7 bo {R yi5[tra(tJ the purchaser. If iho blanket Certificate box is Checked, you may Consider this certificate part of any Order received from the purchaser. A blanket certificate remra il fi torte uric it t it ri3'purchase r gives you written notice of revocation, or until fire Tax Department notifies you that the purchaser may not make exempt purchases. 4r riL Purchaser You must pay tax on utilities (telephone, telegraph, electricity or gas service) heating ail, motor fuel and diesel motor fuel at the flare of purchase and claim a refund for any exempt use" (If you are purchasing diesel motor fuel for exclusive consumption in farm machinery used to produce tangible personal property for sale, you may use Form FT -1004, Farmers Exemption Certif for Purchases of Diesel Motor Fuel to porch... that fuel exempt.) if the blanket court! Cate box is checked, you may consider this certificate part of any order received from the purchaser. A blanket certificate remains in force until the purchaser gives you wrinn -_n ni tice of revocation, or until the Tax Department notifies you that the purchaser may not make exempt purchases. 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 snow: 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)) 1214034794 Sta. 43 Flooring $863.73 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 VOUCH N WAR NO. ALLOWED 20 Tractor Supply IN SUM OF P.O. Box 9020 Des Moines, IA 50368 -9020 $863.73 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 1214034794 43- 501.00 $863.73 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 MAY 9 2 2009 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund