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180340 12/09/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 'Page 1 of 1 ONE CIVIC SQUARE TRACTOR SUPPLY CO CHECK AMOUNT: $787.30 CARMEL, INDIANA 46032 PO BOX 689020 DES MOINES IA 50368 -9020 CHECK NUMBER: 180340 CHECK DATE: 12/9/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION ,1120 4235000 S'T'REET 524.85 6035301200050860 2201 4237000 STREET 94.98 6035301200050860 2201 4356001 STREET 167.47 6035301200050860 t page 1 of 5 TX 7 011700 00 m 1i1p c o o t BUSINESS ACCOUNT 0000377 0 ♦r Previous Balance 535.97 Closing Date 11/18/09 Payments 0.00 Next Closing Date 12/18/09 CARMELSTREETOEPT Credits 0.00 Payment Due Date 12/13/09 CINDY Purchases 787.30 3400 W 131ST ST Debits 0.00 Current Due 787.30 WESTFIELD, IN 46074 -8267 FINANCE CHARGES 0.00 Past Due Amount 535.97 Credit Line 5,250 Late Fees 0.00 Minimum Payment Due 1,323.27 Credit Available 3,926 New Balance 1,3Z3.27 CURREN AC TIVITY TEaE1$ it3F1 i4St4'8f1O s u K *1TIQt. OCT 22 GOODS AND SERVICES NOBLESVILLE IN 89.97 TOTAL 6035301200074795 $89.97 OCT 27 GOODS AND SERVICES NOBLESVILLE IN 5.7, NOV 17 GOODS AND SERVICES WESTFIELD IN TOTAL 6035301200074803 $29.74 OCT 26 GOODS AND SERVICES WESTFIELD IN 39.98 TOTAL 6035301200074811 $39.98 1 NOV 17 GOODS AND SERVICES WESTFIELD IN 77.50 FINANCE CHARGE SUMMARY r 5 Current Billing Period Pre7UIUAill ling Period Balance Daily Days in ANNUAL Balce Daily Days in ANNUAL Subject to P an eriodic 8llmg PERCENTAGE Subject to Periodic Billing PERCENTAGE Finance Charge Rate Period RATE Finance Charge Rate Period RATE REGULAR REVOLVE CREDIT PLAN 0. 00 .00000 29 0.00 0.00 00000 32 0.00 s 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 !f 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, street) as soon as possible at the billing error address on the front of your statement. yde 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 Otter, 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. 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: R 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" page 2 Of 5 TX 7 D113 ®StCQ BUSINESS ACCOUNT 0000378 CURRENT ACTIVITY Transaction�1 3 Lacatlont V "P M- t�ate eSCiiptWn Amount TOTAL 6035301202895866 $77.50 NOV 10 GOODS AND SERVICES WESTFIELD IN 5.26 TOTAL 6035301202895973 $25.26 NOV 17 GOODS AND SERVICES WESTFIELD IN 524.85 TOTAL 6035301202896062 $524.85 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. LIP 0- C I �5 acs ��.�A Remit To: 6 1 BIII To: page 3 or s TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 TwT0R DEPT.30 1200050860 RON WILLIAMS ®SuLY o PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000379 Payment Due Date: 12/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP TO: INVOICE: 624200000446012 431000970371010 Purchase Order: Purchase Order: MIKEK SHOP AMOUNT DUE: 89.97 AMOUNT DUE: 35.98 Store: 574000624 INVOICE DATE: 10/22 /09 Store: 514000431 INVOICE DATE: 101'13/09 SWTSHIRT XL HOOD NV BNC 7121085 1.00 29.99 29.99 ROLLER CHAIN 60 LOFT 1150078 1.00 31.99 31.99 SWTSHIRT XL HOOD NV BNC 7121085 1.00 29.99 29.99 LINK CONN 60 1151074 1.00 3.99 3199 SWTSHIRT XL HOOD NV BNC 7121085 1.00 29.99 29.99 SUBTOTAL 35.98 SUBTOTAL 89.97 TAX 0.00 TAX 0.00 SHIPPING 0.00 SHIPPING 0.00 TOTAL 35.98 TOTAL 89.97 J o. SHIP TO: INVOICE: SHIP TO: INVOICE: 624200001317010 431000979060010 Purchase Order: Purchase Order: SHOP SHOP AMOUNT DUE: 5.76 AMOUNT DUE: 23.98 Store: 574000624 INVOICE DATE: 10/27 109 Stare: 574000431 INVOICE DATE: 11/17 /09 G8 GALV AND COTTERPIN B 5568887 1.65 3.49 5.76 BLOW GUN W EXTN NOZZLE 3314262 1.00 11.99 11.99 BLOW GUN 2FT EXTN 3324160 1.00 11.99 1.1.99 SUBTOTAL 5.76 TAX 0.00 SUBTOTAL 23.98 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 5.76 TOTAL 23.98 Please Direct Inquiries to: Phone: 800-559-8232 Fax: 801- 779 -7425 It Remit To: Bill To: page 4 or 5 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860R' =5! DEPT.30 1200050860' GARY JONES I V UMYC =H.PO BOX 689020 211 2ND ST SW BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000380 Payment Due Date: 12/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: SHIP To: INVOICE: 431000970503010 431000973737010 Purchase Order: Purchase Order: 101409 SHOP AMOUNT DUE: 5.29 AMOUNT DUE: 39.98 Store: 57400043/ INVOICE DATE: 10/14 /09 store: 574000431 INVOICE DATE: 10/26 /09 LINK OFFSET 60H 1152088 1.00 5.29 5.29 FLOOD LIGHT 3X5 HALOGEN 0283933 1.00 19.99 19.99 FLOOD LIGHT 3X5 HALOGEN 0283933 1.00 19.99 19.99 SUBTOTAL 5.29 TAX 0.00 SUBTOTAL 39 -98 SHIPPING 0.00 TAX 0.00 SHIPPING 0.00 TOTAL 5.29 TOTAL 39.96 SHIP TO: INVOICE: SHIP TO: INVOICE: 431000979074010 J 431000977361010 Purchase Order: Purchase Order: BOOTS TRUCK57 AMOUNT DUE: 77.50 AMOUNT DUE: 25.26 Store: 574000431 INVOICE DATE: 11/17 /09 store: 574000431 INVOICE DATE: 11110/09 SPECIAL ORDER PAYMENT 431052304 1.00 77.50 77.50 LINK QUICK ZINC 5 /16IN 3551042 1.00 2.49 2.49 LINK LAP 5/161N 3551107 1.00 1.29 1.29 SUBTOTAL 77.50 DRAWBAR 1 /2IN HOOK 3PT 0268080 1.00 18.49 18.49 TAX 0.00 HITCH PIN 3 /8X4IN 3PT 0268656 1.00 2.99 2.99 SHIPPING 0.00 SUBTOTAL 25.26 TOTAL 77.50 TAX 0.00 SHIPPING 0.00 TOTAL 25.26 l0 0. Q� Please Direct Inquiries to: Phone: 800 -559 -8232 Fax: 801 779 -7425 I Remit To: Bill To: page s or 5 TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200050860 CM DEPT.30- 1200050860 BONNIE CALLAHAN )PSUMyc PO BOX 689020 3400 W 131 ST ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000381 Payment Due Date: 12113!09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: 431000979051010 Purchase Order: STATION43 AMOUNT DUE: 524.85 Store: 574000431 INVOICE DATE: 11117 109 STALL HAT 486 RUBBER, 2219003 15.00 34.99 524 -85 SUBTOTAL 524.85 TAX 0.00 SHIPPING 0.00 TOTAL 524.85 Please Direct Inquiries to: Phone: 800 -559 -8232 Fax: 801- 779 -7425 li REMIT TSC BUSINESS ACCOUNT PAYMENTS ONLY TRACTOR SUPPLY COMPANY SWVMYCO P.O. Box 689020 Tractor surPlr Coau=, ay Des Moines, IA 50368 iJ1fs� U,4,, 31 N Digit Account Number uEe fields Its s60, 4 TSC TEAM MEMBER TO COMPLETE Please include 16 Di g' (317) B67 -M505 6035 301 NAME I_fiRMEL ST REET D[ ,5400 Q l .s i a f ST LTSTF IELD IN )607488267 ADDRESS (D'() i'33 -2001 CITY STATE ZIP PHONE 431 431000185 2 977.361 11:1012009 10:32an CUSTOMER TO COMPLETE 35510.42 Lli)'t WICK ZINC 5/16 1.00 2 2.44 2.49 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Governnlcll't A±er,ca:es The undersi ned certifies' 3551107 LINK LAP 5/1,61N g The undersigned party certifies their exemption from 1 00 J 1,29 1.29 NT compliance with the agricultural payment of sales and use tax on tangible personal Government Aser.cies sales tax exemption law of the state property as indicated below and /or, purchaser is 02690 in 1/2IN HOOK 3 indicated below and understands engaged in the business of agricultural production of 1.00 113.49 19,49 NT and agrees with the General food or fiber, horticulture, aquaculture of floriculture for uovernhien Asenci es Exemption Statement at right and resale and /or uses the farm machinery, equipment or 02613659 HITCH F'fN 3/041N 3P the applicable statement of the other agricultural production items purchased free of 1 1.00 9 2.99 2.99 if'1' respective state printed on the tax, as defined by state law, and as indicated below. Govermient Asencies reverse side of this form. PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they subtotal STATE: understand they may be liable for payment of all taxes 7,00% T 0.00 (REQUIRED) due on the purchase price for the goods as allowed by Fatal 25 (Exceptions: Georgia, New York a Ke ntucky state law should such goods be used or consumed in T!C Car°u 25.26 COMPLETEREVERSESIDE) ataxable manner as defined by state laws. I�cctt: tstRraxarrS97i PURCHASER IS ENGAGED IN: (REQUIRED) Au t'hS O 1 068 Ref 4:1009 Resale Under penalty of perjury, signee swears the PO t;TPUCK 5r Government information on this statement is true and, correct in Chant -:e 0 Exempt organization every material manner. A willfully, false representation C Back Agricultural Production of exemption will cause the purchaser to b6' subject to F Dohs Production Livestock Production penalty and /or other provisions as allowed under state. Bit-for a4t�nawledses the rece in of a cirtitrle ri Floriculture /Aquaculture Production law•. f£ t! t ai f t 5ale5 sIiI n t he i -p O °a yy 41 ,1i� d tI "il.1�' D ther merc a, ;:t; ,d i'tandise shalt be in ITEMS PURCHASED WILL ILCBE USED FOR: (REQUIRED} 1 111E descri I be S accordance with the Cardlolder Asreerltent, Farm MachlnerylRepatr Parts 'Government Agency (Entity in: F cLlvestock In)estibles or Inlecpbles Exempt Orgamzatiori (Entity NC only DOT and US Government are exempt r Q sFerttllzerlAgnchemtcals Fztra i tin atar r j ❑i R a is i a ed in Production (KS) al at Tax Permit 1 Q consumed, s %��aE p Ingredient or Component Parts (KS) ti t U 1 I rie I i l Sns� Other i CUSTOMER SIGNATURE: (REQUIRED)' MGR. .APPROVAL I LLL- SHADE AREA ONLY CASH; CHECK VISA MIC DISCOVER` 'TSC CHARGE ACCOUNT NO.` "y Y CHG EXCH:4' DATE Ll i ITEM NUMB ON DESCRIPTI UNIT PR TAX 4 Form No. -00401 (12108) n CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT T PAYMENTS ONLY TO: TRACTOR SUPPLY COMPANY lractc'r strpi.y Carla -hnY SW1PPLYCo 181 tfie d, N 460' P.O. Box 689020 Westfiel.d.P( 46074 Des Moines, IA 50368 (31 7) 1367 •3505 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number 431 431 000 182 2 9 6035 301 1 1 11 7,k I,i NAME tt 'SPECIAL ORDER CONTRACT 382 ADDRESS Sf -eCial Order 4110523041 CARMEL STREET OEF'F Y•400 W 131ST ST CITY STATE ZIP PHONE WLS(1"IELD (N 460F,182 (317) 7 -2001 CUSTOMER TO COMPLETE 0222220 DOOT'r 1. 2 F7. SO 0 so NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Eaaveriirie.nt Ftsenc:i.es The undersigned certifies The undersigned party certifies their exemption from compliance with the agricultural payment of sales and use tax on tangible personal 5kibtotal sales tax exemption law of the state property as indicated below and /or purchaser is 7.00% Tax 0.00 indicated below and understands Total 77.50 and agrees with the ktyi4 7750 General engaged in the business of agricultural production of Der� Exemption Statement e right and food or fiber, horticulture, aquaculture of floriculture for Dee, Card 77,5 0 resale and /or uses the farm machinery, equipment or the applicable statement of the P,cctu: t t ssss$ :a�5g respective state printed on the tax, a s defined by pr state law, items and as indicated indic free aktIhO 01 7S94 Reft :17102�188i reverse side of this form. tax, as below. I C PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies th Chine 0,00 STATE: understand the y ma y p ayment be liable for of all taxes `'a'h Bcr cic (REQUIRED) due on the purchase price for the goods as allowed by riLANCi DUE: 0 00 Exceptions: Georgia, New York Kentucky state law should such goods be used or consumed in COMPLETE REVERSE SIDE) Rv y er aclunowled59 "s the rPl7eiY f Of a LUf!if -le a taxable manner as defined by. state laws. t ,d PURCHASER IS ENGAGED IN: (REQUIRED)., LOPY O'F tftis Si!TE'5 Slit �tiirl the PUrCfl�S� O p Resale Un der penalty of perjury, signee swears the 0 Government information on this statement is truer and correct in p Ex6rriptorganization every material manner. A willfully false representation the 6escribed Pierchandise 511-all be in 0, Agricultural Production accordance with tile Cardholder tlsreeinent of.exemption will cause the purchaser to to F1 Dairy Pr6duct penalty and/or other provisions as'allowed understate: L,vestock:Production l I Floriculture /Aquaculture Production. law' i 5isttafEire: Other ITEMS PURCHASED WILL BE USED FOR (REQUIREQ)r�� k T) C7 Farm Machinery/Repair Parts Governmehi Agency. (Entity Livestock Inyestibles or- Inlectibles 4[] "Exempt Organization (Entity n lN; <NC oM DOT.and:USGovernmentateexem f ti iiis'' i a. �gt3k& tt 4Yxy2 #C3El �:a i 8>3 #x 'Millrzer /Agr,chemicals r Yn 1 p i, f dil l {j. al e7g r stiti;i 7 r; ru t p_ Consumed in Production (KS) j r Flesale (Sales Tax Permrt z l;t 1) l cul,)i Z1 :.5 trve-/ ard! .t,F` en` eyed in D Ingrei,eni or `Component Parts (KS} t i7 r i t i i g �l I ft t r n. r I u tf u s Tor 4 trCr �e i tt7it ff`.tY ilj 4h4 f:i tJ :1 r Y� 3iik7t'{' n9 �'•'r('L., CI other x k,7 a1Ei: i wat`.ded �5 Li t Ga3 1) lU f`{ij2GN SF OR 3 FURA fIECKSSAiiY, n0S 9.',$()'10 s CUST MER SIG NATURE: (REQU (REQUIRED) MGR: APPROVAL y X i USE SHADED AREA ONLY CASH CHECK VIA M!C j01SCOVER TSC CHARGE ACCOUNT NO. CHG EXCH.. 'DATE y 0 0° a ITEM NUMBER DESCRIPTION UNIT PRICE Form No. 99 -00401 (12108) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT T=TOR® PAYMENTS ONLY TO: W TRACTOR SUPPLY COMPANY Su yc® P.O. Box 689020 Tractor Suvpl -Y Collie Des Moines, IA 50368 10160 U.S. 31 Norilt Westfield,IN 16074 TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number (317) 867• 3505 6035 301 NAME CARMEL V DEPT 3400 W 131ST ST 1WESTFIELD IN 460748267 ADDRESS (31 733 -2001 CITY STATE ZIP PHONE 431 43100018S 2 973'737 10/26/2009 01:50i-n1 CUSTOMER TO COMPLETE 028 3933 FLOOD LIGHT 3X5 HALO. 1.00 L 19,99 19.9'3 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT. Governnien t Agencies ned certifies 0283933 FLOOD LIGHT 3X5 HALO The undersigned The undersigned party certifies their exemption from 1.00 19.99 19.99 NT compliance with the agricultural payment of sales and use tax on tangible personal Government Agencies sales tax exemption law of the state property as indicated below and /or purchaser is indicated below and understands engaged in the business of agricultural production of Subtotal 39,98 and agrees with the General food or fiber, horticulture, aquaculture of floriculture for 7, 00% Tax Exemption Statement at right and resale and /or uses the farm machinery, equipment or Total 39,98 the applicable statement of the other agricultural production items purchased free of TSC Card 39.90 respective state printed on the tax, as defined by state law, and as indicated below. Acct 11; ;94; ;$4811 reverse side of this form. Authe:026972 Ref#:2612504199 PRODUCT ISTO BE USED INTHE FOLLOWING The undersigned party further certifies they PO *:shop STATE: understand they may be liable for payment of all taxes Charlsre 0,00 (REQUIRED) due on the purchase price for the goods as allowed by Cass, Bac k (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. Buyer acknowledges the receirf c,+ 4.01.1 le PURCHASER IS ENGAGED IN: (REQUIRED) t ,d ❑'Resale Under penalty of perjury, signee swears the, col of this sales Slip and t11e purchasa o Government information on this statement is true and correct in Exempt organization every material manner. Awillfully false representation the described merchandise shall tie in Agricultural Production of exemption will cause the purchaser to be subject to accordance with the Car•dflold r A9reem -ril Dairy Production Livestock Production penalty and /or other provisions as allowed under state Floriculture /Aquaculture Production law' Other: r' Signature: ITEMS PURCHASED WILL 8E USED FOR: (REQUIRED) i' Farm Machinery /Repair Parts Government Agency (Entity ,t Llvestock Inlestlbles or In)ectibles Exempt Organization (Entity 1 NC :only DOT and US Government are exempt p Fertl6zer /Agnchemlcazs t '1 I :F p Resale(SalesTazPe�mtf# ,f,: dl PaII (300-68-0734 within 7,daY5 iq Consumed In Production (KS) t nz7� {�ta1 vl: COmI'Iete, 3 5UrVeY and be.er;tetcd in Ingredient or Component Parts (KS) 4 t Ir monthly dt a, aTt t for a t itL +.rsCe to win •a Other; t 1C I5 'rtf .6 $Z CD shopei.ng sere t J' r= 1111, j i, (Aweai�dec 05 Gifq Card) NO.F'J';LHASE CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL X IN USE SHADED AREA ONLY WHEN REGISTER IS CASH CHECK VISA M/C DISCOVER TSC CHARGE ACCOUNT N0. CHG. EXCH. DATE' ITEM NUMBER DESCRIPTIO Form No. 99- 00401 (1M11) CUSTOMER ORIGINAL REMIT TSC BUSINESS ACCOUNT PAYMENTS ONLY TO: T�® TRACTOR SUPPLY COMPANY vsupny CO P.O. Box 689020 tractor suprir COI11F a�Y Des Moines, IA 50368 18160 U.S, 31 North TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number tdestf ield, lid 460e.4 (317) 867 3505 6035 301 NAME CARMEL 51 BEE Dk f'T 3400 td Is1ST ST ADDRESS WESTFI IN 46074OZ67 (317) 7 3,�- 2001 CITY STATE ZIP PHONE 431 431000182 2 979060 11!1 10:53am CUSTOMER TO COMPLETE 1314262 1;i_0W GUN to EXIA NOZZ 1 100 11,99 11,99 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government iAsencies The undersigned certifies The undersigned art certifies their exemption from 33`'4160 BLOW GUN 2FT E:XTN compliance with the agricultural g party exem p 1.00 La 1 v9 1 i i`!T sales tax exemption law of the state payment of sales and use tax on tangible personal property as indicated below and /or purchaser is Government HDenciE$ indicated below and understands engaged in the business of agricultural production of and agrees with the General food or fiber, horticulture, a uaculture of floriculture for Sub tat•a1 23 .98 Exemption Statement at right and q 7,00% T 0.00 the applicable statement of the resale and /or uses the farm machinery, equipment or Total 23.9e respective state printed on the other agricultural production items purchased free of TSC Card 23.98 reverse side of this form. tax, as defined by state law, and as indicated below. Acr_t #:s +91t11tt 14003 PRODUCT ISTO BE USED INTHE FOLLOWING The undersigned party further certifies they 11ut ht; 01760'I R00:1709530899 1'0 t shcP STATE: understand they may be liable for payment of all taxes Chaj �,r 0.00 (REQUIRED) due on the purchase price for the goods as allowed by Cash Erick (Exceptions: Georgia New York a Kentucky state law, should such goods be used or consumed in COMPLETE REVERSE SfDEj a taxable manner as defined b state laws. y Duyer ack,iowle&iea thtt rsceiot :Df a ccoca, le PURCHASER 1S ENGAGED IN: (REQUIRED) ki'd F1 Resale Un der penalty of perjury, signee swears' the COPY of thin sales stir and the f urLtrse u Government information on this statement is true and correct in Exempt organization every material manner. A willful false representation Agricultural the described lite•chaodise shall 6, io 9 of. exemption will cause the purchaser to. subject to Dairy Production zraor •r 11re with the Cardholder Asrer!'e�lt. Livestock Production penal #y and /or other provisions as llowed�uKd,6r.state Floriculture /Acivaculture Production IoW' Other G" Sisnafure: I ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) Farm Machinery" /Repair Hart§ p Government Ag6ncy(Entity Livestock In estibles or In ectibles i 0 J J j ExemptOrganizatiort(EntitytJ 1, I S$ IR3$ SSXTB£r388>rX8Rr1L'�P>#3f88Zu;1 Fertih 'r /Agnchemlcais x' NC only DOT and US Consumed in Production (K Resale (SalesTax Permit „t1 r l S j Zal,l 00, 968 Within 1' 6afs to m 1t f t J p,�tiy_ Ia I. Ci1iilPlc?t3 a'sueveY a:,d be ��ttttrcd atr ia: EM,] Ingredient or Component Parts (KS) r t c c p Ip1z p t �lt'i1i1Y lfrtllfAn`_: or 1 Ctltln to win 4t- Qi Other r E il baC1Q 5ttl? E Sn:3 SrhLf t g Y 1 ii �t jn !il S�'1 t +G }i df lJ Uift c l'd) Nd URrl 4)) -r 1; CU TOMERSI NATO E; (REQUIRED] "MGR. APPROVAL (f USE SHADED AREA ONLY CASH j� CKr VISA ACCOUNT NO. CHG EXCH DATE rr�� M� DIS® ER ..,TSC CHARGE ACC .I N ON D ESCRIPTI O N Form No. 99 -00401 (12/08) CUSTOMER ORIGINAL NFTRACTOR TractorSupplycom 2375 EAST PLEASANT ST., RT, 97 NOBELSVTLLE, SN 46060 317 776 1883 Ticket: 1317 Date: 10/27/09 Time: 2:42 pX Store: 624 Register: 2 Cashier; 00125109 Business Customer: CARMEN STREET DEPT 3400 w 13TST ST WESTFIELD, IN 46074 -8267 317 733 -2001 4** 1r x, r wxxx* xxwww x* x* www k* kxxwww*** x* xwx 4ik* w* wxxww *xxwwwxx *tx wwxx *wx* xww* w** wxxw, rA*** xwrr, rwrtw* itxxx w#**# kxwxw�.* �xxxw* x** x txwwa +xxx,rxw,ttt *xx,rrwxx xxxw *a.wxxww x txxw "'wREPRINT REPRINT .REPRINT REPRINT************* xx*+, r�xxx *,F,k *,rxx #,txxx *x #kxr. *+,t yrxxxw *xwwxw� *www,F *fF *xxx #i�bx xyr �F,tx *xww *xx 4* xxx**, t* wx, r+ klr** wwky xww w+ t, trF# xwa rirxxw* x* txww+ Fxx *ww *,F *,�ww *xt *w1 aw *it* G8 GALV AND COTTERPrN BULK SELL 3568887 1.55 3.49 5.76 E Subtotal 5. Tax 0.00 Total 5.76 T'SC Business Account XXXXXXXXXXXX4003 5.76 Auth :027715 PO shop Buyer: JEFF STEWART TO 39ad OSl Z8TZ9LttTET 00:9T 6002 /T0 /ZT Change 0.00 I agree to pay the above amount according to my card issuer agreement, awwwwwwwrw �f#**, t, F *,1,1 *irwwwwww,rwwwww *,F Tax Exempt information Name: CARMEL STREET DEPT Address: 3400 W 131ST ST City /St: WESTFIELD, IN Zip Code: 46074 8267 Phone: 317 733 2001 Tax Exempt Reason: Government Agencies Expiration Date: Tax Exempt Holder: Under penalty of perjury, signee swears the items he /she has purchased the applicable products exempt from sales and use tax, has been done so with the understanding that under state law he /she is attesting to having a valid exemption for the purchased items. Additionally, the customer attests that all information he /she has provided is accurate. Any willfully false representation of exemption or customer information is subject to penalty under state law. 1 f —7 z This transaction consists of one or more items exempt from state sales or use tax. Before completing this transaction you attested that the information provided, including name, address, and sales tax exemption, number (if necessary), is accurate. In addition you have sworn that you legally have a right to purchase the above items exempt frorn sales and use tax, for the reason indicated as defined by this State's laws and regulations. 4 w w r wwt# wwfrwwww #w w,► #t�wwww +,�,t For complate detain go to: Call 800 -968 -0734 within 7 days to Z0 30dd Osl Z8L7,9LLLT61 00:91 G00Z /ti0 /ZZ 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)) 11/30/09 $94.98 11/30/09 $167.47 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 VOUCHER N WARRANT NO. ALLOWED 20 Tractor Supply IN SUM OF P. O. Box 9020 Des Moines, IA 50368 -9020 $262.45 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Member 2201 42- 370.00 $94.9 1 hereby certify that the attached invoice(s), or 2201 43- 560.01 $167.47 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 Friday, Decernber 04, 200 Street Commissioner Street Title Cost distribution ledger classification if claim paid motor vehicle highway fund F 7113ti=R S UPPL Y C BUSINESS ACCOUNT 0000377 �s!�� ,.z3 „3� �tsuu�'�_:;e. 4��. �fi,<a ��.'�aeu ,a »em...� �,a��,€�.�r_ fw�.�� +.w.:: r •,s�.:,2� sc. 3;..s �'a�� ?�,F &��:,s„��c"a"�f. Previous Balance 535.97 Closing Date 11/18/09 Payments 0.00 Next Closing Date 12/18/09 CARMEL STREET DEPT Credits 0.00 Payment Due Date 12/13/09 CINDY Purchases 787.30 3400 W 131 ST ST Debits 0.00 Cuttent Due 787.30 WESTFIELD, IN 46074 -8267 FINANCE CHARGES 0.00 Past Due Amount 535.97 Credit Line 5,250 Late Fees 0.00 Minimum Payment Due 1,323.27 Credit Available 3,926 New Balance 1,323,27 CURRENT ACTIVITY T[SIt88Ct1U�*€�•' s f .LlCatll)nf ice- r� a^�.,. AftTOtiTi� s` L k i xd''» Mil fit, dr a3 4N ��if wt(dn V OCT 22 GOODS AND SERVICES NOBLESVILLE IN 89.97 TOTAL 6035301200074795 $89.97 OCT 27 GOODS AND SERVICES NOBLESVILLE IN 5.76 NOV 17 GOODS AND SERVICES WESTFIELD IN 23.98 TOTAL 6035301200074803 $29.74 OCT 26 GOODS AND SERVICES WESTFIELD IN 39.98 TOTAL 6035301200074811 $39.98 NOV 17 GOODS AND SERVICES WESTFIELD IN 77.50 FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daly Days in ANNUAL Subject to Periodic &]I PERCENTAGE Subject to Parize 9illtrg PERCENTAGE Finance Charge Rate Penod RATE Finance Charge Rate Perwd RATE REGULAR REVOLVE CREDIT PLAN 0.00 .00000 29 o -00 0.00 .00000 52 0.00 This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1- 800.559 -8232 FAX NUMBER 1 -801- 779 -7425 Rem l -'0' Bill To: page 5 or 5 �TRA R= SI�rPPLY CREDIT PLAN ACCOUNT: 6035301200050860 T TO+ DEPT.30 1200050860 BONNIE CALLAHAN PO BOX 689020 3400 W 131 ST ST BUSINESS ACCOUNT DES MOINES IA 50368 -9020 0000381 Payment Due Date: 12/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN SHIP TO: INVOICE: 431000979051010 Purchase Order: STATION43 AMOUNT DUE: 524.85 Store: 574000431 INVOICE DATE: 11117 /09 STALL MAT 4K6 RUBBER 2219005 15.00 34.99 524.85 SUBTOTAL 524.05 TAX 0.00 SHIPPING 0.00 TOTAL 524.05 Please Direct Inquiries to: Phone: 800- 559 -8232 Fax: 801 779 -7425 R REMIT TSC BUSINESS ACCOUNT PAYMENTS ONLY TO: TRACTOR SUPPLY COMPANY su YC® P.O. Box 689020 Tractor Supply Cofil?aTty Des Moines, IA 50368 10160 U.S, 31 Norih TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number ties j F fie ltd 46071 E:,ll3 H,6'r' 3,50 6035 301 NAME CARREL STREET DEPT 3400 W 131ST ST WESTFIELD IN 46074 8267 ADDRESS (317) 733• 2001 CITY STATE ZIP PHONE 43 1 431000182 2 97"r051 11/17/200; 10:24ar: CUSTOMER TO COMPLETE 221'1 STALL NAT 4X6 RUBBER 15.00 34,99 524.85 NT CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Asencies The undersigned certifies The undersigned party certifies their exemption from Subtotal 524,85 compliance with the agricultural payment of sales and use tax on tangible personal 7.00% Tax 101.00. sales tax exemption law of the state property as indicated below and /or purchaser is total 524.85 indicated below and understands engaged in the business of agricultural production of T,C Gard 524.IRS and agrees with the General food or fiber, horticulture,aquaculture of floriculture for Acct�::s$s #$###s1 %6062 Exemption Statement at right and resale and /or uses the farm machinery, equipment or y Autnm;017555 isef�;1741243i39l3 the applicable statement of the respective state printed on the other agricultural production items purchased free of F0 0;5tation 43 reverse side of this farm. tax, as defined by state law, and as indicated below. Chanse 0,00 Cash Back. PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they STATE, understand they may be liable for payment of all taxes Buyer a.cknowiedses the receipt o4 a rnwl.e (REQUIRED) due on the purchase price for the goods as allowed byt ed Exceptions: Georgia, New YorkBKentucky state law should such goods be used or consumed In COPY OI' this 5ale5 SIiP and the rurclia:5e o COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. r' PURCH ASER IS ENGAGED IN: (REQUIRED) the described nier chandisu 5hall be ill 71 Resale Under penalty of perjury, signee swears the accordance with the Cardholder A9reenlent. 0 Government information on this statement is true and, correct in Fli Exempt organization every material manner. A willfully, false representation p. agricultural Production of exemption will cause the purchaser to be subject to. si!3nc,t'ure: Dairy Production penalty and/or other. provisions As understate Llvestock Production Flonct i Ito re /Aquaculture.Production l ad' �:0 Other •.1. ,I; i ITEMS PURCHASED WILL ,BE USED FOR: (REQUIRED) I b8888># .t #$8t #tf #S #8 t Parm Machinery /Repair Parts Government Agency (Entity t r R r ,Js Call 800- 9613 -0734 within T days to Livestock midst bles or In)ectlbles Ezem t Or aAization (Entity 1 il, P 9 y I cunlPlLt'e a survey and be enterer; i a NC only DOT an US Government are'exempt 7 ❑:Fertilizer /Agnchemicals Ij. ra t1 r elc�nttilr diawins or a cn�nti? ko win 1 Al x Resale (Sales Tax Permli 1 I X2500 "Shoo P int 5F t eN pi Consumed m Production (KS) tl 1 li I =,I l (Awarded i75 Gzft'Cat'1) i+Ea fUhtHA�f Ingredient or Component Parts {KS) f I ';f i f 'URV €r "tdEf �SSFtRY, EIitis 9/ 40/10. Other F', �1.. 4.t3��j e'' i i �..i 1. ESFx I ..4 Lt,2 ii is CUSTOMER SIGNATURE: (REQUIRED) MGR. APPROVAL G y X USE SHADED AREA ONLY WHEN REGISTER IS INOPERATIVE. CASH CHECK VISA M!C DISCOVER: TSO CHARGE ACCOUNT NO CMG EXCH.= "'DATE ITEM NUMBEfR NON DESCRIPTION UNIT PRICE TAX Form No. 99- 00401(12108) 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)) $524.85 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 VOUCHER NO. WARRANT NO. i ractor Supply ALLOWED 20 IN SUM OF P.O. Box 9020 Des Moines, IA 50368 -9020 $524.85 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO #IDept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 42- 350.00 $524.85 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 NOV 2 3 2009 t Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund