178426 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
CHECK AMOUNT: $70.96
CARIIAEL, INDIANA 46032 Po sox 6e9020
•ui� h �o` DES MOINES IA 50368 -9020 CHECK NUMBER: 178426
CHECK DATE: 10/14/2009
6EPARTMENT ACCOUNT PO NUMBER INVOICE NUM BER AMOUNT DESCRIPTION
2201 4232100 70.96 6035301202510622
10/06/2009 15:31 3175712265 CARMEL UTILITIES PAGE 01/03
page 1 of 3 Tx 7 0 170000000
1) 5() ��S 6USIMESS A
q 3 ti
Previous Balance 9 Closing Date 09/18/09
Payments 99. 39 N" Closing Date 10/20/09 CARMEL UTILITIES
Credits 59 99 Payment Due Date 10/13/09 TREASURER 0li
Purchases 130 .95 700 3RD "S sw
Debits q 0.00 Current Duo 70.96 CARMEL, IN 48032.2072
FINANCE CHARGES 4 0.00 Past Due Amauttt 0.00 Credit Line Soo
Late Fees 11.00 Minimum Psymem Duo 70.96 Credit Available 429
Now Balance 70 .96
CURRENT ACTIVITY
INS
AUG 19 GO ODS AND SERVICES WESTFIEL IN 59.99
AUG 21 GOODS AND SERVICES WESTFIELD IN CREDIT 59.99
TOTAL 6035SSU1202515464 $0.00
AUG 26 GOODS AND SERVICES WESTFIELD IN 70.96
TOTAL 60353012OZ5154VS $70.96
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
AUG 20 PAYMENT REF P9194007609NEOA13 99.99
FINANCE CHARGE SUMM IMY
Currant Billing Period Previous Billing Period
safance "ailf Daya In ANNUAL gal -Ama Daly 0 �.t'n ANNUM.
8uk{ectty P4flaxtc Billing PERCENTAGE "act to Pr.rladlc Blldnp PENCLNTA(#t
F11 ciirargo Rata Pe+iod RATE Phenco 0harye Rate Porlad RATE
RR(WLAR REVOLVE CREDIT PLAN 0.00 .00000 Ila e.aa 0.01 _00000 29 0.00
e- Y 44.an nh
1% rurn4�,1 N.A CUSTOMER SEFSVICE I =900- 559 -B232 FAX NLIM13ER 1 -801 .7,7.9.7A
1010612009 15:31 3175712265 CARMEL UTILITIES PAGE 03103
vspe w
TRACTOR s u
SUPPLY CREDIT PLAN ACCOUNT: 6035301202510622
DEPT.30 1202510622 CALVIN COOPER
PO BOX 689020 ONE CIVIC SQUARE BUSINESS Ac
DES MOINES IA 60369 -9020
E Payment Due Date: 10/13!09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP To: INVOICE SHIP rD
INVOICE-
431000957286010 431000997788010
AMOUNT DUE: 59.a9 AMOUNT DUE: 59.139-
Stars! 674000481 INVOICE DATE: 08/99109 stew: 576000431 INVO DATE: OV21 109
I
HYDRANT WT BURY 51161d9 7.00 59.99 59.99 HYDRANT OFT BURY 9113169 L.DD 59199 59.99
SUBTOTAL 59.79
TAN O. DD sugiDTAL 59.97
TAX 9.DD
SHIPPING 0.00 SHIPPINO 4.00
TOTAL 59.99 TOTAL 59.99
sH TA_ INVOICE:
4310DO$50919010
Purchase Order:
SHOP
AMOUNT DUE' 70.96
Store-- 374DO0433 INVOICE DATE: OB /2S !09
BIU itIU TAPE MEASURE B'3 4035601 1.00 6199 6
BLO RID TAPE MEASURE 39 4 1.00 6.99 6.99
BiD RIG TAPE KASURE 33 0SE6al 1.00 6.99 6.99
BOOSTER 20Fr 4GAU CABLE 0976303 1.60 49.99 49-99
SUBTOTAL 70.96
TAK 0.00
3HIPPIND 0.00
TOTAL 70.16
Please Direct Inquiries to: Phone: 800 -559 -9232 rax: 501- 779 -7425
7
V REMIT TSC BUSINESS ACCOUNT
PAYMENTS ONLY TO:
7 TAT TUB TRACTOR SUPPLY COMPANY
QW1 FnyC0 P.O. Box 689020 Tractor supply Conlp
au Des Moines, 1A 50368 18160 U,S. 31 Narth
we5tfield,IN 460?4
T TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number (317)1867-3505
6035 301
NAME U
CARMEL UTILITIES
I CIVIC Sw
ADDRESS CARMEL IN 460322584
(317) 57
CITY STATE ZIP PHONE 431 ('86000104 2 958919
08/26/2009 10:56am
CUSTOMER TO COMPLETE 4053601 BIG RIG TAPE MEASURE
1.00 &99 6.99 NT
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Government Agencies
405 3681 BIG RIG TAPE MEASURE
The undersigned certifies The undersigned party certifies their exemption from 1.00 63Y
compliance with the agricultural ayment of sales and use tax on tangible personal 6. 99 N'r
P sales tax exemption law of the state GOVePtiment Asencir,�5
Property as indicated below and/or purchaser is 405360I BIG RIG TAPE MEASURE
indicated below and understands engaged in the business of agricultural production of 1.00 6.99
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for 130 6.99 NT
Exemption Statement at right and vernment Agencies
the applicable statement of the resale and/or uses the farm machinery, equipment or 0476308 BCOSTER ZOFT 4GAU CA
respective state printed on the other agricultural production items purchased free of 1.00 l? 49.99 44,99 NT
reverse side of this form. tax, as defined by state law, and as indicated below. Government Asc
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they Subtotal, 70 96
STATE: understand they may be liable for payment of all taxes 7.00% Tax
(REQUIRED) due on the purchase price for the goods as allowed by T.o t a. I
(Exceptions: Georgia, New York Kentucky state law should such goods be used Or consumed in TS(„ Card
70.96
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. Ah:rt#:tttttjts*stt5498 70.96
PURCHASER IS ENGAGED IN: (REQUIRED) AL'th61026862 'Ref t:2609560600
F Resale Under penalty of perjury, signee swears the 1`6 0; slice
E] Government information on this statement is true and correct in Ch I BC, 0100
Exempt organization every material manner. A willfully false representation Cash Back
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 Buyer acknowledges the receipt c-f a collIple
F1 Floriculture/Aquaculture Production law. t?d
Other: Copy 04 this sales slip and the purchase 0
ITEMS PURCHASED WILL BE USED FOR: (REQUIRED) the described merchandise Shall be in
Farm Machinery/Repair Parts Government Agency (Entity accordance wifh the Cardholder A3reement.
Livestock Injestibles or Injectibles p Exempt Organization (Entity
Fertilizer/Agrichomicais NC: only DOT and US Government are exempt
SiSn(' tL
Consumed in Production (KS) Resale (Sales Tax Permit.#
Ingredient or Component Parts (KS)
F Other:
_CUM R OSIG TURE:(REQUIRIED) MGR. APPROVAL
X
USE SHADED AREA ONLY WHEN REGIStER IS INOPERATIVE.
A CHECK VISA M/0 'DISCOVER' TSC,qHARGE ACCOUNTNO. b, CHG. EX01-1, DATE,
J
.1
Li 13,
ITEM NUMBER NON DESCRIPTION UNIT PRICE
TAX
Form No. 99-00401 (12/08) 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 not attached inv oice(s) o r bill(
08/26/09 43100095891901C $70.96
1 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 NO. WARRANT NO.
ALLOWED 20
Tractor Supply
IN SUM OF
P. O. Box 9020
Des Moines, IA 50368 -9020
$70.96
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
[312 0z5 C1
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board MemberE
2201 13100095891901C 42- 321.00 $70.96 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
fidj 09, 2009
Street Com i ioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund