177874 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 306840 Page 1 of 1
ONE CIVIC SQUARE TRACTOR SUPPLY CO
0 CHECK AMOUNT: $199.98
CARMEE_, INDIANA 46032 Po eox 6e9020
*ti;• ok DES MOINES JA 50368 -9020 CHECK NUMBER: 177874
CHECK DATE: 912912009
DEPARTMENT ACCOUNT PO NUMB IN NUM BER AMOU D ESCRIPTION
601 5023990 UTILITIES 199.98 6035301200182572
page t of 2 TX 7 D 1 30000000
i
VFS ��V
BUSINESS ACCOUNT
r
AGCO UNT$UMII�ARY
f 03412?
Previous Balance 54.99 Closing Date 09/18/09
Payments 54.99 Next Closing Date 10/20/09 CARMEL UTILITIES
Credits 0.00 Payment Due Date 10/13/09 ACCOUNTS PAYABLE
Purchases 199.98 3450 W 131ST ST
Debits 0.00 Current Due 199.98 WESTFIELD, IN 46074 -8267
FINANCE CHARGES 0.00 Past Due Amount 0.00 Credit Line 750
Late Fees 0.00 Minimum Payment Due 199.98 Credit Available 550
New Balance 199.98
CURRENT ACTIVITY
Transaction uLacatiant �g
Amount
AUG 24 GOODS AND SERVICES WESTFIELD IN 99.99
TOTAL 6035301200201083 $99.99
AUG 28 GOODS AND SERVICES WESTFIELD IN 99.99
TOTAL 6035301202905657 $99.99
PAYMENTS, CREDITS, FEES, and ADJUSTMENTS
AUG 20 PAYMENT REF P9194007809NEDAKL 54.99
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 all �rg PERCENTAGE Subject to Periodic Bilking PERCENTAGE
Finance Charge Rate Penod RATE Finance Charge Rate Period RATE
REGULAR REVOLVE CREDIT PLAN 0.00 .00000 so 0.00 0.00 .00000 29 0.00
This Account Issued by Citibank (South Dakota), N.A. CUSTOMER SERVICE 1 -8UC- 559 -8232, FAX NUMBER .1 '861'729'7425
I I.............................................................................................
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
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 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 clay.
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 10106
902TV5741006 PCT
803
Remit To: Bill To: page 2 or 2
TRACTOR SUPPLY CREDIT PLAN ACCOUNT: 6035301200182572 ®SU .YCO
aEPT.30.- 1200182572 SEAN WHITLOW
PO BOX 689020 130 1 ST AVE SW BUSINESS ACCOUNT
DES MOINES IA 50368 -9020
Payment Due Date: 10/13/09 Please make checks payable to TRACTOR SUPPLY CREDIT PLAN
SHIP TO: INVOICE: SHIP To: INVOICE:
431000958550010 431000959409010
Purchase Order:
KR828
AMOUNT DUE: 99.99 AMOUNT DUE: 99.99
Store: 574000431 INVOICE DATE: 08/24 /09 Store: 574000431 INVOICE DATE: 08/28 /09
BOOT LTHR STOE 15M TL67 7342398 1.00 99.99 99.99 BOOT LTHR STOE 10.5M TL 7342356 1.00 99.99 99.99
SUBTOTAL 99.99 SUBTOTAL 99.99
TAX 0.00 TAX 0.00
SHIPPING 0.00 SHIPPING 0.00
TOTAL 99.99 TOTAL 99.99
Please Direct Inquiries to: Phone; 800 -559 -8232 Fax; 801- 779 -7425
REMIT TSC BUSINESS ACCOUNT
PAYMENTS ONLY TO:
TRACTOR SUPPLY COMPANY SopP.ty Eons vny
SUMYCOM P.O. Box 689020 18160 U.S. 31 North
IA 50368 ielrt, Iry 46074
Des Moines, 1A 867 -3305
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
6035 301# CARNEL UTII_ITICS
3450 W 131ST S T
NAME UESIFTELG IN 4607 8267
(317) 7s3 2855
ADDRESS
431 786000104 2 9SE550
CITY STATE ZIP PHONE 00/24/2009 02:12?m
7342398 BOOT LT14R 5TOE 13h T
CUSTOMER TO COMPLETE 1.00 a 99.99 99.99 NIT
utility
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: Subtotal 99,99
The undersigned certifies The undersigned party certifies their exemption from 7.00% Tax 0100
compliance with the agricultural payment of sales and use tax on tangible personal Total 9?.99
sales tax exemption law of the'state property as indicated below and /or purchaser is TSC Card 99.99
indicated below and understands engaged in the business of agricultural production of Acct4:$$rt$$
and agrees with the General food or fiber, horticulture, aquaculture of floriculture for Autho 024129 Ref o 2413121707
Exemption Statement at right and resale and /or uses the farm machinery, equipment or Chanse 0.00
the applicable statement of the other agricultural production items purchased free of Cash Back
respective state printed on the tax, as defined by state law, and as indicated below.
reverse side of this form. Buyer acknowledses the receipt of a come 1
PRODUCT I5 TO BE USED IN THE FOLLOWING The undersigned party. further certifies theyi.d
STATE: understand they may be liable for payment of all taxes crup of this 5ale,3 slip and the vvrCiz
(REQUIRED) due on the purchase price for the goods as allowed b�
Exceptions: Georgia, New York &Kentucky state law should such goods be used or consumed in t5e described merchandise shall lie in
COMPLETE REVERSE SIDE) a taxable manner as defined by state laws. a c cordafice With th Ca Asreeraen
PURCHASER IS ENGAGED IN:(REQUIRED)
Resale Under penalty of perjury, signee swears the
Government information on this statement is'true and correct, in sisnaturls
Exempt organization every material manner. A willfully false representation
Agricultural Production of exemption will cause the purchaser to be subject to
P ion
Lives
Livestock Production penalty and /or other provisions as allowed under state
IaW
FloricullurelAquacultureProduction $88888.3$$ $8$$28$$$ #8888$3$t$8$$t'ti$E
Other. 8$ 88$ E '8888888888t38838888F8$$i8x883$
ITEMS PURCHASED WILL BE USED FOR :(REQUIRED) Call 800-968-0734 Ui'thin 7 days to
complete a Survey and be entered in a
Farm Machinery /Repair Parts' Government Agency (Entity
monthly drawing for a chance to wiii a
Livestock Iniestibles or lniestibles Exempt Organization (Entity 1 $2500 shoppins Spree.
FertilizerlAgrichemicals NC: only DOT and US Government are exempt (Awarded as Gift Card) NO PURCHASE
Consumed in Production (KS) Resale (Sales Tax Permit OR SURVa$$xa8$$aa$3$a$s$$$$$$$$a$$$aEY NECESSARY. Ends 9130109.
x$ sa3 aa
Ingredient or Component Parts (KS)
Other: Enter Store 0431
CUSTOMER SIGN ATUREc EOU MGR. APPROVAL
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CASH CHECK VISA MIG DISGOVER ;TSC CHARGE ACCOUNT NQ b R ✓HG y t EXCH "K i t �z DATEr
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REMIT TS 18,60 U'IS. "0 North,
PAYMENTS ONLYTO: I4 0 d DN
TIMTOR TRACTOR SUPPLY COMPANY `317)
P.O. Box 689020 C.
sumyc D Moines,
IA 50368 _4'S 1
TSC TEAM MEMBER TO COMPLETE Please include 16 Digit Account Number
(6035 301
NAME 431 4_3100.rii'72 2 ?5941"19
08/2 I 1 4 i
ADDRESS
99, 91, 9?-99 NT
CITY- ST ATE ZIP PHONE W i I i
Ski h to a!
CUSTOMER TO COMPLETE 7 14 'i a v
0.
'r a t o 1 9 9. ;19
CERTIFICATE OF EXEMPTION: GENERAL EXEMPTION STATEMENT: TSC !Card ?9,99
The undersigned certifies The undersigned party certifies their exemption from
ktho:r' ?8319 R•_ +:«:213
I' w ith the agricultural payment of sales and use tax on tangible personal
com' an ce
sales tax exemption law of the state property as indicated below and/or p ChZ1jJ5 0
urchaser Is U 6: kv B20
Jindicate,d below and understands engaged in the business of agricultural production of it, Back %Fv
I
and ag with the General food or fiber, horticulture, aquacultu.re of floriculture for Ca
Exemption Statement at right and resale and/or uses the farm machinqry, equipment or
the applicable statement of the B
other agricultural production items purchased free of ed A F acknuwled -Be5 the reccirt Qt a
respective state printed on the tax, as defined by state law, and as indicated below. LOPY Of sal slit,
reverse side of this form, tnd the 111U'Lhit5(1
PRODUCT IS TO BE USED IN THE FOLLOWING The undersigned party further certifies they the described iierchatidi5e shall 64-
STATE: understand they may be liable for payment of all taxes 11ccordance with JhF_ Cardholder
(REWIRED) 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 manne r as defined by state laws.
PURCHASER IS ENGAGED IN:(REOUIRED)
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 representation
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
Floriculture/Aquacultbre Production law. Call 800 within 7 days to
F Other: comi a 5urve anti be entei in a
monthly dra�lins for a chance to win a
ITEMS PURCHASED WILLBE USED FOR:(REQUIRFD) $2500 ;horpiiis 5t-ree,
Farm Machinery/Repair Parts E] Government Agency (Entity 1 (Awarded as Gift Card) NO PURCH E
Livestock Injestibles or Iniectibles C3 Exempt Organization (Entity 1 OR CURVEY NLCESSARY, Eiids 9/30/09
Fertilizer/Agrichemicals NC: only DOT an d US Government are exempt
Consumed in Production (KS) Resale (Sales Tax Permit
4 RECEIVED DYL&=
F (ngredient.or Component Parts (KS) fl. TF
I)A
F Other:
PO#
ACCT#
CUS16AtR;SI!IT: R UIRE MGR. APPROVAL
US IEQ
X
DISCOVER TSCCHARGEACCOt1NTN0+ :m CHG 'CASH
mic
Form No. 99-00401(12JOB) 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 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 9/24/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/24/2009 4310009585`. $99.99
U
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 Officer
VOUCHER 093084 WARRANT ALLOWED
306840 IN SUM OF
TRACTOR SUPPLY CO
P.O. Box 689020s
Des Moines, IA 50368 -9020
ERR
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
43100095855 01- 6200 -06 $99.99
Voucher Total i1 q 9, 9
L
Cost distribution ledger classification if
claim paid under vehicle highway fund