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HomeMy WebLinkAbout228543 1 /28/2014 CITY OF CARMEL, INDIANA VENDOR: 00353214 Page 1 of 1 ONE CIVIC SQUARE DAN GRESKAMP CHECK AMOUNT: $119.99 CARMEL, INDIANA 46032 CIO ENGINEERING CIO ENGINEERING CHECK NUMBER: 228543 CHECK DATE: 1/28/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4467099 119 . 99 OTHER EQUIPMENT ®TRACTOR SU YC® TractorSupply.com UT 2375 EAST PLEASANT ST_ RT. NOBLESVILLE, IN 46060 317-776-1883 Ticket: 341777 gate: 1/16/14 Time: 6:49 PM Store: 624 Register: 2 Cashier: 00243135 Customer: Diana Cordray Phone #: 3175712418 Company: City Of Carmel Building Department Item Qty Price Amount BOOT 9M 6IN STOE DO WW63 7724540 1 119.99 119.99 E Subtotal 119.99 Tax 0.00 Total 119.99 ---------------------------------------- 119.99 Ruth #:016336 ------------------------- ------------------ Change 0.00 I agree to pay the above amount according to my card issuer agreement. Tax Exempt Information Ilame: Diana Cordray Address: One Civic Square City/St: Carmel, IN Zip Code: 46032 Phone: 317-571-2418 Tax Exempt Reason: Government Agencies Expiration'Date: rax Exempt Holder: Diana Cordray Under penalty of perjury, signee declares 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 .m der state law. ` I chis 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 declared that you legally have a right to purchase the Above items exempt from sales and use tax For the reason indicated as defined by this State's laws and regulations. Go to TractorSupplySurveg.com or Call 1-877-789-1443 within 7 days to complete a survey and be entered in a monthly drawins for a chance to win a $2500 shoppins spree. (Awarded as Gift Cards) Ends 12/31/2014 For complete details or to participate without purchase or survey, so to TractorSuppis.com/customersurvey Enter Store #: 0624 Enter Reference #: 02341777 SOLD ITEM COUNT = 1 VIII IIII II IIIIII IIII II II I I I I T1X141PGKC4AMFXK Please call 877-872-7721 for Customer Service. Sign up now for ads, news, and more at TractorSupplg.com Customer Copy Tract®rSupplyoc®m D D O Tract®rSupplyoc®m Tract®rSupplyoc®m D 0 Q Trac$®rSupplyoc®m wlffx@nm D D Q OTMIN(99 Trac$®rSupplyoc®m Iff mom �j o o QO OTM,9 @© Tract®rSupplyecom wlffmmm OTM19@9 Tract®rSupplyocom 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 Dan Greskamp Purchase Order No. Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 1/0/1900 0 Construction Boots $ 119.99 Total $ 119.99 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. ,20 Clerk-Treasurer VOUCHER NC WARRANT NO. Dan Greskamp ALLOWED 20 IN SUM OF$ $ 119.99 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or DEPT# INVOICE NO. ACCT#/TITLE. AMOUNT I hereby certify that the attached invoice(s), 0 0 2200-4467099 $ 119.99 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 1/27/2014 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund