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2004 II Department of Finance and Administration Office of City Clerk 300 West Ash Street, Suite 206 . P.O. Box 736 Salina, KS 67402-0736 Rodney Franz, Finance Director' Lieu Ann Elsey, City Clerk Telephone (785) 309-5735 . Fax (785) 309-5738 , Salina Thursday, November 13, 2003 PLEASE RETURN YELLOW COPY WITH PAYMENT Michael Ross Ross Truck Lines P.O. Box 2803 Salina, KS 67401-2803 081-11-0-30-02-005 1345 W. Old Highway 40 "'_11_"-' '_1'_"_"_1'__ '_1' _1'_ .._. 1_1'_ "_1'_'1- .._.._ .._.._ "_"_'1 _.._ "_"_1'_"-"-"_"_1'_1'- ..- ..- ..-. STATEMENT FOR 2004 RURAL FIRE CONTRACT January 1, 2004 through December 31, 2004 CateQorv ~ Percent Value Mill Levv Amount Land Commercial 25.0% X $27,160.00 X 0.017598 = $119.49 Buildings Commercial 25.0% X $83,520.00 X 0.017598 = $367.45 Property Commercial 100.0% X $4,015.00 X 0.017598 = $70.66 Amount Due: $557.59 Please make check payable to City of Salina and remit to prior to December 31. City of Salina Attn: City Clerk's Office P.O. Box 736 Salina, KS 67402-0736 -------------------------------------- FOR OFFICIAL USE ONLY Amount Paid: f:I01,eo Receipt No.: lvLf'?hO Received Byi..'J 1 \l~ Date Received:~ 1. ,,/2{) ./2 {)().:s City of Salina P.o. Box 736 Salina, Kansas 67402-0736 RECEIPT NO. .;S 4 :~:::5 () :--1. ,~. .' .i DESCRIPTION AMOUNT FIRE PROTE 081-11-0-30-02-005 l345 WOLD HWV 40 ::=:;5'7 !I 59 1 ()(),o-()()(i 4l=-,(':-t" ()()(; CHELl': 6287 RECEIVED FROM: r_-:"' t:- "~J c:- ro-. ....' .~,.i _,. n '....1 .~::- ROSS TRUCK LINE. INC. OR! C,: ~L; L. tI:L:E r"l TOT{1L. F'Pd D t::-r::soo" c::-r-, .... .._.i .... .. "._,; 'OJ