HomeMy WebLinkAboutCHS Donation to LVFDLHI
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803 Highway 212, South 406-628-5200
P.O. Box 909 chsinc.com
Laurel, MT 59044-0909
June 7, 2019
Laurel Fire / EMS
Attention: Brent Peters, Fire Chief
215 West 15t Street
Laurel, MT. 59044
Dear Mr. Peters,
On behalf of CHS Laurel Refinery, Pipelines & Terminals attached is a
contribution in the amount of $10,000.00 in support of the Laurel Volunteer Fire
Department's efforts to purchase extrication tools. This is the first contribution towards
our commitment of $50,000.00 over a five-year period in support of this purchase.
We are pleased to support the Department's efforts in our community and wish
you continued success throughout the year.
We are also enclosing an Acknowledgement of Gift form for you to complete,
sign and return in the enclosed self-addressed stamped envelope.
Sincerely,
CHS PIPELINES, TERMINALS & REFINERY
Pat Kimmet
Refinery Manager
Enclosures
Farmer -owned with
global connections
LHS -
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Acknowledgement of a Gift of $250 or More
As required by Section 170 of the Internal Revenue Code
Donee organization:
Name of donor:
CHS Inc.
A. Amount of Cash Contribution
B. Description of Property Contribution:
C. Check one of following:
Date:
Address:
5500 Cenex Drive
Inver Grove Heights, MN 55077
0
5500 Cenex Drive
Inver Grove Heights, MN
55077
The donee organization provided no goods or services in consideration, in whole or in part,
for the donor's contribution.
The donee organization provided only tangible religious benefits to the donor in
consideration, in whole or in part, for the donor's contribution.
The donee organization provided goods and/or services to the donor in consideration, in
whole or in part, for the donor's contribution.
n of the goods and/or services provided:
The estimated value of these goods or services:
THE AMOUNT OF THE CONTRIBUTION THAT IS DEDUCTIBLE FOR FEDERAL INCOME TAX PURPOSES IS
THE EXCESS OF THE AMOUNT CONTRIBUTED OVER THE VALUE OF THE GOODS OR SERVICES PROVIDED
BY THE DONEE ORGANIZATION.
Signature
Please complete and remit to:
CHS Inc.
Val Bruce
PO Box 909
Laurel, MT 59044
Or Val.Bruce@chsinc.com
P.O. Box 64089, St. Paul, MN 55164-0089
VENDOR NAME: LAUREL VOLUNTARY FIRE DEPARTMENT
VENDOR 640344
CHECK 10210690
DATE 6/6/2019
INVOICE
DESCRIPTION
i DATE
AMOUNT
LRLEMS-06-19
19 CONTR. EXTRICATION
06/04/2019
10,000.00
REMITTANCE ADVICE
MI =ACC MMC Al U O=C = MMn^I MIKI1
CHECK NO.
CHECK DATE
CHECK TOTAL
10210690
6/6/2019
$10,000.00
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND - NOT A WHITE BACKGROUND
Wells Fargo Bank, N.A. BDATE CHECK NO.
LHI
1021 6/6/2019 10210690
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P.O. Box 64089, St. Paul, MN 551:64-0089
PAY THIS -AMOUNT
TEN THOUSAND AND 001100" .................��.....,..,,,,,.,y.........*,., $"*•1�i,000.D0•}.
PAY TO THE ORDER OF:
LAUREL VOLUNTARY FIRE DEPARTMENT
215 W 1ST ST I
J- '/
LAUREL MT 59044 �V-�✓��
THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW