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CITY OF CARMEL, INDIANA VENDOR: 00350268 Page 1 of 1
0 ONE CIVIC SQUARE PEERLESS- MIDWEST, INC CHECK AMOUNT: $1,050.00
CARMEL, INDIANA 46032 55860 RUSSELL INDUSTRIAL PARKWAY
MISHAWAKA IN 46545 CHECK NUMBER: 155464
CHECK DATE: 1/10/2008
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 22900 1,050.00 REPAIR PARTS
i
t Peerless Midwest Inc.
55860 Russell Industrial Parkway Mishawaka, Indiana 46545 574 254 -9050 Fax 574 254 -9650
Federal ID 35- 1284374
21099 INVOICE NO. Vendor#
City of Carmel Street Department 22900
SOLD TO Accounts Payable TERMS- NET 30 DAYS, 1.5% SERVICE CHARGE (18% ANNUAL RATE) EACH
3400 W 131 st St MONTH THEREAFTER
Westfield, IN 46074 Invoice Date Proj Mgr.
12/17/2007 TTH
S. O. No. Your Order No.
21911 Jason Force
Tax Exempt? Reason Tax Exempt
SHIP TO Fountain Pump #2 Yes 0 No F
Pol. Sub.
Labor Cost Material Cost Tax
Pull pump and install back -up pump. Disassemble and inspect old pump.
Labor and Equipmen
10/26/2007 Pull old pump and install new pump 600.00
Disassemble and inspect pump and motor 450.00
TOTAL AMOUNT OF THIS INVOICE 1,050.00
FILE: 19932 (B)
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
\khom, 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 note attached invoice(s) or bill(s))
Total
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 NO. WARRANT NO.
1^^ ALLOWED 20
IN SUM OF
I KJ 4 g) 5
11050, 00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
G 00 3 �1 C 05C, 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
JAN 0 7 9-995 20
OA
Sign t re
z t CM M I lam( 0
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund