177802 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00350268 Page 1 of 1
ONE CIVIC SQUARE PEERLESS- MIDWEST, INC
CHECK AMOUNT: $2,447.00
CARMEL, INDIANA 46032 55860 RUSSELL INDUSTRIAL PARKWAY
'4 0„ i� MISHAWAKA IN 46545 CHECK NUMBER: 177802
CHECK DATE: 9/29/2009
DEPARTM ACCO PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION
601 J 5023990 W08962 27100 1,080.00 REPAIR WELL
601 5023990 W08962 27101 1,367.00 REPAIR WELL
'i3O2* Peerless Midwest Inc.
P 55860 Russell Industrial Parkway Mishawaka, Indiana 46545 574 254 -9050 Fax 574 254 -9650
Federal ID 35- 1284374
INVOICE NO. Vendor#
8135•
City of Carmel Utilities 27101
SOLD TO Accounts Payable TERMS- NET 30 DAYS. 1.5% SERVICE CHARGE (18% ANNUAL RATE) EACH
3450 W 131st St MONTH THEREAFTER. A lien will be filed for unpaid invoices after 45 days.
Westfield, IN 46074 Invoice Date Proi Mgr.
c
9/11/2009 TT H
S. O. No. Your Order No.
22946 Rob Lovell
Tax Exempt? Reason Tax Exempt
SHIP TO Yes FX No r—] Pol. Sub.
Labor Cost Material Cost Tax
Well 10 Shafting
Material
4) 1" x 10' Stainless Steel Shafts 752.00
2) 1" x 5' Stainless Steel Shafts 304.00
7) 1" Stainless Steel Couplings 124.00
5) 1" Stainless Steel Shaft Sleeves 187.00
Total Amount for Material------ 1,367.00
TOTAL AMOUNT OF THIS INVOICE------ 1,367.00
R rCETVED By k L 12C,
DATE
Po#
ACCT# oz
USE ->v 1 1 77-
WE APPRECIATE YOUR BUSINESS. THANK YOU!
We Accept American Express, Visa and MasterCard Call 574 254 -9050
FILE: 18513(B)
Peerless Midwest Inc.
55860 Russell Industrial Parkway Mishawaka, Indiana 46545 574 254 -9050 Fax 574 254 -9650
Federal ID 35- 1284374
INVOICE NO. Vendor#
8135
City of Carmel Utilities 27100
SOLD To Accounts Payable y TERIv1S- NET 30 DAYS. 1.5% SERVICE CHARGE (18% ANNUAL RATE) EACH
3450 W 131st St MONTH THEREAFTER. A lien will be fled for unpaid invoices after 45 days.
Westfield, IN 46074 Invoice Date Proj Mgr.
9/11/2009 TTH
S. O. No. Your Order No.
22946 Rob Lovell
Tax Exempt? Reason Tax Exempt
SHIP TO Yes FX No
Pol. Sub.
Labor Cost Material Cost Tax
Well 10
Labor and Equipment
V
Transported Shafting
Straightened Shafting
Installed Sleeves
Changed Sleeve
12 man hours $90.00 per hour
Total Amount for Labor and Equipment------ 1,080.00
TOTAL AMOUNT OF THIS INVOICE------ 1,080.00
RECEIVED BYX -1 L
DATE )0_�
PO#
USE j
WE APPRECIATE YOUR BUSINESS. THANK YOU!
We Accept American Express, Visa and MasterCard Call 574 254 -9050
FILE: 18513 (B)
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
ra
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
350268
PEERLESS MIDWEST, INC Purchase Order No.
55860 RUSSELL INDUSTRIAL PARKWA Terms
MISHAWAKA, IN 46545 Due Date 9/24/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/24/2009 27101 $1,367.00
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
tits G�
Date Officer
VOUCHER 093077 •WARRANT ALLOWED
IN SUM OF
PP- 350268
ERLESS- MIDWEST, INC
55860 RUSSELL INDUSTRIAL ftfi
MISHAWAKA, IN 46545
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
27101 01- 6200 -02., $1,367.00
Voucher Totala447 z 0
Cost distribution ledger classification if
claim paid under vehicle highway fund