215138 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 00350268 Page 1 of 1
0 ONE CIVIC SQUARE PEERLESS-MIDWEST,INC
CARMEL, INDIANA 46032 55860 RUSSELL INDUSTRIAL PARKWAY CHECK AMOUNT: $3,276.00
MISHAWAKA IN 46545 CHECK NUMBER: 215138
CHECK DATE: 12/412012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 34655 3 , 276 . 00 OTHER EXPENSES
K RUM
MIDWESTE."
55860 Russell Industrial Parkway/Mishawaka, Indiana 46545 1574.254.905()/Fax 574.254.9650
Federal ID#35-1284374
8135
INVOICE NO. Vendor#
Carmel Water Department 34655
SOLD TO 14 ATTN: Accounts Payable TERMS- NET 30 DAYS. 1.5%SERVICE CHARGE(18%ANNUAL RATE)EACH
3450 W 131 st Street MONTH THEREAFTER.A lien will be filed for unpaid invoices after 45 days.
Carmel, IN 46074 Invoice Date Proj Mgr.
10/11/2012 TTH
S. O. No. Your Order No.
26058 W09747
Tax Exempt? Reason Tax Exempt
SHIP TO 14 kloveall @carmel.in.gov Yes QX No
Pol. Sub.
(Kerri Loveall) Labor Cost Material Cost Tax
WATER PLANT 4; HIGH SERVICE PUMP 1
Material
(1) 75 HP, US Motor
Catalog No. D75E1 ES Lf"-7
Model No. H630 W b
Total Amount for Material------As Quoted------------$ 2,946.00
3
DO Freight------------$ ' 330.00
TOTAL AMOUNT OF THIS INVOICE------------$ 3,276.00
WE APPRECIATE YOUR BUSINESS. THANK YOU !
We Accept American Express, Visa and MasterCard. Call 574/254-9050 for details.
FILE: 26058(B) -
VOUCHER # 122823 WARRANT # ALLOWED
350268 IN SUM OF $
PEERLESS-MIDWEST, INC
55860 RUSSELL INDUSTRIAL PARKW)
MISHAWAKA, IN 46545
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
34655 XDepciaticon 0 $2,946.00
34655 $330.00
on J
Voucher Total $3,276.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 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 11/27/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/27/201: 34655 $3,276.00
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
Date Officer