216154 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00350268 Page 1 of 1
ONE CIVIC SQUARE PEERLESS-MIDWEST,INC
CARMEL, INDIANA 46032 55860 RUSSELL INDUSTRIAL PARKWAY CHECK AMOUNT: $5,400.00
MISHAWAKA IN 46545 CHECK NUMBER: 216154
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CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 35163 5, 400 . 00 6360 . 02
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55860 Russell Industrial Parkway/Mishawaka, Indiana 46545/574.254.9050/Fax 574.254.9650
Federal ID#35-1284374
8135 INVOICE NO. Vendor#
Carmel Utilities 35163
SOLD TO 0 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 fled for unpaid invoices after 45 days.
Carmel, IN 46074 Invoice Date Proj Mgr.
12/12/2012 TTH
S O. No. Your Order No.
25367 W09752
kloveall @carmel.in.gov Tax Exempt? Reason Tax Exempt
SHIP TO Yes FX No
� (Kerri Loveall) Pol. Sub.
Labor Cost Material Cost Tax
ANNUAL WELL & PUMP PERFORMANCE TESTING AND SERVICE
Tested and serviced sixteen (16) wells and pumps @ $150 each $ 2,400.00
Serviced two (2) wells and pumps (Well #27 & Well #28) @ $150 each 300.00
Serviced six (6) high service pumps (Plant 5) @ $150 each 900.00
Serviced six (6) transfer pumps (Plant 5) @ $150 each 900.00
Serviced one (1) ground storage pump @ $150 each 150.00
Serviced three (3) high service pumps (Plant 3) @ $150 each 450.00
Serviced two (2) regeneration pumps (Plant 5) @ $150 each 300.00
b9-7 , --,) TOTAL AMOUNT OF THIS INVOICE------------$ 5,400.00
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WE APPRECIATE YOUR BUSINESS. THANK YOU!
We accept Visa, MasterCard, and American Express. Call (574) 254-9050 for details.
We only accept credit cards within 30 days of invoice date.
FILE: Maintenance - __
VOUCHER # 123110 WARRANT # ALLOWED
IN SUM OF $
PEERLESS
19
P -4441
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
35163 01-6360-02 $5,400.00
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Voucher Total $5,400.00
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
355789
PEERLESS PUMP Purchase Order No.
P.O. BOX 644419 Terms
PITTSBURG, PA 15264-4441 Due Date 12/29/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/201: 35163 $5,400.00
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