225507 10/23/2013 ° .F 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: $2,374.00
?� MISHAWAKA IN 46545
CHECK NUMBER: 225507
CHECK DATE: 10/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350100 36211 37533 2 , 374 . 00 FLOWING WELL REPAIRS
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55860 Russell Industrial Parkway/Mishawaka, Indiana 45545/574.254.9050/Fax 574.254.9650
Federal ID#35-1284374
8130 INVOICE NO. Vendor#
Carmel Clay Parks& Recreation 37533
Accounts Payable
SOLD TO 1411 E. 116th St. TERMS- NET 30 DAYS. 1.5%SERVICE CHARGE(18%ANNUAL RATE)EACH
Carmel, IN 46032 MONTH THEREAFTER.A Lien will be filed for unpaid invoices after 45 days.
Invoice Date Proj Mgr.
9/30/2013 TTH
S. O. No. Your Order No.
26965 36211
Please Email Invoices to: Tax Exempt? Reason Tax Exempt
SHIP TO dkoe er carmelcla arks.com Yes � No
PP @ YP Certificate on File
Labor Cost Material Cost Tax
FLOWING WELL
Troubleshoot Problem with Flowing Well; video inspect well; X
Collect bacteriological sample
OCT 0 4 2013
Labor and Equipment
BY:
9/9 Inspected;
(2) Crew hours at $200 per hours $ 400.00
9/25 Pulled pump; tried to fish line into well; set pump
(6) Crew hours at $200 per hour 1,200.00
Total for Labor and Equipment------ $ 1,600.00
Color Video Inspection of Well 750.00
Material
(4) 1/2" Chrome sample cocks at $6 each
' I I Total for Material------ $ 24.00
u,chas-3 —1owLn'
a c i J,en
.L.# I Q5-9-0-1 Q 5c_1 QCD TOTAL AMOUNT FOR THIS INVOICE------------ $ 2,374.00
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_inn Llescr
'urchaser Date
A.,_p ✓al. Date
WE APPRECIATE YOUR BUSINESS. THANK YOU
We Accept American Express, Visa and MasterCard. Call 574/254-9050 for details.
We only accept credit cards within 30 days of invoice date.
FILE: 26965 (O & B)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Peerless Midwest Inc. Terms
55860 Russell Industrial Parkway
Mishawaka, IN 46545
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/30/13 37533 Flowing Well repairs 36211 $ 2,374.00
Total $ 2,374.00
1 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.
Peerless Midwest Inc. Allowed 20
55860 Russell Industrial Parkway
Mishawaka, IN 46545
In Sum of$
$ 2,374.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#[TITL AMOUNT Board Members
Dept#
36211 37533 4350100 $ 2,374.00 1 hereby certify that the attached invoice(s), or
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
17-Oct 2013
Signature
$ 2,374.00 Accounts Payable Coordinator
Cost distribution ledger classification ifr Title
claim paid motor vehicle highway fund