Approval of State Revolving Fund (SRF) Planning and Design Reimbursement #1 – Water Treatment Plant — E-7

Please remit to: MSA 1230 South Boulevard Baraboo, WI 53913 City of Tiffin PO Box 259 300 Railroad Street Tiffin, IA 52340 Invoice No: 000657 Invoice Date: 12/20/2023 Invoice Terms: Due upon receipt Project No: R13603007.00 Project Manager: Clint Wienen Client Liaison: Andrew Inhelder From August 13, 2023 To December 20, 2023 R13603007.00 Tiffin Water System Evaluation Progress detail <table> <tr> <th>Phase</th> <th>Percent Fee complete</th> <th>Previous billing</th> <th>Current billing</th> <th>Remaining contract</th> </tr> <tr> <td>Tiffin Water System Evaluation</td> <td>42,500.00<br>93.00%</td> <td>28,900.00</td> <td>10,625.00</td> <td>2,975.00</td> </tr> <tr> <td><b>Subtotal</b></td> <td>42,500.00</td> <td>28,900.00</td> <td>10,625.00</td> <td>2,975.00</td> </tr> <tr> <td colspan="3"><b>Invoice subtotal</b></td> <td>10,625.00</td> <td></td> </tr> <tr> <td colspan="3"><b>Total</b></td> <td>10,625.00</td> <td></td> </tr> </table> For ACH notification, remit to: [email protected] Account Number: 101065930 Routing Number: 075901590 Bank Information: ACH/Wire, Baraboo State Bank, 101 3rd Avenue Baraboo, WI 53913