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

INVOICE INVOICE DATE INVOICE NUMBER 07/07/2023 S102809125.001 ORDERED BY BRETT PAGE NO. REMIT TO: DAKOTA SUPPLY GROUP PO BOX 74007497 CHICAGO IL 60674-7497 1 of 1 TO VIEW AND PAY ONLINE GO TO: http://dsgsupply.com SHIP TO: City of Tiffin:Stock 201 Main Street Tiffin IA 52340 <table> <tr> <th>CUSTOMER NUMBER</th> <th>CUSTOMER PO NUMBER</th> <th>JOB NUMBER / RELEASE NUMBER</th> <th>SALESPERSON</th> </tr> <tr> <td>79809</td> <td>WATER</td> <td></td> <td>Dave Roster</td> </tr> <tr> <th>WRITER</th> <th>SHIP VIA</th> <th>TERMS</th> <th>SHIP DATE</th> <th>ORDER DATE</th> </tr> <tr> <td>Dave Roster</td> <td>SALESPERSON</td> <td>Net 30 Days</td> <td>07/07/2023</td> <td>06/09/2023</td> </tr> <tr> <th>ORDER QTY</th> <th>SHIP QTY</th> <th>DESCRIPTION</th> <th>UNIT PRICE</th> <th>EXT PRICE</th> </tr> <tr> <td>1ea</td> <td>1ea</td> <td>GEAR BOX F/ SYLAX BUTTERFLY VALVE (S3W10G)<br>* Item not returnable without RGA *<br>Pn: 574482</td> <td>235.000/E</td> <td>235.00</td> </tr> <tr> <td>26ea</td> <td>26ea</td> <td>TRUMB SINGLE CHAIN LOOP 367-1895 4/0 GALV<br>* Item not returnable without RGA *<br>Pn: 410765</td> <td>2.583/E</td> <td>67.15</td> </tr> <tr> <td>1ea</td> <td>1ea</td> <td>367-1995 CONNECTING LINK 4/0 CHAIN GALV TRUMBULL<br>* Item not returnable without RGA *<br>Pn: 468505</td> <td>9.237/E</td> <td>9.24</td> </tr> <tr> <td>1ea</td> <td>1ea</td> <td>367-1877 TR-2.5 TRUMBULL CHAIN WHEEL<br>* Item not returnable without RGA *<br>Pn: 565415</td> <td>134.293/E</td> <td>134.29</td> </tr> </table> ONLINE BILLPAY NOW AVAILABLE DSG has partnered with Billtrust to provide a new feature to help you view, print and download your invoices and statements. Online BillPay is easy to use, simple to navigate and is user-friendly. Access this tool through your DSGSupply.com account. ENROLL TODAY BY CONTACTING US AT: [email protected] or 1-833-374-2745 (all calls returned within 24 hours). Invoice is due by 08/06/23. Past Due invoices will be subject to 1.50% late charge. Thank you for your Business! <table> <tr> <th></th> <th></th> <th></th> </tr> <tr> <td>Subtotal</td> <td>$445.68</td> <td></td> </tr> <tr> <td>S&H Charges</td> <td>$0.00</td> <td></td> </tr> <tr> <td>Tax</td> <td>$0.00</td> <td></td> </tr> <tr> <td>Amount Due</td> <td>$445.68</td> <td></td> </tr> </table>