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

INVOICE Remit To: 1106 Shaver Road NE Cedar Rapids, IA 52402 Phone: 319-365-9421 Toll Free: 800-728-9421 SCHIMBERG CO. Order Date | Invoice Date | Invoice # 05/03/2023 | 05/05/2023 | 8283828-00 Outside Rep | PO # | WATER SCOTT MCMURRIN | WATER Placed By | Taken By | BRETT | CORY BECKER Bill To TIFFIN CITY CLERK OFFICE PO BOX 259 TIFFIN, IA 52340 US Ship To TIFFIN CITY SHOP 201 RAILROAD ST TIFFIN, IA 52340 US Notes PHONE: (319) 545-2572 EMAIL: [email protected] Terms | Ship Point | Ship Via | Shipped Date | Tax Jurisdiction NET 30 DAYS | SCHIMBERG CEDAR RAPIDS | PICK UP | 05/03/2023 | US,IA, LINN L <table> <tr> <th>Line #</th> <th>Product And Description</th> <th>Quantity Ordered</th> <th>Quantity Shipped</th> <th>Quantity B/O</th> <th>PQty UM</th> <th>Unit Price</th> <th>Extended Price</th> </tr> <tr> <td>1</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>2</td> <td>94820211600<br>ROMAC 202N TAP SAD 16WM/IPX1CC<br>202N-17.40-18.90X1CC</td> <td>1.0</td> <td>1.0</td> <td>0.0</td> <td>EA</td> <td>260.99</td> <td>260.99</td> </tr> <tr> <td>4</td> <td>94547110114<br>AY 747011 LF RED BUSH 1CCX3/4CC</td> <td>1.0</td> <td>1.0</td> <td>0.0</td> <td>EA</td> <td>20.61</td> <td>20.61</td> </tr> <tr> <td>3 Lines Total</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td>TOTAL</td> <td>281.60</td> </tr> <tr> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td>INVOICE TOTAL</td> <td>281.60</td> </tr> </table> SALES PERSON CONTACT INFORMATION CORY BECKER [email protected] RECEIVED MAY 08 2023 By [signature] Product Warranty: Published warranty of manufacturer only, no other warranty or liability assumed by this supplier. ALL ACCOUNTS ARE SUBJECT TO A FINANCE CHARGE OF 1 1/2% PER MONTH, OR 18% PER ANNUM, WHEN 30 DAYS OR MORE PAST DUE. MINIMUM FINANCE CHARGE OF $.50 PER MONTH.