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PLEASE <br />>> <br />Please remit To: <br />Invoice No: <br />` <br />American Electric Power <br />DETACH <br />>> <br />I&M CIAC - IMPC 25 <br />Company No: <br />STUB <br />)> <br />PO Box 60 <br />Contract No: <br />Fort Wayne, IN 46801-2604 <br />Customer No: <br />ARID <br />>> <br />Amount Due: <br />Bill <br />Bill To: <br />RETURN <br />>> <br />CITY OF SOUTH BEND <br />731 S. LAFAYETTE ST. <br />WITH <br />>> <br />South Bend, IN 46601 <br />Amount Remitted: <br />PAYMENT <br />>> <br />Contract No: DWMS00000438736 <br />Date: 9/27/2018 <br />170 <br />DWMS00000438736 <br />11076181 <br />9/27/2018 <br />17,232.64 <br />Invoice No: <br />Customer No: 11076181 <br />Work Request #: 70049782 <br />Description Quantity UOM Init Amt Net Amount <br />Convert existing 277/480v 3Ph 1.0 EA 17,232.64 1-1,232.64 <br />Service to a 120/208v 1Ph (200amp) <br />Service for Customer <br />owned/maintained Street Lights. <br />Amount Due: 17,232.64 <br />Payment Options: <br />1. Check: Send payment and top section of this Pro -Forma to the address shown above. <br />2. For ACH/Wire Transfer or Credit card payments, contact CIAC clerk to obtain an invoice <br />number prior to attempting payment: Phone # 260-408-3594 <br />a. ACH/Wire 'Transfer - Send Funds to: Sndiana Michigan Power <br />Citibank, N.A. New York <br />ABA/Routing #: 021000089 <br />Account #: 00034403 <br />b. Credit Card: <br />i. Visa, Mastercard or Discover only <br />ii. Transactions are limited to $1,500.00 per card per transaction <br />iii. Contact FiSery directly after receiving your invoice number from CIAC clerk <br />866-270-'7946 or www.aepTA,creceivables.com <br />*}* No work will be scheduled until payment has cleared *** <br />** Contact CIAC clerk with any billing related questions ** <br />