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PLEASE <br />>> <br />Please remit To: <br />Invoice No: <br />American Electric Power <br />DETACH <br />>> <br />I&M CIAC - IMPC 20 <br />Company No: <br />PO Box 60 <br />Contract No: <br />STUB <br />>> <br />Fort Wayne, IN 46801-2604 <br />Customer No: <br />Date: <br />AND <br />» <br />Amount Due: <br />Bill To: <br />City of South Bend Waste Water <br />Treatment <br />RETURN <br />>> <br />3113 Riverside Drive <br />WITH <br />>> <br />South Bend, IN 46628 <br />Amount Remitted: <br />PAYMENT <br />Contract No: DWMS00000489784 <br />Date: 7/l/2020 <br />PRO FORMA <br />170 <br />DWMS00000489784 <br />11059676 <br />7/l/2020 <br />25,792.09 <br />Invoice No: <br />Customer No: 11059676 <br />Work Request #: 71366405 <br />Description Quantity UOM Init Amt Net Amount <br />Provide upgraded service to Re -Use 1.0 EA 25,792.09 25,792.09 <br />Building as part of Waste Water <br />Treatment Plant's Improvement <br />Project. <br />Amount Due <br />25,792.09 <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 number <br />prior to attempting payment: Phone # 260-408-3594 <br />a. ACH/Wire Transfer - Send Funds toffndiana 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.aepmiscreceivables.com <br />*** No work will be scheduled until payment has cleared *** <br />** Contact CIAC clerk with any billing related questions ** <br />