HomeMy WebLinkAbout230025 03/12/14 C,q.
*F CITY OF CARMEL, INDIANA VENDOR: 366179
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ONE CIVIC SQUARE LIBERTY MUTUAL INSURANCE CO CHECK AMOUNT: $ .....100.00*
CARMEL, INDIANA 46032 25761 NETWORK PLACE CHECK NUMBER: 230025
CHICAGO IL 60673-1257 CHECK DATE: 03/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
801 4347500 601001685 100.00 GENERAL INSURANCE
Someday is Today,LLC
I rbcst�,�l�i�u�l. 7116 E 71ST ST
INDIANAPOLIS,IN 46256-1997
Liberty Mutual Surety Bond Invoice
1465 1 MB 0.432 P:1465 / T:7 / S1 :1 / S2:0 Statement Date: 02/20/2014
1'II�����"I'��IIII�III�IIII��sll�f�llfl�l'�'�'��If��l�lf f'll�l11 Premium: 100.00
MILLER ADAM C Applicable Taxes: 0.00
CITY U CARMEL POLICE DEPARTMENT pp
3 CIVIC SQ Applicable Fees: 0.00
CARMEL IN 46032-2584
Amount Due: 100.00
Payment Due Date: 4/06/2014
Ntake checks payable to: Liberty Ntutual
BondNumbe_r.; 601001685
Your Liberty Mutual Surety Bond Activity Summary
Effective Date: 5/18/2014
Bond Description: Renewal -New Bond Official
Police Pension Secretary
Obligee: Carmel Police Department
Issuing Company: Ohio Casualty Insurance Company
Billing is automatic until the bond is cancelled. If your bond is no longer needed or required, please notify your agent
for cancellation.Thank you!
For billing questions or to pay by credit card,please call the Liberty 1\,tutual Surety Billuzg Center at 1-800-773-3312
PLEASE DO NOT SEND ANY CORRESPONDENCE WITH YOUR PAYMENT;
THIS MAY DELAY THE PROCESSING OF YOUR PAYMENT.
Help Us To Serve You Better:
Please remember to include the bottom portion of this invoice with your payment. This will assist us in properly
crediting your account.
Please do not send any correspondence with your remittaunce;this nuy delay the processing of your payment.
In addition,please assist us by indicating your bond number on your check,making check payable to
Liberty Mutual,and using the return envelope provided for your convenience.
Premium: Total amount due after applying all payments, credits, or additional charges since
the last billung.
Applicable Taxes W"here applicable, these fees are assessed by your state and local government and
&Fees: are sent from Liberty Mutual to the appropriate govermnent agency. V/here
applicable, these fees are assessed by your agent and sent from Liberty Mutual to
your agent of record.
Mailing Instructions: Please mail at least fifieeu days prior to the payment clue date.
Pavments not received in a tunely manner are subject to cancellation
Credit Card Payments:
)'on can pay this uavoice by using your Visak AlastercardLR), or American ExpresstD card. To pay by credit card,
please call our billing center at 1-800-773-3313.
Billing Questions or Issues: Libertv itMutual
1333 IM in Street,Suite 600
Columbia,SC 29201
1-800-773-3512
Please Note: To dispute the premium amount owed, please send a written notification to the address shown
above. This vvntten notification must be received prior to the payment due date. The folio-,«ng information
should be included: 1) Naine appearing on bond 2) Pond number 3) Any supporting documentation which may
offer further explanation of the unount in dispute
Upon receipt of the written notification vve «ill suspend billing of the :unount in question until a resolution to
your dispute can be made. Hovvever, you wihl still be required to pav in full the undisputed aunount by the
payment clue date shown on this billing notice.
Bond Questions or Issues: Contact your local agent. (See activity summary for agent contact nafomnation.)
Address Changes:
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
\ZS Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
Com.�. cao
\L- 2-51
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
SG7 kQ50.iZj0 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
bo 20
Signature ,
Cost distribution ledger classification if Titl
claim paid motor vehicle highway fund