HomeMy WebLinkAbout242781 03/03/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 366179
ONE CIVIC SQUARE LIBERTY MUTUAL INSURANCE CO CHECKAMOUNT: $*******100.00*
CARMEL, INDIANA 46032 25761 NETWORK PLACE CHECK NUMBER: 242781
CHICAGO IL 60673-1257 CHECK DATE: 03/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
801 4347500 100.00 GENERAL INSURANCE
Someday is Today,LLC
Liberty lltlyd '7116 E 71ST ST
� Y µ. INDIANAPOLIS,IN 46256-1997
Liberty Mutual Surety Bond Invoice
2556 1 MB 0.432 P:2556 / T:11 / S:1 Statement Date: 02/20/2015
Premium: 100.00-
xY MILLER ADAM C Applicable Taxes: 0.00
{ CITY U CARMEL POLICE DEPARTMENT
3 CIVIC SQ Applicable Fees. 0.00
CARMEL IN 46032-2584 Amount Due: 100.00
Payment Due Date: 4/06/2015
Make checks payable to: Liberty Mutual
Bond Number: 601001685
Your Liberty Mutual Surety Bond Activity Summary
Effective Date: 5/18/2015
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 bill'ng questions or to a b credit card lease call the Liberty Mutual Sure Billie Center at 1-800-773-3312
g q pay Y �P �Y Surety g
PLEASE DO NOT SEND ANY CORRESPONDENCE WITH YOUR PAYMENT;
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'VUIQ MAV nIPT AV TT-TF PRni FCCTNr OF VOTTR 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 remittance;this may 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 billing.
Applicable Taxes Where applicable, these fees are assessed by your state and local government and
&Fees: are sent from Liberty Mutual to the appropriate government agency. Where
applicable, these fees are assessed by your agent and sent from Liberty Mutual to
your agent of record.
Mailing Instructions: Please mail at least fifteen days prior to the payment due date.
Payments not received in a timely manner are subject to cancellation
Credit Card Payments:
You can pay this invoice by using your Visas, Mastercard®, or American Express® card. To pay by credit card,
please call our billing center at 1-800-773-3312.
Billing Questions or Issues: Liberty Mutual
1333 Main Street,Suite 600
Columbia,SC 29201
1-800-773-3312
Please Note: To dispute the premium amount owed, please send a written notification to the address shown
above. This written notification must be received prior to the payment due date. The following information
should be included: 1) Name appearing on bond 2) Bond number 3) Any supporting documentation which may
offer further explanation of the amount in dispute
Upon receipt of the written notification we will suspend billing of the amount ni question until a resolution to
your dispute can be made. However, you will still be required to pay in full the undisputed amount by the
payment due date shown on this billing notice.
Bond Questions or Issues: Contact your local agent. (See activity summary for agent contact information)
Address_Chanes:_
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHERCity Form No.201(Rev.199
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
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 accor-
dance with IC 5-11-10-1.6.
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Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
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IN SUM OF $
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ON ACCOUNT OF APPROPRIATION FOR
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the materials or services itemized thereon
for which charge is made were ordered and
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