246361 06/1 7/1 5 CITY OF CARMEL, INDIANA VENDOR: 00352999
CHECK AMOUNT: $********50.00*
(9,
ONE CIVIC SQUARE HYLANT GROUPCARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 246361
CINCINNATI OH 45263-8720 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4347500 82029 50.00 NOTARY
Hylant-Indianapolis Invoice # 82029
At HYLANT 301 Pennsylvania Pkwy,Ste 201 Date ° Bal�ndCe Due On
Indianapolis,IN 46280
6/10/2015 -T 8/1/2015
hylant.com
Insured �
City of Carmel
Account Number Amount Due 3v ,
CARMELO-02 $50.00
City of Carmel
Attn: STEVE ENGELKING
One Civic Square
Carmel, IN 46032
Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720 ***NEW ADDRESS
Bond-Notary Policy# 32S473864 Effective: 8/1/15 8/1/23
Issuing Company Ohio Casualty Insurance Company
554540 8/1/2015 8/1/2015 NEWB NOTARY BOND FOR CYNTHIA L. SHEEKS 50.00
Total Invoice Balance: $50.00
**PLEASE NOTE REMITTANCE ADDRESS CHANGE"
III HYLANT Hylant-Indianapolis 301 Pennsylvania Pkwy,Ste 201 Indianapolis IN 46280
6/10/201 City of Carmel Loan# Invoice#82029 UBAMA1 Page 1 of 1
HYLANT
June 10, 2015
Re: Notary Bond
Enclosed please find your Notary Bond and Notary Public Errors &Omissions Insurance.
You will need to apply for your notary commissions at www.sos.in.Aov.
On this website, you will click on Business Services Division, on the left side and then click on Notary.
The State will accept payment for the Notary fees of$11.22 via Master Card, Visa or an IN gov subscriber
account.
Our-invoice for the 8-Year premium.is also enclosed.
Should you have any questions, please feel free to contact me.
Sincerely,
Marianne Uban, CIC, CISR
Client Service Manager - -
Hylant Group
301 Pennsylvania Parkway, Ste. 201
Indianapolis, IN 46280
Direct: 317-817-5136
Fax: 317-817-5151
Email: marianne.uban(a),hylant.com
*bertx
u .i1.
SURETY
NOTARIAL BOND Bond No. 32S473864
KNOW ALL MEN BY THESE PRESENTS, That we CYNTHIA L SHEEKS
(Name of Applicant) _
as principal (Applicant) and The Ohio Casualty Insurance Company as corporate surety, are held and firmly
bound unto the State of Indiana, in the penal sum of FIVE THOUSAND DOLLARS ($5,000), the payment of which, well
and truly to be made, we bind ourselves, our heirs, executors and administrators,firmly by these presents.
WHEREAS, the above bound principal has applied for appointment by the Governor of the State of Indiana as a
Notary Public, in and for the State of Indiana, for an eight year term.
Now, if the said principal shall truly and faithfully perform and discharge the duties of said office of Notary Public,
in all things according to law, then the above obligation to be null and void, otherwise to remain in full force and virtue in
law.The term of this bond is from the effective date of the principal commission to the expiration date of the same:
pV��( liVsli
CJ ooRPoaq> y
0
191.9..
`kms o
Timothy A.Mikolajewski,Assistant Secretary ° ha�nPe�aa3
Congratulations,you have successfully obtained a notary bond for the State of Indiana.
Bond# 32S473864
Surety Company: The Ohio Casualty Insurance Company
To obtain the notary commission:
Each notary applicant must now access the Indiana Notary Public Application online at www.in.gov to complete the pre-
qualification, training and oath agreement.After successfully completing, the applicant must pay the application fees to
the State of Indiana via MasterCard or Visa. Once the fees are,paid, your client can download.a file that contains the
Notary Commission Certificate.
LMS-16080DA 04110
The Ohio Casualty Insurance Company
NOTARY PUBLIC ERRORS AND OMISSIONS POLICY
POLICY NO. E&O 32S473864
The Ohio Casualty Insurance Company will pay on behalf of CYNTI-IIA L SHEEKS
of 14382 WHISPER WIND DR CARMEL,IN 46032
(Address)
(hereinafter called the insured),all sums which the insured shall become obligated to pay by reason of liability for breach of duty
while acting as a duly commissioned and sworn Notary Public, claim for which is made against the insured by reason of any
negligent act, error or omission,committed or alleged to have been committed by the insured,arising out of the performance of
notarial service for others in the insured's capacity as a duly commissioned and sworn Notary Public.
POLICY PERIOD:This policy applies only to negligent acts, errors or omissions which occur during the policy period and then
only if claim,suit or other action arising therefrom is commenced during the policy period,and is not barred by the applicable
Statute of Limitations pertaining to the insured.The Policy Period commences on the effective date of the insured's commission
as a Notary Public and terminates upon the expiration of the Insured's commission as a Notary Public unless cancelled earlier as
provided in this policy.This policy is not valid for more than one commission term.
LIMITS OF LIABILITY:The liability of this company shall not exceed in the aggregate for all claims under this insurance the
amount of Five Thousand Dollars And Zero Cents
($5,000.00 ). In addition to the limit of liability and in accordance with the other provisions of this policy,this company
will pay costs and expenses paid and incurred in investigating, contesting or settling liability in an amount not to exceed, in the
aggregate,one-half of the limit of this policy.
INSURED'S DUTIES IN THE EVENT OF OCCURRENCE,CLAIM, OR SUIT:
(a) Upon knowledge of any occurrence which may reasonably be expected to result in a claim or suit,written notice
containing particulars sufficient to identify the Insured and also reasonably obtainable information with respect to the time,
place and circumstances thereof,and the names and addresses of the potential claimant and of available witnesses, shall
be given by or for the Insured to the Company or any of its authorized agents as soon as practicable, but in no event
longer than forty-five(45)days after discovery.
(b) If claim is made or suit is brought against the Insured,the Insured shall immediately forward to the Company every
demand,notice,summons or other process received by him or his representative.
(c) The Insured shall cooperate with the Company and,upon the Company's request, assist in making settlements, in the
conduct of suits and the Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining
the attendance of witnesses.The Insured shall not,except at his own cost,voluntarily make any payment,assume any ,
obligation or incur any expense except with the prior written consent of the Company.
EXCLUSIONS:Coverage under this policy does not apply to any dishonest,fraudulent,criminal or malicious act or omission of
the insured.
CO-INSURANCE: If the insured has other insurance against a loss covered by this policy,the company shall not be liable
under this policy for a greater proportion of such loss,cost and expenses than the limit of liability stated in this policy bears to the
total limit of liability of all valid and collectible insurance against such loss.
CANCELLATION:This policy may be canceled by the Company by mailing thirty(30)days written notice to the Insured and
may be canceled by the Insured by surrender thereof to the Company or any of its agents or by mailing to the Company thirty
(30)days written notice and this policy shall be deemed canceled and the Policy Period terminated upon such return or at-the
expiration of said thirty(30)days.A pro rata return premium shall be allowed on cancellation.
Dated,signed and sealed this 1st day of August 2015
The Ohio Casualty Insurance Company
Address Claims to: _11 INsv
Liberty Mutual SuretyyJP6naPQ'ia�'�y
1001 4th Avenue,Suite 1700 i,� ° m By I
Seattle,WA 98154 0 1919 w o Timothy A. Mikolajewski,Assistant Secretary
y� Ft�yA
MPSIN. a da
LMS-16835/DA 06103
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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
CPurchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
a �
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
�S or 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
20
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund