HomeMy WebLinkAbout256419 03/15/16 / �. CITY OF CARMEL, INDIANA VENDOR: 366179
® t°i ONE CIVIC SQUARE LIBERTY MUTUAL INSURANCE CO CHECK AMOUNT: $*******100.00*
s. ��a CARMEL, INDIANA 46032 25761 NETWORK PLACE CHECK NUMBER: 256419
9MQtON�` CHICAGO IL 60673-1257 CHECK DATE: 03/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
801 4347500 601001685 100.00 GENERAL INSURANCE
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
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.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
to
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
j SCJC VZ fQ, 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
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Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
". Someday is Today,LLC
ti1)er btutxu-,' 7116 E 71ST ST
INDIANAPOLIS,IN 46256-1997
Liberty Mutual Surety Bond Invoice
2830 1 MB 0.436 P:2830 / T:14 / S:1 Statement Date: 02/23/2016
Premium: 100.00
.xY MILLER ADAM C Applicable Taxes: 0.00
CITY R CARMEL POLICE DEPARTMENT
' 3 CIVIC SQ Applicable Fees: 0.00
CARMEL IN 46032-2584 Amount Due: 100.00
Payment Due Date: 4/08/2016
- Make checks payable to: Liberty Mutual
._Bond-'luruber:----- ---601001685 --- -- _-� --Your Liberty Mutual Surety Bond Activity Summary
Effective Date: 5/18/2016
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 Mutual Surety Billing Center at 1-800-773-3312
PLEASE DO NOT SEND ANY CORRESPONDENCE WITH 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 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 Visa®, 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 appearuig 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 in 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.)