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CITY OF CARMEL, INDIANA VENDOR: 00352999ONE CIVIC SQUARE HYLANT GROUPCHECK AMOUNT: S****13,100.00*
CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 258732
CINCINNATI OH 45263-8720 CHECK DATE: 05/18/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4341999 33861 113023 13,100.00 BUILDER RISK POLICIES
Prescribed by State Board of Accounts City Form.No.201(Rev.1995)
VOUCHER NO, - WARRANT.NO:
ALLOWED 20
ACCOUNTS PAYABLE.VOUCHER
.HYLANT GROUP
SLIM
IN 01 $
Po Box 638720
CITY OF CARMEL.
r. m
An invoice o bill to be properly itemized must show kind of service where performed,dates service.
CINCINNATI;.OH.45263-8720 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit;etc.. .
Payee
$13,100.00
ON ACCOUNT OF.APPROPRIATION FOR Purchase Order#
Redevelopment Commission
Terms.
Date Due
PO# ACCT#'. DATE INVOICE# DESCRIPTION
DEPT#: INVOICE# Fund# AMOUNT Board Members. DEPT# . FUND# (or note'attached invoice(s)or,bill(s)) AMOUNT
33861. 113023 43-419.99' $13,100:00I hereby certify that the attached invoice(s),or 5/12/16 113023 Builder's risk for Sophia Square and City $13,100.00
902 . 902 902 902 Center
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
Tuesday, May 17,2016
A.
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
Cost distribution ledger classification if claim paid motor vehicle highway fund.
Clerk-Treasurer
H"'"'-
ylant-Indianapolis Invoice # 113023
At HYLANT 301 Pennsylvania Pkwy,Ste 201 Date Balance Due On
Indianapolis,IN 46280
P-(800)678-0361 5/12/2016 5/16/2016
hylant.com F-(317)817-5151 Insured
City of Carmel
Account Number -Amount Due
CARMELO-02 $13,100.00
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
Item# -� Trans Eff Date Due Date —TransDescription Amount
i
Builder's Risk/installation-Commercial Policy# 416526 Effective: 4125116 - 9125116
Issuing Company Federal Insurance Company
810117 4/25/2016 5/16/2016 NEWB Sophia Square Builders Risk 1,010.00
4/25/2016 5/16/2016 RVPM Sophia Square Builders Risk 3.00
Builder's Risklinstallation-Commercial Policy# 416527 Effective: 5112/16 - 8/1117
Issuing Company Federal Insurance Company
810118 5/12/2016 5/12/2016 NEWB City Center Garage Builders Risk 12,087.00
Total Invoice Balance: $13,100.00
At HYLANT Hylant-Indianapolis 301 Pennsylvania Pkwy,Ste 201 Indianapolis IN 46280
5/12/2016 City of Carmel Loan# Invoice#113023 FARWEI Page 1 of 1