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HomeMy WebLinkAbout304034 10/10/16 CITY OF CARMEL, INDIANA VENDOR: 00352999 ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: S""'"""100.00• CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 304034 vM,_ CINCINNATI OH 45263-8720 CHECK DATE: 10/10/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1801 4347500 126195 100.00 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) HYLANT GROUP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 638720 IN SUM OF$ CITY OF CARMEL An invoice or 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. $100.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Redevelopment Department 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 126195 43-475.00 $100.00 1 hereby certify that the attached invoice(s),or 9/30/16 126195 POB bond for Henry Mestetsky $100.00 1801 101 1801 101 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 Monday, October 03,2016 Come Meyer 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 Hylant-Indianapolis Invoice # 126195 AP HYLANT 10401 North Meridian St,Ste 280290 Date Balance Due On Indianapolis,IN 46 P-(800)678-0361 9/30/2016 10/10/2016 hylant.com F-(317)817-5151 Insured Carmel Redevelopment Commission Account Number Amount Due CARMRED-01 $100.00 Carmel Redevelopment Commission Attn: Michael Lee 30 West Main St.Ste.220 Carmel, IN 46032 Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720 'tem# Trans Eff Date Due Date Trans Description Amount Bond-Public Official(Specify) Policy# 106601389 Effective: 9/21/16 - 9/21/17 Issuing Company Travelers Casualty Ins Co Amer 924846 9/21/2016 10/10/2016 NEWB 16/17 POB Henry Metestsky 100.00 Total Invoice Balance: $100.00 At HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 280 Indianapolis IN 46290 9/30/2016 Carmel Redevelopment Commission Loan# Invoice#126195 FARWE1 Page 1 of 1