Loading...
HomeMy WebLinkAbout304626 10/31/16 4�r 4,pMff CITY OF CARMEL, INDIANA VENDOR: 00352999 J' CHECKAMOUNT: $********66.00* .�; ,• ONE CIVIC SQUARE HYLANT GROUP =Q CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 304626 9y�,._,� CINCINNATI OH 45263-8720 CHECK DATE: 10/31/16 �ruN�°' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4347500 100758 66.00 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) HYLANT GROUP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 638720 IN SUM OF$ 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. $66.00 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR General Administration 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 100758 43-475.00 $66.00 1 hereby certify that the attached invoice(s),or 10/14/16 100758 $66.00 1205 101 1205 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 17,2016 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 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720 tem# - «TransEff.Date Due.Date _ Trans 'Descr ., _ i Amount v� R i tion..'.f- Package-Commercial Policy# 630581M4076TIL15 Effective: 1/1/15 - 1/1116 Issuing Company Travelers Prop Cas Co of Amer 712273 7/16/2015 1/20/2016 ENDT Add 248 Gracile Drive 66.00 Total Invoice Balance: $66.00 bb mmiitt-ttee-dd TT oo SSuu OCT 17 2016 filer Treasurer At HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290 10/14/2016 City of Carmel Loan# Invoice# 100758 FARWE1 Page 1 of 1