HomeMy WebLinkAbout305176 11/14/16 y u,,c�q�
�( �'? CITY OF CARMEL, INDIANA VENDOR: 00352999
® ) ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $*****1,211.00*
�. ?� CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 305176
, TON�� CINCINNATI OH 45263-8720 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 128312 1,211.00 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
HYLANT GROUP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 638720 IN SUM OF$ 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.
$1,211.00 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
128312 43-475.00 $1,211.00 1 hereby certify that the attached invoice(s),or 10/28/16 128312 $1,211.00
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 31,2016
F
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
Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720
temrans':EffDate�' Due'D"ate Trans «'Description �: s "' Amount
Package-Commercial Policy# 630581M4076 Effective: 1/1/16 - 1/1/17
Issuing Company Travelers Prop Cas Co of Amer
943693 8/31/2016 11/11/2016 ENDT Add Improvements to Sophia Square 328.00
943694 9/19/2016 11/11/2016 ENDT Add Fire Station#44 747.00
945232 9/19/2016 11/11/2016 ENDT Re-Rate Adding Fire Station 44 136.00
Total Invoice Balance: $1,211.00
[ub i ed ` o
OCT 3 1 2016
asurer
/A HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
10/28/2016 City of Carmel Loan# Invoice#128312 FARWE1 Page1�ofi]