HomeMy WebLinkAbout305584 11/28/16 a or.c,xb
{ � CITY OF CARMEL, INDIANA VENDOR: 00352999
® it ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $"'"""200.00"
CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 305584
CINCINNATI OH 45263-8720 CHECK DATE: 11/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 130515 50.00 GENERAL INSURANCE
1205 4347500 130518 50.00 GENERAL INSURANCE
1205 4347500 130520 50.00 GENERAL INSURANCE
1205 4347500 130532 50.00 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
HYLANT GROUP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 638720 IN SUM OF$ 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.
$200.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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
130532 43-475.00 $50.00 1 hereby certify that the attached invoice(s),or 11/15/16 130515 $50.00
1205 101 1205 101
130520 43-475.00 $50.00 bill(s)is(are)true and correct and that the 11/15/16 130520 $50.00
1205 1 101 materials or services itemized thereon for 1205 1 101
130518 43-475.00 $50.00 11/15/16 130518 $50.00
1205 101 which charge is made were ordered and 1205 101
130515 43-475.00 $50.00 received except 11/15/16 130532 $50.00
1205 101 1205 101
Monday, November 21,2016
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
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
tem# TTrans Eff Date Due Date Trans Descriptiort Amount
Bond-Notary Policy# 6297730ON Effective: 2/25/17 - 2/24/25
Issuing Company Western Surety Company
960513 2/25/2017 2/25/2017 RENB 6297730ON IN State of IN Marie L.Doan$5,000+ 50.00
$5,000 E&O 02/25/17
Total Invoice Balance: $50.00
[ubinitted To
NOV 21 2016
ClEerk TFSES� rer
16 HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
11/15/2016 Cityof Carmel Loan# Invoice#130515 FARWE1 Page 1 of 1
Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720
em& ' Tirans Eff'D 1 Due Dat� ion Amount
Bond-Notary Policy# 62977391N Effective: 12/28/16 - 12/27/24
Issuing Company Western Surety Company
960520 12/28/2016 12/28/2016 RENB 62977391 N IN State of IN Lisa Michelle Scott$5,000 50.00
+$5,000 E&O
Total Invoice Balance: $50.00
ENOVilAmedTo
2 1 2016
Tressurer
&HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
11/15/2016 Cityof Carmel Loan# Invoice#130520 FARWE1 Page 1 of 1
Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720
tem# = Trans Eff Dati t;- Due Date°" '"Trans3 ,'`" Description Amount
Bond-Notary Policy# 62977343N Effective: 1/6/17 - 1/5/25
Issuing Company Western Surety Company
960517 1/6/2017 1/6/2017 RENB 62977343N IN State of IN Amanda Bennett$5,000+ 50.00
$5,000 E&O 01/06/17
Total Invoice Balance: $50.00
aJ
tte
o
NOV 2 2016
Clerk; f reasurer
eb HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
11/15/2016 City of Carmel Loan# Invoice#130518 FARWEI Page 1 of 1
Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720
Trans.,Eff Date Due''Date ,. "%Trans Description =` i: Amount
Bond-Notary Policy# 62977717N Effective: 3/18/17 -. 3/17/25
Issuing Company Western Surety Company
960553 3/18/2017 3/18/2017 RENB 62977717N IN State of IN Rachel Michelle Keesling 50.00
$5,000+$5,000 E&O
Total Invoice Balance: $50.00
Submil-ted To
NOV 21 2016
I � Treasurereasurer
&HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
11/15/2016 City of Carmel Loan# Invoice#130532 FARWE1 Page 1 of 1