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307638 01/27/17
CITY OF CARMEL, INDIANA VENDOR: 00352999 o ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $"""""""572.00• CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 307638 yiroN CINCINNATI OH 45263-8720 CHECK DATE: 01/27/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4347500 133171 572.00 GENERAL INSURANCE o @ -DI < « o q -u o 2 O % q O W § 2 2 D co k ° © > x a 2 q I q e o m \ 2 = 2 C O w O w 2 K - k k ? o \ q O % § / n 1 & 2 � 7 / ` w d -4 / -n > k / k 4 �E § 2 ] # CL ° z 2 z 2 > O a m K 3 C § § | C) ¥ 6 _ J a i 3 R 2 r, z k 0 g k ƒ ) 3 ` F cr 9 / § ? g k § CL 0 § e m p _ G a. ; # f � I m/ % CL § = _ CD / m { \ CD CD = X E 3 0 k k EL § 0 CD CML E co CL rCD § / / \ § w E § £ a § o cr fu , y _0 %i / q o [ s w a > CD \ § ) cr \ } M. ; ; cr 3 6 D / 3 2 0 § k m < 0 CD _ z ID o c . /CD \ k ƒ \ ) O ^ k �_ \ « } N %k § E g C7 3 0� O \f } / f� / ( ) D a & _ 90 CE) 7 ; q CL > 2 i n k m 9 / \ j E r- 0 m ¥ 2 \ ] i a ° % \ / E $ / 0 p CL 0 $ -4g # } G \ 7 \ } § k ^ 7 ® CA CD k > 2. j Ln o m k 8 ® ) Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Fonn No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee \/ / — 0/I\s Purchase Order No. l( /4Jl� "Jll� X Terms Aduffidy))k `w v /V Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s or bill(s)) - Total — I hereby certify that the attached invoice(s), or bill(s), is (are) a correct and I e u ' ed same in accor- dance with IC 5-11-10-1.6. —� , 20 Clerk-Treasur Ur Hylant-Indianapolis Invoice # 133171 eb HYLANT 10401 North Meridian St,Ste 200 Indianapolis,IN 46290 P-(800)678-0361 12/20/2016 1/1/2017 hylant.com F-(317)817-5151 City of Carmel CARMELO-02 $572.00 City of Carmel One Civic Square Carmel,IN 46032 Please Return Top with Remittance To: PO Box 638720,Cincinnati,OH 45263-8720 r z k R o t Bond-Public Official(Specify) Policy# 106469657 Effective: 1/1/17 - 1/1/18 Issuing Company Travelers Casualty&Surety Co 985669 1/1/2017 1/1/2017 RENS 106469657 IN Christine S. Pauley Treasurer 572.00 $300,000 01/01/17$572 Total Invoice Balance: $572.00 A/HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290 12/20/2016 City of Carmel Loan# Invoice#133171 FARWE1 Page 1 of 1