330699 10/02/18 y ��p" CITY OF CARMEL, INDIANA VENDOR: 00352999
CINCINNATI OH 45263-8720
ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $****10,199.00*
f? CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 330699
9y.. /r:
„oN�• CHECK DATE: 10/02/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 194069 10,199.00 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00352999 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
HYLANT GROUP IN SUM OF$ CITY OF CARMEL
PO BOX 638720 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.
CINCINNATI, OH 45263-8720
Payee
$10,199.00
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
194069 43-475.00 $10,199.00 1 hereby certify that the attached invoice(s),or 9/26/18 194069 Policy 630581m4076 $10,199.00
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 1,2018
CA-4 cl.�
Crider,James
Administration
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
RGI11 R I 101 GII WOM vuC uGaC 1 runs u65GfIpI1Vr1 ArnOUnt
Package-Commercial Policy# 630581 M4076 Effective: 1/1/18 - 1/1/19
Issuing Company Travelers Prop Cas Co of Amer
1530336 8/1/2018 10/11/2018 ENDT Add Multiple Water Dept Buildings 10,199.00
Total Invoice Balance: $10,199.00
'tted To
SEP 2 7 2018
G`8' Treasurer
HYLANT Hylant-Indianapolis 10401 North Meridian St,Ste 200 Indianapolis IN 46290
9/26/2018 City of Carmel Loan# Invoice#194069 FARWE1 Page 1 of 1