334817 01/25/19 CITY OF CARMEL, INDIANA VENDOR: 373070
® ONE CIVIC SQUARE PROGRESSIVE CAR INS CO#28678 CHECK AMOUNT: S*......137.76*
s•. j?� CARMEL, INDIANA 46032 PO BOX 94568 CHECK NUMBER: 334817
'MroN�o. CLEVELAND OH 44101 CHECK DATE: 01/25/19
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1541287001 137.76 OTHER EXPENSES
VOUCHER NO. 183883 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 373070 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
PROGRESSIVE CAR INS CO #28578 CITY OF CARMEL
PO BOX 94568 An invoice or bill to be properly itemized must show: kind of service,where performed,
CLEVELAND, OH 44101 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
137.76 373070 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR PROGRESSIVE CAR INS CO #28578 Terms
Carmel Water Utility PO Box 94568 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), CLEVELAND, OH 44101
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were,ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
1541287001 01-4611-00 $137.76 and received except 1/17/2019 1541287001 $137.76
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20
Clerk-Treasurer
City of
armel Utilities Account Number 1541287001
P.O. Box 109 Carmel, IN 46082-0109
Amount Due
Customer Service
www.carmelutilities.com (317)571-2442
Mon- Fri 8am-5pm Amount Due
After Due Date
PROGRESSIVE CAR INS CO#28578 B051 Service Address
PO BOX 94568 4642 NORTHWESTERN DR
CLEVELAND, OH 44101-4568
FINAL
Service Period .. .
Number
PAYMENT RECEIVED, THANK YOU (275.52)
11/11/18 12/10/18
PREVIOUS BALANCE CREDIT (137.76)
0
0
LL
U