HomeMy WebLinkAbout195076 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $3,406.00
0 CARMEL, INDIANA 46032 P 0 BOX 40925
INDIANAPOLIS IN 46082 -4910 CHECK NUMBER: 195076
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 752139 3,406.00 GENERAL INSURANCE
UtH P.O Box 40925
HYLANT
Indianapolis, IN 46280-0925
Local: 317-817-500 INVOICE# 752139
A 0
-0
GROUP -107—
CARME 79 02/16/
GP09313908
W. Michael Wells
City of Carmel
01/01/10 01/01/11 01110/10
M.;
RE
FM"
Steve Eagelking 3,406.00
One Civic Square
Carmel, IN 46032
INVOICE 752139
0001110 AUD CR-S GPO9313908 AUTO AUDIT Travelers Insurance Companies S 3,406.00
FINAL AUDIT AUTO PERIOD: I A 0A 0- 11
ALLOCATE PREMIUM: FIRE DEPT. $1,022; POLICE DEPT. $2,384
Invoice Balance. 3,406.00
FL8 2 8 2011
By
301 Pennsylvania Parkway Suite 201 P. Box 40925 Indianapolis, IN 46280-0925
Toll Free: 800-678-0361 Local: 317-817-5000 Fax: 317-817-5151
Risk Manageniont �401 (10 -160jstrneht.s
t
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hylant Group
l IN SUM OF
301 Pennsylvania Parkway, Suite 201
Indianapolis, IN 46280 -0925
$3,406.00
I
ON ACCOUNT OF APPROPRIATION FOR
Carmel Administration
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1205 752139 I 43- 475.00 I $3,406.00 1 hereby certify that the attached invoice(s), or
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
M onday, February 28, 2011
i Y A
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 291 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/16111 752139 I $3,406.00
1 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
Clerk- Treasurer