156600 02/21/2008 CITY OF CARMEL, INDIANA VENDOR 117775 Page 1 of 1
ONE CIVIC SQUARE H.J. SPIER CO, INC
CARMEL, INDIANA 46032 5750 CASTLE CHEEK PARKWAY SUITE 15 CHECK AMOUNT. $77.50
S
INDIANAPOLIS IN 46250 4359 CHECK NUMBER: 156600
CHECK DATE: 2121/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESC RIPTION
1160 4341999 77.50 O'PHER PROFESSIONAL FE
FEB -t5 -2008 FRI 09;18 AM H. J, Spier Co.. Inc. FAX N0. 3178498800 P. 01
February 15, 2008 ;��6ec.✓ /Sly
SINCE 1930
City of Carmel
Attn: Jenny Chastain
1 Civic Square
Carmel, IN 46032
Re: Notary Public Application
Dear Jenny:
We appreciate the opportunity to assist you in applying for a Notary Public
Commission. The enclosed application contains the Notarial Oath and the Notarial
bond (same sheet, two sided) and instructions. Please return the completed
application to our office. Do not mail directly to the Secretary of State. Our office
must first sign and notarize this form. Please make sure to:
1. Complete items 1-6. (7 also if you are a current notary)
2. Under item 9, sign and have your signature notarized.
3 Print your name and sign in item 10, and have your signatu(e
notarized in it 11
4. Return to me the notarized application with two checks made out to:
1. Secretary of State for the processing fee of $5.
2. H. J. Spier Co. Inc. for the 8 -year notary and E &O bonds for JZZM total.
When we receive the Commission back from the Secretary of State, we will assign
you an Errors Omissions policy number and forward the bond and commission to
you. Unless you are a current notary and your commission hasn't expired yet, you
should not notarize anything until the E &O policy has been issued. Please call me
with any questions you may have. Thank you.
Sin rely,
4 ura J. S trous205 -2543
Enclosures
H.J. SPIER (1900 -1982) HERBERT J. SPIER, JR. JOHN S. NULL, J.D. DONALD R. BROWN, CPCU
MICHAEL J, GLASER JOHN DAVID NULL, CPCU JAMES G. NULL, J.O. CHRISTOPHER O'CONNOR, A.A.I.
DONALD G. STROUSE JOSEPH O. PORTER MELISSA B. VANDERWAAL, LTCP JEFFREY D. FOX
5750 Castle Creek Parkway North Drive, Suite 150 Indianapolis, IN 46250.4359
www.hjspier.com (317) 849 -8800 FAX (317) 576 -5058
i FEB`15 -2008 FRI 09;18 AM H, J. Spier Co.. Inc, FAX N0, 3178498800 P. 03
Do Not wrlte In This Box For Office Use Onl
Commission p Expiration Date of New Commission
APPLICATION FOR APPOINTMENT AS A NOTARY PUBLIC IN THE STATE OF INDIANA
Complete and Return to Notary Department, Secretary of State, Room 201, State House
Indianapolis, Indiana 46204: Telephone: 317 232.6542
To: THE GOVERNOR OF INDIANA
I respectfully request that I be appointed and commissioned a Notary Public. In support of my application, I submit herewith the required bond,
oath of office, and foo of FIVE DOLLARS ($5), payable to the Secretary of State, in the form of a checker money order (Do not send currency In
the marl.) (IC 33.16.2.1)
PRINT OR TYPE
L NAME Jenny A Chastain
Year bed alendum N whidl dommledan Wql be keu6U -eea ItmWCdon q3
2. HOME ADDRESS 511 Second Avenue NE
NurrWand seael
Carmel IN 46032
dry alma ZIP coo
3. COUNTY OF RESIDENCE Hamilton
4. Business or Employer's Name City of armel
5, Business or Employees Address One Civic Square Carmel IN 46017
Street MY e18ne ZIP mile
8. HOME PHONE (317) 566 -8812 OFFICE PHONE
AraCods Number A aCade Number
7, If you have a current valid notary commission, show your expiration data:
5, If you are how a notary public and your name or county has changed since your last application, please give bath old and new information.
OLD:
NEW:
9, NOTARIAL OATH
STATE OF INDIANA I SS:
COUNTY OF ��whien been a se nninis terw
I do solemnly swear (or affirm) that I will support the Constitution of the United States, and the Constitution of the State of Indiana; that I am duly
qualified to hold office under the Constitution and laws of the Slate; that I am 18 years of age or over, that I am of good moral character and Intagdty;
that I am a resident of Indiana; that my answers to questions on this application are true and complete to the best of my knowledge; that I have
carefully read all of the instructions which came with this application, and that I will faithfully and Impartially discharge the duties of NOTARY
PUBLIC If so commissioned by the Governor, according to the best of my skill and ability, so help me God (or undor the pains and penalties of
elanaWm of applkanl
Place Ofncoes Seal Hem Subscribed and sworn or affirmed to before me, this 5 day of
A.D. 20 IN TESTIMONY WHEREOF, I, L
Ppn we o typal mane or oMw
�1LYlILeQ l IAC a Mt for the
Sler Iwo of en.Wry pubV ot btiiar e cm buttrorunid la warinloler onths emdd
County of State of Indiana.
our of ence
My commission expires. C)
NOTE: The Bond Farm, starting with #10 on the back of this a plicatioh, must be completed before mailing to the Secretary of State.
The applicant must sign again in #10.
NEO 0697 IN (1/03)
FEB —;5 -2008 FRI 09:18 AM H. J. Spier Co.. I nc, FAX N0, 3178498800 P. 02
10. NOTARIAL BOND Bond No. 'IN
KNOW ALL BY THESE PRESENTS, that we as principal
Merchants Bondi Co Name orAppicanl
(applicant) and 8 P' Y I'MuNal) of
Name or Sumq
2100 Fleur Drive Des Moines, Iowa 50321 -1158 and Polk County as
8116611 ads... Oy, gale a LIP dodo
freehold or corporate surety, are held and finely bound unto the State of Indiana, in the penal sum of FIVE THOUSAND DOLLARS ($5,000), the
payment of which, well and truly to be made, we bind ourselves, our heirs, executors and administrators, firmly by these presents.
WITNESS our signatures as acknowledged below. THE CONDITION OF THE ABOVE OBLIGATION IS AS FOLLOWS,
TO -WIT.
WHEREAS, the above bound principal has applied for appointment by the Governor of the State of Indiana as a
Notary Public, in and for the State of Indiana, for a eight -year term.
Now, if the said prindpal shall truly and faithfully perform and discharge the duties of said office of Notary Public, In all things according to
law, then the above obllgaGon to be null and vold, otherwise to remain In full force and virtue in law. The teen of this bond is from the effective
date of the p I I's commission to the expiration date of the same.
el wre df appYmnt n M eanowpdead debw In kt 7 Slpllelure of surety. Mual ba acknawledgetl below N k14
11. ACKNOWL4DGEMENrOF APPLICANTS SIGNATURE BY A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED BY
LAW TO TAKEt�A�C-KNOWLEDGEMENTS
STATE OF— 1 r COUNTY OF LL'17 to k 6! :SS:
aaunry r w w aeknwek0pwnml b baba madd
Before me the undersigned, an officer authorized to take the acknowledgement of deeds (Notary Public, County Clerk, etc.) personally appeared
Jenny A. Chastain and acknowledged the execution of the foregoing bond for the uses and
Pdnlad w d name or applicant
purposes therein expressed, wlthout or reservation. r— d
Plana 1)elaara seal here IN TESTIMONY WHEREOF, I I l X! r Y lYX(1 �(�'�fll�1,G have hereunto set my
Pnnletl nano at aMwr
hand d official seal, this r day of "7j 20
e
Siena) dl Y ordcw HMCo
for the County of ,qe State of
My commission expires: o �1� 02 o10I
12. ACKNOWLEDGEMENT OF SURETY'S SIGNATURE (Corporate) BY A NOTARY PUBLIC OR OTHER OFFICER
AUTHORIZED BY LAW TO TAKE ACKNOWLEDGEMENTS (NOTE: The officer cannot acknowledge Mather own signature)
STATE OF COUNTY OF SS:
County in wNtli scsnnmadparnani w bone nwo
Before me the undersigned, an officer authorized to take the acknowledgement of deeds (Notary Public, County Clerk, etc.) personally appeared
Pdnbd or O'Ped name o161dMldual sense od W roly and acknowledged the execution of the foregoing bond for the uses and
purposes therein expressed, without condition or reservation.
Piave 0111Wd aeal hero IN TESTIMONY WHEREOF, I P have hereunto set my
nmdd or rypeo name or
hand and official seal, this day of 20
a
slanaturd WaulnoNad oMCar oMm
for the County of State of
OMnra I.aunlY of mJdnnrn
My commission expires:
For the statute pertaining to surety company bonds, see Indiana Code 27 -1 -22. For the statutes pertaining to Officer's Bonds and
Oaths. sna Intliana nelp';.A
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form 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
H. J. Speir Co., Inc. Purchase Order No.
'5750 Castle Creek Pkwy North Drive
Ste 150 Terms
,Indianapolis IN 46250 -4359
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
L etter Notary Bond for jenny A. Chastain per the attached $77.50
Application for Appointment As a Notary Public
in the State of Indiana
Total $77
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
VOUCHER NO. WARRANT NO._
ALLOWED 20
H. S. Snei r Cn. Tnr IN SUM OF
5750 Castle Creek Pkwy North Drive
Ste. 150
Indianapolis IN 46250 -4359
77.50
ON ACCOUNT OF APPROPRIATION FOR
1160 -410 General Insurance
Board Members
Pop or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
1160 $77,SQ 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
/.t
20
Signature
Cost distribution ledger classification if TI
claim paid motor vehicle highway fund