HomeMy WebLinkAbout157789 03/25/2008 CITY OF CARMEL, INDIANA VENDOR: 361029 Page 1 of 1
ONE CIVIC SQUARE UNITED INSURANCE AGENCIES, INC
CARMEL, INDIANA 46032 90 EXECUTIVE DRIVE SUITE F CHECK AMOUNT: $55.00
CARMEL IN 46032
CHECK NUMBER: 157789
CHECK DATE: 3/25/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1301 4347500 25596 55.00 NOTARY —KIM ROTT
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INVOICE
United Insurance Agencies, Inc. All Premiums payable on or
90 Executive Drive, Suite F. before due date of policy
Carmel, Indiana 46032
Account No. Date'
25596 March 19, 2008
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PLEASE RETURN
c/o Carr►iel City Center THIS TO INSURE
1 CivtcSquarePROPER CREDIT
,Carmel; IN .46032° THANx Youl
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Insured $55.00
Name: Kimberly Rott Payment Enclosed
Please detach and return this portion with your remittance
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05/04/2008 05/04/2016 PENDING Notary Bond $50.00
Application Fee for State of $5.00
Indiana
Total Amount Due $55.00
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Prescribed by State Board of Accounts City Form No. 201 (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.
g 0 ��LYi('; 12�t le_1 Ac)wItLu Terms
Date Due
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Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3 /ice
To
Total SS
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
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IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
C i9 L
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20
ignature
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Cost distribution ledger classification if
claim paid motor vehicle highway fund