HomeMy WebLinkAbout199165 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 354229 Page 1 of 1
L t. ONE CIVIC SQUARE R M DIPATTI
CARMEL, INDIANA 46032 PO BOX 1167 CHECK AMOUNT: $100.D0
RICHMOND IN 47375 CHECK NUMBER: 199165
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
802 4347500 27375 100.00 GENERAL INSURANCE
P.O. Box 1167 Richmond, IN 47375 v r r
Office (765) 966 -7531 Fax (765) 935 -2476
RM
Toll Free (800) 783-3179
Indianapolis Office: Bruce A Knott (P0B)
M A N 7116 E. 71st Street Indianapolis, IN 46256
Office (317) 845 -1547 Fax (317) 841 -8847
wArv.rmdpai ti, corn Toll Free (800) 720 -2440 s 27375
06/1.7/2011
Joseph.Glaser
Susan Tplletson
City of Carmel
2 Civic Square
Carmel, IN 46032
100 00=
PAYMENT-FOR;'. invoice 4531123`
Thank You
PLEASE DETACH AND RETURN WITH PAYMENT
Client: Bruce A Knott PQB
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Policy #601004590 06/0]./.2011 06%01/2012
Ohio Casualty Group
531123 06/01/2011- New business Bonds New business 100.00
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PLEASE 'PAY WIT 20' -DAYS OF INVOICE DATE =OR- CALL IMMO IF' IN TS
INCORRECT,
Thank You
MBWRMDIPATTI
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317.845.1547
06/17/2011
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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
27375 $100.00
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
RMD Insurance
IN SUM OF
P.O. Box 1167
Richmond, IN 47375
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
27375 I I $100.00 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
u
1 n
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund