205198 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $760.00
CARMEL, INDIANA 46032 P 0 Box 40926
INDIANAPOLIS IN 46082 -4910 CHECK NUMBER: 205198
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 780253 760.00 GENERAL INSURANCE
M H YLA NT ndi B po 0 IN 46280 -0925 Local: 317 17 -soao INVOICE 780
G ROUP CSR U a»-
CARM180 79 12/27/11
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104864945
W. Michael Wells
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City of Carmel 0 01/01/13 01 /01/12
MOUNTDUE ...a,f. -ws
Steve Engelking I 760.00
One Civic Square
Carmel, IN 46032
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INVOICE 780253
01/01/12 REN CR -S 104864945 IDENTITY FRAUD Travelers Insurance Companies 760.00
Invoice Balance: 760.00
Fy 2012
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 -678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -5151
e
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hylant Group
IN SUM OF
301 Pennsylvania Parkway, Suite 201
Indianapolis, IN 46280 -0925
$760.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1205 780253 43- 475.00 $760.00
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
Wedtnesday, January 04, 2012
Director, Administratio
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/27/11 780253 $760.00
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