HomeMy WebLinkAbout177248 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $25,194.25
CARMEL, INDIANA 46032 P 0 BOX 1910
CARMEL IN 46082 CHECK NUMBER: 177248
CHECK DATE: 9/1512009
D EPARTM ENT ACCOUNT PO NUMB INVOICE NUMBER AMO D ESCRIPTION
302 5023990 702660 25,194.25 OTHER EXPENSES
INVOICE K 702660
01/01/09 NIS WC -S WCX002730 10/1/09, 4 of WC Insts Citizens Ins Co of America 14,056.75
01/01/09 NIS WC -S WCX002730 10 /I /00, 4 of TPA Insts Citizens Ins Co of America 11,137.50
Invoice Balance: 25,194.25
HYLANT GROUP www.hylant.com
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Local: 317- 817 -5000 Fax: 317- 817 -5151
Prescrib.10 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
Hylant Group Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
'Date Number (or note attached invoice(s) or bill(s))
5,194.25_
Total
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 191 14109 WARRANT NO.
ALLOWED 20
FJU OX 1910 IN SUM OF
Carmel. IN 46082
$25,194.25
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
302 Workers Comp Fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
302 $25,194.25 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
ignat rye e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund