HomeMy WebLinkAbout215362 12/11/2012 a CITY OF CARMEL, INDIANA VENDOR: 366179 Page 1 of 1
f ONE CIVIC SQUARE LIBERTY MUTUAL INSURANCE CO
CARMEL, INDIANA 46032 25762 NETWORK PLACE CHECK AMOUNT: $975.00
+ � CHICAGO IL 60673-1257 CHECK NUMBER: 215362
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CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4347500 975 . 00 GENERAL INSURANCE
Liberty Mutual Surety INVOICE
Invoice Summary CORDRAY, DIANA L.
Balance overdue 0.00 US Dollars
Balance currently due 975.00 US Dollars
Less unapplied funds 0.00 US Dollars
Total due Liberty Mutual Surety by Nov 15,2012 975.00 US Dollars
Auing-of Over_d.ve_Balances_ _
Receivable account for US Dollars transactions is current as of Nov 1, 2012
Please direct any questions regarding this invoice to the National Bond Center at 888-844-2663 or bonds @libertymutual.com.
Please direct any payment inquiries to our Customer Accounting Department at 877-751-2640 or suretyinvoice @libertymutual.com.
Liberty INVOICE DATE: November 1, 2012
Mutual. Bond Transaction Detail
CORDRAY, DIANA L. -953935871
Indianapolis
Transactions in US Dollars
Premium Now Due
Surcharges
Transaction Dividends Other Net Premium
LMS Bond# Alt Bond# Bond Description Bond Amount Obligee Period Premium Expenses Amount Cleared Balance
o LSF022774 5067093 Treasurer Treasurer 300,000.00USD CITY OF CARMEL 01101113-01101114 I 975.00 0.00 0.00 975.00
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N Total Premium Now Due in US Dollars 975.00 0.00 0.00 975.00
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A Member of the Liberty Mutual Group
WARRANT NO.
ALLOWED 20
IN SUM OF $
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INT OF APPROPRIATION FOR
Board Members
DICE NO. ACCT#!TITLE AMOUNT 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
Signature
stribution ledger classification if Title
aid motor vehicle highway fund
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Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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