Lay the pavers. Then set the medalion in the spot where it goes. Cut the pavers. Then, remove an area 3'x3'. Excavate down 6". Pour a slab and brush finish it so the top of the slab is even with the bottom of the medalion.
Lay the pavers back, but you will have to cut the pavers at the hieght you need to bond to the concrete. Bond them to the concrete.
Then apply goober goop (paver bond) or use epoxy to the top of the concrete where the medallion goes.
To keep the medalion shiney, use two part acrylic and dump over the top, let dry.
Works fairly well.
In the year 1491, if the Naturescape Landscape Company did the site work in Pisa, Italy, they would not be calling it the "leaning" tower.
Encinitas, Ca. 92024