HomeMy WebLinkAbout229328 2 /25/2014 CITY OF CARMEL, INDIANA VENDOR: 362876 Page 1 of 1
ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $526.76
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 229328
CHECK DATE: 2/25/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 455729 -4, 471 . 24 CREDIT
1205 4347500 455729 4, 998 . 00 GENERAL INSURANCE
Aimbk
TRAVELERS ) PAGE 1
14T62033-ZLP 5216X7087 01/31/2014 000455729 02/15/2014 4,998.00
' � �F-'VK-- CURRENT
CLAIM#: EYQ4713 DATE OF LOSS: 10/10/2013
DESCRIPTION: PROF C - WYNN, BARBARA EEOC COMPLAINT FOR WRONGFUL
TERMINATION FROM CA
CLAIMANT: BARBARA M WYNN
EXPENSE 4,998.00
CLAIM TOTAL 4,998.00
CURRENT CHARGES $4,998.00
ACCOUNT SUMMARY
CURRENT CHARGES 4,998.00 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 4,998.00
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 4,998.00
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE-HELPDESK@TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1-860-277-6812 ANTONIO CONTRERAS
Sze `11� Submitted T®
ll FEB 2 4 2014
Clerk Treasurer
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00763 39190
CITY OF CARMEL, CARMEL CLAY PARKS BUILD
ONE CIVIC SQUARE
CARMEL IN 46032
0
m
n
a
0
0
0
N
O
Q
O
N
VOUCHER NO. WARRANT NO.
Travelers ALLOWED 20
IN SUM OF $
13607 Collections Center Drive
Chicage, IL 60693
$10,847.25
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members .
000455729 43-475.00 $526.76 1 hereby certify that the attached invoice(s), or
� bill(s) is (are)true and correct and that the
0000455728 43-475.00 $1,902.80
materials or services itemized thereon for
1205' 000455727 43-475.00 $2,031.95 Which charge is made were ordered and
/.
1205! 000455727 43-475.00 $6,385.74 received except
Monday, February 24, 2014
Director, Administration
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))
01/31/14 000455729 Fire $526.76
01/31/14 0000455728 Police $1,902.80
01/31/14 000455727 Utilities $2,031.95
01/31/14 000455727 Street $6,385.74
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