HomeMy WebLinkAbout236549 08/27/14 CITY OF CARMEL, INDIANA VENDOR: 362876
ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $*****2,166.85*
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 236549
a'IruN�. CHICAGO IL 60693 CHECK DATE: 08/27/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 466643 200.10 GENERAL INSURANCE
1205 4347500 466644 1,966.75 GENERAL INSURANCE
TRAVELERS PAGE 1
14N99887-ZPP 5216X7087 07/31/2014 000466644 08/15/2014 1,966.75
CURRENT
CLAIM#: EXK2736 DATE OF LOSS: 07/01/2012
DESCRIPTION: ALLEGATION THAT A CITY OF CARMEL POLICE OFFICER RAN
THE CLMT'S PERSONA
CLAIMANT: NICOLE RYERSON
EXPENSE 906.60
CLAIM TOTAL 906.60
CLAIM#: EYQ5411 DATE OF LOSS: 07/25/2012
DESCRIPTION: PROF C - CIMT WAS ARRETED BY THE MARION COUNTY DRUG
TASK FORCE AND CHA
CLAIMANT: JONAH LONG
EXPENSE 1,060. 15
CLAIM TOTAL 1,060.15
CURRENT CHARGES $1,966.75
ACCOUNT SUMMARY
CURRENT CHARGES 1,966.75 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 1,966.75
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 1 ,966.75
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE-HELPDESK@TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1-860-277-6812 ANTONIO CONTRERAS
Submitted To
AUG 2 5 2014
Clerk `treasurer
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00765 39181
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46032
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TRAVELERS J� PAGE 1
303GP64A-810 521GX7087 07/31/2014 000466643 08/15/2014 200. 10
1 �"of C R CURRENT
CLAIM#: E1E2887 1 DATE OF LOSS: 06/27/2014
DESCRIPTION: BAUT C - WESTHOFF, CHRISTINE: IV ON AN EMERGENCY RUN
HIT MIRROR ON OV
CLAIMANT: CHRISTINE WESTHOFF
LOSS 200.10
CLAIM TOTAL 200.10
CURRENT CHARGES �O-10
ACCOUNT SUMMARY
CURRENT CHARGES 200. 10 INSURED NAME: CITY OF CARMEL,CARMEL CLAY
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 200.10
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 200. 10
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE-HELPDESK@TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1-860-277-6812 ANTONIO CONTRERAS
Submitted To
AUG 252014
Clerk Treasurer
TRAVELERS
NON—FUNDED DEPARTMENT
ONE TOWER SQUARE —9CR
HARTFORD, CT 06183
00766 39180
CITY OF CARMEL,CARMEL CLAY
ONE CIVIC SQUARE
CARME-L I N --46032—
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Travelers
IN SUM OF$ .
13607 Collections Center Drive
Chicage, IL 60693
$2,166.85
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICENO. ACCT#/TITLE AMOUNT Board Members
1205 000466644 43-475.00 $1,966.75 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1205 000466643 43-475.00 $200.10
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday,August 25, 2014
Director,A ministratio
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))
07/31/14 000466644 $1,966.75
07/31/14 000466643 $200.10
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