HomeMy WebLinkAbout239382 11/19/14 CITY OF CARMEL, INDIANA VENDOR: 362876
ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $****21,604.47*
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 239382
CHICAGO IL 60693 CHECK DATE: 11/19/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 472073 713.12 GENERAL INSURANCE
1205 4347500 472074 7,533.00 GENERAL INSURANCE
1205 4347500 472075 13,358.35 GENERAL INSURANCE
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00708 39251
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46032
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TRAVELERS PAGE 1
14N99887-ZPP 5216X7087 10/31/2014 000472075 11/15/2014 13,358.35
T7 Rollc.,— CURRENT
CLAIM#: EVB6603 DATE OF LOSS: 11/08/2012
DESCRIPTION: C -PARK,GREG EEOC COMPLAINT OF DISCRIMINATION BASED ON
RETALIATION FOR
CLAIMANT: GREG PARK
EXPENSE 9,405.97
r7 �j�l•�� CLAIM TOTAL 9,405.97
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 74.50
CLAIM TOTAL 74.50
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 1,702.68
CLAIMANT: JONAH LONG
EXPENSE 1,218.20
CLAIM TOTAL 2,920.88
CLAIM#: EIE6133 DATE OF LOSS: 07/01/2012
DESCRIPTION: ALLEGATION THAT A CITY OF CARMEL POLICE OFFICER RAN
THE CLMT'S PERSONA
CLAIMANT: NICOLE RYERSON
EXPENSE 957.00
CLAIM TOTAL 957.00
CURRENT CHARGES $13,358.35
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00710 39248
CITY OF CARMEL,CARMEL CLAY
ONE CIVIC SQUARE
CARMEL IN 46032
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TRAVELERS PAGE 1
: il 11
303GP64A-810 521GX7087 10/31/2014 000472073 11/15/2014 713. 12
CURRENT
CLAIM#: E2J5533 DATE OF LOSS: 10/13/2014
DESCRIPTION: BAUT C- - YOUNG, WILLIAM P. IV WAS IN STOP AND GO
TRAFFIC AT A LIGHT AN
CLAIMANT: WILLIAM P YOUNG .
LOSS 713.12
CLAIM TOTAL 713.12
CURRENT CHARGES $713.12
ACCOUNT SUMMARY
CURRENT CHARGES 713. 12 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 713.12
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 713. 12
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
FNOV
itted To
17 2014
clerk -Treasurer
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00709 39249
CITY OF CARMEL, CARMEL CLAY PARKS BUILD
ONE CIVIC SQUARE
CARMEL IN 46032
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14TG2033-ZLP 521GX7087 10/31/2014 000472074 11/15/2014 7,533.00
CURRENT
CLAIM#: EON3470 DATE OF LOSS: 05/28/2014
DESCRIPTION: EPL CLAIM: OFFICER CLAIMS SEXUAL HARASSMENT AND
HOSTILE WORK ENVIRONME
CLAIMANT: CRYSTAL HUGHES -
EXPENSE 2,533.00
CLAIM TOTAL 2,533.00
CLAIM#: EIP1011 DATE OF LOSS: 04/03/2014
DESCRIPTION: GLIA C- NASH, MICHAEL, NOTICE OF POTENTIAL SUBROGATION
FROM USAA FOR B
CLAIMANT: MICHAEL NASH
LOSS 5,000.00
CLAIM TOTAL 5,000.00
CURRENT CHARGES $7,533.00
ACCOUNT SUMMARY
CURRENT CHARGES 7,533.00 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 7,533.00
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 7,533.00
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE-HELPDESK@TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1-860-277-6812 ANTONIO CONTRERAS
Submitted To
Submltte�
NOV 17 2014
Cberk treasurer
TRAVELERSJ� PAGE 2
DEDUCTIBLE / SELF-INSURED INVOICE
itml 14r
14N99887-ZPP 521GX7087 10/31/2014 000472075 11/15/2014 13,358.35
ACCOUNT SUMMARY
CURRENT CHARGES 13,358.35 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 13,358.35
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 13,358.35
CONTACT--YOUR AGENT -LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE-HELPDESK@TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1-860-277-6812 ANTONIO CONTRERAS
Submitted To
N0V 1 7 2014
Clerk Treasurer
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00708 39250
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46032
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Travelers
IN SUM OF$
13607 Collections Center-Drive
Chicage,°IL 60693
$21,604.47
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members III
I hereby certify that the attached invoice(s), or
.1205 000472074 43-475.00 $7,533.00
- bill(s) is (are)true and correct and that the
1205 000472073 43-475.00 $713.12 i
- . materials or services itemized thereon for
1205_ I 000472075 I 43-475.00 I $13,358.35 which charge is made were ordered and
9 I
received except
Monday November 17, 2014
t 6
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Director, Administration
Title
i
.Cost distribution ledger.classification if ! .
claim paid motor vehicle highway fund
i �I
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))
10/31/14- 000472074 $7,533.00
10/31/14 000472073 $713:12
10/31/14 I 000472075 I I $13,358.35
i
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