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240890 01/08/15 +u.c4gM �fi" .'• _ CITY OF CARMEL, INDIANA VENDOR: 00352999 d i ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $""'820,227.00' ,. a° CARMEL, INDIANA 46032 301 PENNSYLVANIA PKWY,SUITE 201 CHECK NUMBER: 240890 °1,,i r�N�� INDIANAPOLIS IN 46280 CHECK DATE: 01/08/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4347500 CARMELO-0 19,514.54 GENERAL INSURANCE 1192 4347500 CARMELO-0 7,500.00 GENERAL INSURANCE 1205 4347500 CARMELO-0 586,779.46 GENERAL INSURANCE 1207 4347500 CARMELO-0 10,000.00 GENERAL INSURANCE 1120 4347500 CARMELO-02 90,485.46 GENERAL INSURANCE 1205 R4347500 31661 CARMELO-02 105,947.54 INSURANCE i HYLANT LI GROUP 301 Pennsylvania Parkway, Suite 201 INVOICE _ -Page 1. Indianapolis, IN 46280-0925 ACCOUNT# CSR I,DATE Phone:317-817-5000 CARMEL&02 79 12/9/2014 PRODUCER W. Michael Wells To: City of Carmel EFFECTIVE (EXPIRATION BALANCE DUE ON Attn: Steve Engelking 1/1/2015 1/1/2016 1/1/2015 One Civic Square Amount Due Carmel, IN 46032 $196,433.00 {INVOICE FOR: CRC, 4CDC, CGDC AND CRA I ' 6 Invoice# Trans Policy# Description Company Amount 66199 REN H630581 M4076TI L Property/IM Travelers $148,174.00 66201 REN ZLP14T62033 Genl Liab Travelers $32,806.00 66202 REN H8103036P64ACOF Auto Travelers $0.00 66198 REN XC00000374 Umbrella National Casualty Co. $15,453.00 Amount Due $196,433.00 PREMIUWALLOCATIONS. Prop/11111 Genl Liab Auto Umb Total 4CDC $ 8,028 $ 3,280 $ 1,545 $ 12,853 CGDC $ 8,028 $ 3,280 $ 1,545 $ 12,853 CRA $ 96,337 $ 13,123 $ 6,181 $ 115,641 CRC $ 35,781 $ 13,123 $ 6,182 $ 55,086 TOTALS $ 148,174 $ 32,806 $ 15,453 $ 196,433 ECIerk mitted �-1?S_ 0 5 2014 treasurer 301 Pennsylvania Parkway, Suite 201, Indianapolis, IN 46280 Toll Free: 800-678-0361 Local: 317-817-5000 Fax:317-817-5151 NHYLANT AZJAGRoup 301 Pennsylvania Parkway,Suite 201 INVOICE Page 1 Indianapolis, IN 46280-0925 ACCOUNT# -CSR I DATE Phone: 317-817-5000 CARMELO-0 79 12/9/2014 PRODUCER W. Michael Wells To: City of Carmel EFFECTIVE IEXPIRAT BALANCE DUE ON v Attn: Steve Engelking 1/1/2015 1/1/2016 1/1/2015 One Civic Square _ Amount Due Carmel, IN 46032 $623,794.00 ['INVOICE-FOR ' CITY"OF CARMEL Invoice# Trans Policy# Description Company Amount 66199 REN H630581M4076TIL Property/IM Travelers $72,837.00 66201 REN ZLP14T62033 Genl Liab Travelers $287,017.00 66202 REN H8103036P64ACOF Auto Travelers $208,308.00 66198 REN XC00000374 Umbrella National casualty Co. $55,632.00 Amount Due $623,794.00 �2�5 J �Z 9 301 Pennsylvania Parkway, Suite 201, Indianapolis, IN 46280 Toll Free: 800-678-0361 Local: 317-817-5000 Fax: 317-817-5151 VOUCHER NO. WARRANT NO. Hylant Group ALLOWED 20 IN SUM OF$ " 301 Pennsylvania Parkway, Suite 201 f Indianapolis, IN 46280-0925 $820,227.00 ON ACCOUNT OF APPROPRIATION FOR Administration Department i PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Prior Year Board Members " i � 14 43-475.00 I hereby certify that the attached invoice(s), or ;h. $90,485.46 Prior Year bill(s) is (are)true and correct and that the I .' fi<< 31661 12 4 43-475.00 $105,947.54 Prio'' Ye materials or services itemized thereon for °a© 149.14 43-475.00 $10,000.00 PriorYear ,cj which charge is made were ordered and off— 12.09.14 43-475.00 $7,500.00 O received except Prior Year t, C) 12. .14 43-475.00 $19,514.54 Prior Year 1205 12.09.14 43-475.00 $586,779.46 Wednesday, January 07, 2015 Director, Administration 1 Title r 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 'Y CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by 1 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. } Payee Purchase Order No. :r ' Terms .� ° Date Due Invoice Invoice Description Amount ..y:.. Date Number (or note attached invoice(s)or bill(s)) 12/09/14 12.09.14 FIRE $90,485.46 12/09/14 12.09.14 ADMIN $105,947.54 12/09/14 12.09.14 GOLF COURSE $10,000.00 12/09/14 12.09.14 COMMUNITY SERVICES $7,500.00 w ; ,. 12/09/14 12.09.14 FIRE $19,514.54 12/09/14 12.09.14 ADMIN $586,779.46 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 Clerk-Treasurer