240908 01/13/15 ,:'.c�A,,f� CITY OF CARMEL, INDIANA VENDOR: 00352999
® � ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $***255,172.00*
?� CARMEL, INDIANA 46032 301 PENNSYLVANIA PKWY,SUITE 201 CHECK NUMBER: 240908
9�,_ INDIANAPOLIS IN 46280 CHECK DATE: 01/13/15
�*ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4347500 PARKS 55,936.00 GENERAL INSURANCE
1125 4347500 PARKS 17,462.00 GENERAL INSURANCE
601 5023990 UTILITIES 93,448.00 INSURANCE
651 5023990 UTILITIES 88,326.00 INSURANCE
HYLANT
MGROUP
301 Pennsylvania Parkway,Suite 201 INVOICE
Indianapolis, IN 46280-0925 ACCOUNT# `CSR ` DATE_,
s.
Phone: 317-817-5000 CARMELO--02 7912/9/2014
PRODUCER , , ' _
W. Michael Wells
To: City of Carmel EFFECTIVE EXPIRATIO BALANCE D.UEON y
Attn: Steve Engelking 1/1/20151 1/1/2016 1/1/2015
One Civic Square M 'Due ,
Carmel, IN 46032 $181,774.00
INVOICE FOR UTILITIES t '
N { f
i f i 4. d t •4 'E 3y.Y Y� t A f - Y f �
Invoice# Trans Policy# Description Company Amount
66199 REN H630581M4076TIL Property/IM Travelers $67,509.00
66201 REN ZLP14T62033 Genl Liab Travelers $43,742.00
66202 REN H8103036P64ACOFAuto Travelers $49,918.00
66198 REN XC00000374 Umbrella National Casualty Co. $20,605.00
Amount Due $181,774.00
PREMIIUM ALLOCATIQNS�� ' � �
Prop/IM Genl Liab Auto--- __ Umb `Total 00�
Sewer $ 34,404 $ 22;308 $ 19,153 $ 10,509 '$,-A%374,,
Water:; $ 33,105 $ 21,434 $ 26,861 $' 10,096 $ 91,496:.
Utilities $ 3,904 $:a:
TOTALS $ 67,509 $ 43,7421 $ 49,918 $ 20,605
301 Pennsylvania Parkway,Suite 201, Indianapolis, IN 46280
Toll Free:800-678-0361 Local:-317-817-5000 Fax:317-817-5151
I
VOUCHER # 142709 WARRANT # ALLOWED
00352999 IN SUM OF $
HYLANT GROUP
P.O. Box 1910
Carmel, IN 46082
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR i
II
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
120914 01-1620-00 $93,448.00
I
V
I
Voucher Total $93,448.00
I
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00352999
HYLANT GROUP Purchase Order No.
P.O. Box 1910 Terms
Carmel, IN 46082 Due Date 1/8/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/8/2015 120914 $93,448.00
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
Date Officer
OHYLANT
GROUP
301 Pennsylvania Parkway,Suite 201 INVOICE ;Page 1
Indianapolis, IN 46280-0925 ACCOUNT#_ CSR � DATE
Phone:317-817-5000 CARMELO-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 $181,774.00
INVOICE FOR: UTILITIES
Invoice# Trans Policy# Description Company Amount
66199 REN H630581M4076TIL Property/IM Travelers $67,509.00
66201 REN ZLP14T62033 Gen[ Liab Travelers $43,742.00
66202 REN H8103036P64ACOFAuto Travelers $49,918.00
66198 REN XC00000374 Umbrella National Casualty Co. $20,605.00
Amount Due $181,774.00
PREMIUM ALLOCATIONS _ _ _
Prop/IM Gen[Liab Auto Umb Total
Sewer $ 34,404 $ 22,308 $ 19,153 $ 10,509 $ 86,374"
Water $ 33,105 $ 21,434 $ 26,861 $ 10,096 $ 91,498
Utilities $ 3,904 $ 3,904 t�y�
TOTALS I 1 $ 67,509 $ 43,742 $ 49,918 1 $ 20,605 1 $. 181;774
301 Pennsylvania Parkway,Suite 201, Indianapolis, IN 46280
Toll Free:800-678-0361 Local: 317-817-5000 Fax: 317-817-5151 - —
VOUCHER # 146376 WARRANT # ALLOWED
00352999 IN SUM OF $
HYLANT GROUP
P.O. Box 1910
Carmel, IN 46082
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
12914 01-1620-00 $88,326.00
1
Voucher Total $88,326.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00352999
HYLANT GROUP Purchase Order No.
P.O. Box 1910 Terms
I
Carmel, IN 46082 Due Date 1/8/2015
I _
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/8/2015 12914 $88,326.00
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
/4/s ,
Date Officer
HYLANT
4 GROUP
JAN 0 ,7 2015
LBY:
301 Pennsylvania Parkway,Suite 201 _j
INVOICE Page 1u
Indianapolis, IN 46280-0925 ACCDlit�7T#
Phone: 317-817-5000 CARMELO-02 79 12/9/2014
W. Michael Wells
To: City of Cannel 1=FEE�TI1 EXPIRAT_fb w GE,DLID(
Attn: Steve Engelking 1/1/2015 1/1/2016 1/1/2015 1-7
One Civic Square
Carmel, IN 46032 $73,398.00
INVOICE FOR. sPARKS:DEP-ARTIIAENT i �" r
Invoice# Trans Policy# Description Company Amount
66199 REN H630581M4076TIL Property/IM Travelers $28,747.00
66201 REN ZLP14T62033 Genl Liab Travelers $24,057.00
66202 REN H8103036P64ACOF Auto Travelers $9,261.00
66198 REN XC00000374 Umbrella National Casualty Co. $11,333.00
Amount Due $73,398.00
PRENII;tIIfA�.,AL�L'RCA�t'�N_5
Prop/IM Genl Liab Auto Umb Total
Monon $ 24,084 $ 21,652 $ 10,200 $ 55;936 — �Ql�
School -
All Other $ 4,663 $ 2,405 $ 9,261 $ 1,133 $ 17,462.
TOTALS $ 28,747 $ 24,057 $ 9,261 $ 11,333 $ 73;398
301 Pennsylvania Parkway,Suite 201, Indianapolis, IN 46280
Toll Free:800-678-0361 Local: 317-817-5000 Fax:317-817-5151
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00352999 Hylant Group Terms
301 Pennsylvania Parkway, Suite 201 Date Due
Indianapolis, IN 46280-0925
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/9/14 66199 Annual insurance premium $ 17,462.00
12/9/14 66199 Annual insurance premium $ 55,936.00
Total $ 73,398.00
1 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
i
Voucher No. Warrant No.
00352999 Hylant Group Allowed 20
301 Pennsylvania Parkway, Suite 201 I'
Indianapolis, IN 46280-0925
In Sum of$
$ 73,398.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund/109 -Monon Center
PO#or Board Members
Deptept# INVOICE NO. kCCT#/TITLI AMOUNT '
1125 66199 4347500 $ 17,462.00 1 hereby certify that the attached invoice(s), or
1091 66199 4347500 $ 55,936.00 bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
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January 8, 2015
1 �
Signature
$ ' 73,398.00 Accounts Payable Coordinator
Cost distribution ledger classification if I Title
claim paid motor vehicle highway fund
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