HomeMy WebLinkAbout256669 03/18/16 CITY OF CARMEL, INDIANA VENDOR: 362876
1 ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $*****8,140.19*
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 256669
Miior(�°, CHICAGO IL 60693 CHECK DATE: 03/18/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 000498751 5,266.60 5216X7087
1205 4347500 000498753 2,873.59 5216X7087
VOUCHER NO. WARRANT NO.
ALLOWED 20
TRAVELERS
13607 COLLECTIONS CENTER DRIVE IN SUM OF $
CHICAGO, IL 60693
$8,140.19
1
ON ACCOUNT OF APPROPRIATION FOR
General Administration
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members
000498753 43-475.00 $2,873.59 1 hereby certify that the attached invoice(s), or
1205 101
000498751 43-475.00 $5,266.60 bill(s) is (are)true and correct and that the
1205 101
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 14, 2016
c
Cost distribution ledger classification if
claim paid motor vehicle highway fund
3rescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
Nhom, rates per day, number of hours, rate per hour, number of units, price per unit,etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
02/29/16 000498753 $2,873.59
1205 101
02/29/16 000498751 $5,266.60
1205 101
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
TRAVELERS, PAGE 1
THE TOTAL DUE INCLUDES PAST DUE CHARGES.
PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY.
14TG2033-ZLP 521GX7087 02/29/2016 000498753 03/15/2016 16,027.79
CURRENT
CLAIM#: EYQ7995 DATE OF LOSS: 10/11/2013
DESCRIPTION: PLAINTIFF ALLEGES FALSE ARREST.
CLAIMANT: CARL COOPER
EXPENSE 1,234. 19
CLAIM TOTAL 1,234.19
CLAIM#: E2SO202 DATE OF LOSS: 12/29/2014
DESCRIPTION: EPLI C- THOMPSON, JAMES L JR. EEOC COMPLAINT ALLEGING
RETALLIATION DUE
CLAIMANT: JAMES L THOMPSON
EXPENSE 30.80
CLAIM TOTAL 30.80
CLAIM#: E4E1787 DATE OF LOSS: 03/07/2014
DESCRIPTION: CLAIMANT ALLEGES THAT POLICE USED AXCESSIVE FORCE
CAUSING BODILY INJUR
CLAIMANT: LOUIS R PASTORE
EXPENSE 215.60
CLAIM TOTAL 215.60
CLAIM#: E4E8697 DATE OF LOSS: 12/29/2013
DESCRIPTION: GLIA C-REED, ANTHONY TORT NOTICE ALLEGING THAT HIS
VEHICLE AND PERSONA
CLAIMANT: ANTHONY W REED Submitted To
PP11YY EXPENSE 1,393.00
CLAIM TOTAL 1,393.00
MAR 14 2016 CURRENT CHARGES $2,873.5
Clerk Treasurer
TRAVELERS J PAGE 2
DEDUCTIBLE / SELF-INSURED INVOICE
14T62033-ZLP 521GX7087 02/29/2016 000498753 03/15/2016 16,027.79
ACCOUNT SUMMARY
CURRENT CHARGES 2,873.59 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 13, 154.20 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 16.027.79
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 16,027.79
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
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9CR
HARTFORD, CT 06183
00507 38965
CITY OF CARMEL, CARMEL CLAY PARKS
ONE C I V I C--SQUARE_ -_-. - - _---- --._
CARMEL IN 46032
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TRAVELERS PAGE 1
THE TOTAL DUE INCLUDES PAST DUE CHARGES.
PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY.
14N99887-ZPP 5216X7087 02/29/2016 000498751 03/15/2016 7,821 .60
CURRENT
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 5,266.60
CLAIM TOTAL 5,266.60
CURRENT CHARGES 66.60
ACCOUNT SUMMARY
CURRENT CHARGES 5,266.60 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 2,555.00 .AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000
TOTAL DUE 7.821.60
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 7,821 .60
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
MAR 14 2016
Clerk Treasurer
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -gCR
HARTFORD, CT o6183
00506 ooysu
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46033