HomeMy WebLinkAbout321238 01/25/18 CITY OF CARMEL, INDIANA VENDOR: 362876
ONE CIVIC SQUARE TRAVELERS
CHECK AMOUNT: $*****8,321.40*
.;, � ;•
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 321238
CHICAGO IL 60693 CHECK DATE: 01/25/18
4.ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 12.29.17 8,321.40 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 362876
TRAVELERS IN Bunn of$ CITY OF CARMEL
13607 COLLECTIONS CENTER DRIVE 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.
CHICAGO, IL 60693
Payee
$8,321.40
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
General Administration Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
12.29.17 43-475.00 $8,321.40 1 hereby certify that the attached invoice(s),or 12/29/17 12.29.17 $8,321.40
1205 101 Prior Year 1205 101
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
Tuesday,January 23,2018
Crider,James
Administration
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Aim
TRAVELERS J PAGE 1
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14T62033-ZLP 5216X7087 12/29/2017 000531998 01/15/2018 8,321 .40
CURRENT CHARGES
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
EXPENSE 292.60
CLAIM TOTAL 292.60
CLAIM#: FAPS677 DATE OF LOSS: 04/25/2017
DESCRIPTION: GLIA C VARHAN FAY AND KRAL V CITY OF CARMEL BOARD OF
ZONING APPEALS
CLAIMANT: FAY-D VARHAN
EXPENSE 2,300.00
CLAIM TOTAL 2,300.00
CLAIM#: FBU4031 DATE OF LOSS: 11/13/2017
DESCRIPTION: EPLI C - STEWART, LISA EEOC COMPLAINT ALLEGING
VIOLATION OF THE ADAAA
CLAIMANT: LISA STEWART
EXPENSE 2,725.80
CLAIM TOTAL 2,725.80
CLAIM#: FBU4032 DATE OF LOSS: 11/03/2017
DESCRIPTION: EPLI C - SMITH, KYLE EEOC CLAIM ARISING OUT OF
DISCRIMINATION BASED ON
CLAIMANT: KYLE N SMITH
EXPENSE 3,003.00
CLAIM TOTAL 3,003.00
TOTAL CLAIM(S) DUE Subm $8,321.40
i'lled To
JAN 2 3 2018
Mark, T assurer
. a
TRAVELERS"T PAGE 2
DEDUCTIBLE / SELF-INSURED INVOICE
° i i : : i
14TG2033-ZLP 521GX7087 12/29/2017 000531998 01/15/2018 8,321 .40
ACCOUNT SUMMARY
CURRENT CHARGES 8,321 .40 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 8.321.40
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 8,321 .40
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE CONTACT YOUR ACCOUNTING SPECIALIST
ROSA TORRES AT 1-880-277-3284 OR EMAIL RTORRES@TRAVELERS.COM