321535 02/13/18 y G4q'' CITY OF CARMEL, INDIANA VENDOR: 00352999
I; 2i ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $****73,21,2.00*
.?�. CARMEL, INDIANA 46032 PO BOX 638720 CHECK NUMBER: 321535
�rt>ud�o
CINCINNATI OH 46263-8720 CHECK DATE: 02/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4347500 167890 59,434.00 GENERAL INSURANCE
1125 4347500 167890 13,778.00 GENERAL INSURANCE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 00352999 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Hylant Group Payee
PO Box 638720
Cincinnati, OH 45263-8720 In sum of$ Purchase Order#
00352999 Hylant Group Terms
$ 73,212.00 PO Box 638720 Date Due
Cincinnati, OH 45263-8720
ON ACCOUNT OF APPROPRIATION FOR
101-General/109 Monon Center
PO#or Invoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1125 167890 4347500 $ 13,778.00 Board Members 12/15/17 167890 Annual Insurance Premium 2018 50889 $ 13,778.00
1091 167890 4347500 $ 59,434.00 12/15/17 167890 Annual Insurance Premium 2018 50889 $ 59,434.00
1 hereby certify that the attached invoice(s),or
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
$ 73,212.00 Total $ 73,212.00
February 12,2018
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
Cost distribution ledger classification if
i
claim paid motor vehicle highway fund Signature —,20—
Accounts
20_Accounts Payable Coordinator Clerk-Treasurer
Title
L_-na
�15Ln Indianapolis �f11� 1678.90
f Cel"#
orth\' idian St;Ste�200t
• 290 Dat �. Balance Due.On
PLANTalis,IN 46290
__ ..
P=- '
(800)678=0361 12/1'x/20 i7 1/1/2018
hylant com' F-(317)817-5151
Insured
City of Carmel.
..Account Number
Ammo
CARMELO-02
3,212 00
City of Carmel
Attn: Parks:Departmen MR,.a � _
One Civic Square -
Carmel, IN 460.32. FEB 0:7 .2018-
BY:
010.BY:
PleaseN'Return f,T§p with_Remittance To PO2 EBgk 638720,Cincinnati,OH 45263-8720
Item#, Trans Eff Date ;Due Date Trans Description A ' ' 'Amount .
Umbrella-Commercial.Excess. Policy# 5111007800. Effective:, . 1/1/18 .= 1/1119
Issuing.Company..
1286159 1/1/2018 1/1/2018 RENB 18/19.Umbrella: 11,635.00.
Package-Commercial, Policy.# 6.30581M4076: Effective: 1/1118 VIM.—
Issuing.
Issuing.Company
1286692 1/1/2018 1/1/2018 RENB .18/19.Property Package. 32,588.00
Business:Auto - Policy'# 8103036P64A: Effective:.: - 111118 1/1/19
Issuing.Company..
1.286154 1/1/201,8 . : 1/1/2018 RENB
18/19 Automobile- 5,054.00 .
Package-Commercial Policy# ZLP14T62033 -'Effective:, 9/1/48. .= -1/1/19
Issuing.Company, .
1286143. 1/1/2018 1/1/2018 RENB . 18/19 Liability Package.' 23,935.00.' .
Total Invoice Balancer
$73,292.00
PACKAGE LIABIUTYPACKAGE Total, .
Departrnent Propei !'Crime Inland/Marine : GL Liquor_ Law Enf Pubic Clgmt EPL _ Auto_- _Umbrella By_Dept
Parks I
tylonon : S 27,514.00 S S :14;070.00;$ .18: 15 1,500,00 1 S 5 800 00 S j S 10550:00L
School .S S -�$ S i..5 1 5
All Other S 3,198 00;S" 1876 00 S 1,585 00;$ 5 : - !$ 180.00 1 S 800 00 ;S 5,054:00 I S 1085.00 .
_ _. _ - _. _.. -
Parks Total !$ 30,712 00 $ 1,876 00,$ '15,655.00:1$ _ $ _ $ 1,680.00 _$. '6.600.00;x$ 5,054.001$ 11i636;00]:$ 13,212.00
HYLANT. Hylant-Indianapolis .10401 North Meridian St,Ste 200 Indianapolis, IN 46290
12/15/2017 .City of Carmel Loan# Invoice#167890 FARWE1 Page 1 of 1