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Home My WebLink About321910 02/13/18 CITY OF CARMEL, INDIANA VENDOR: 362876 ® ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $***""5,792.04* a' CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 321910 CHICAGO IL 60693 CHECK DATE: 02/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4347500 0005333496 5,576.80 GENERAL INSURANCE 1205 4347500 000533498 215.24 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 362876 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER TRAVELERS IN SUM OF$ CITY OF CARMEL 13607 COLLECTIONS CENTER DRIVE An invoice or bill to be properly itemized must show:kind ofservice,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 $5,792.04 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 000533497 43-475.00 $215.24 1 hereby certify that the attached invoice(s),or 1/31/18 000533497 $215.24 1205 101 1205 101 000533496 43-475.00 $5,576.80 bill(s)is(are)true and correct and that the 1/31/18 000533496 $5,576.80 1205 1 1 101 1 materials or services itemized thereon for 1205 1 101 which charge is made were ordered and received except Thursday, February 08,2018 A-0 CL� 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 TRAVELERS PAGE 1 DEDUCTIBLE / SELF-INSURED INVOICE POLICY NUMBER ACCOUNTTOTAL 303GP64A-810 521GX7087 01/31/2018 000533497 02/15/2018 215.24 MAIL PAYMENT TO: PAYER: TRAVELERS CITY OF CARMEL,CARMEL CLAY 13607 COLLECTIONS CENTER DRIVE ONE CIVIC SQUARE CHICAGO, IL 60693 CARMEL IN 46032 RETURN THIS PORTION WITH YOUR CHECK MADE PAYABLE TO TRAVELERS. PLEASE WRITE THE POLICY & ACCOUNT NUMBER ON..YOUR CHECK. TRAVELERS JSk PAGE 1 NUMBERPOLICY : 3036P64A-810 5216X7087 01/31/2018 000533497 02/15/2018 215.24 CURRENT CHARGES CLAIM#: ESM4777 DATE OF LOSS: 11/06/2017 DESCRIPTION: CARDONA, CHRIS VEHICLE WAS BACKED INTO BY INSURED VEHICLE. CLAIMANT: CHRIS CARDONA LOSS 215.24 CLAIM TOTAL 215.24 TOTAL CLAIMS) DUE $215.24 ACCOUNT SUMMARY CURRENT CHARGES 215.24 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 215.24 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 215.24 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 1-860-277-3284 OR EMAIL RTORRES@TRAVELERS.COM FEB 0 8 2018 C" Mi, iyfr.r.rl>c... .ef TR�riELERS� PAGE 1 DEDUCTIBLE / SELF-INSURED INVOICE POLICY NUMBERiTOTAL DUE� 14TG2033—ZLP 5216X7087 01/31/2018 000533496 02/15/2018 13,898.20 MAIL PAYMENT TO: PAYER: TRAVELERS CITY OF CARMEL 13607 COLLECTIONS CENTER DRIVE ONE CIVIC SQUARE CHICAGO, IL 60693 CARMEL IN 46032 RETURN THIS PORTION WITH YOUR CHECK MADE PAYABLE TO TRAVELERS. PLEASE WRITE THE POLICY & ACCOUNT NUMBER-ON YOUR CHECK. TRAVELERS PAGE 1 THE TOTAL DUE INCLUDES PAST DUE CHARGES. PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY. POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER 14TG2033—ZLP 5216X7087 01/31/2018 000533496 02/15/2018 11111AG, 13, 8.20 CURRENT CHARGES " I CLAIM#: E4ES697 DATE OF LOSS: 12/29/2013 DESCRIPTION: GLIA C—REED, ANTHONY TORT NOTICE ALLEGING THAT HIS VEHICLE AND PERSONA CLAIMANT: ANTHONY W REED EXPENSE 140.00 CLAIM TOTAL 140.00 CLAIM#: E7C8067 DATE OF LOSS: 10/24/2017 DESCRIPTION: VECTREN ENERGY — EMPLOYEES OF UTILITY DEPARTMENT WAS USING A PROBE ROB CLAIMANT: /VECTREN ENERGY LOSS 5,000.00 CLAIM TOTAL 5,000.00 CLAIM#: FBU4031 DATE OF LOSS: 11/13/2017 DESCRIPTION: EPLI C — STEWART, LISA EEOC COMPLAINT ALLEGING VIOLATION OF THE ADAAA CLAIMANT: LISA STEWART EXPENSE 405.60 CLAIM TOTAL 405.60 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 p EXPENSE 31 .20 CLAIM TOTAL 31.20 b FEB ® 8 2018 f, PPPLLL ITr�ffi�..it.r__.v.>a.: l.._.t.i-. .....-...-r..•._`.[.a.=.�rv. TRA�/ELFRS J� PAGE 2 DEDUCTIBLE / SELF-INSURED INVOICE POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER PAYMENT DUE TOTAL DUE 14T62033-ZLP 521GX7087 01/31/2018 000533496 02/15/2018 13,898.20 PAST DUE 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 EXPENSE292.60 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 eCj 3,003.00 TOTAL CLAIMS) DUE $13,898.20 ACCOUNT SUMMARY CURRENT CHARGES 5,576.80 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN PAST DUE CHARGES 8,32 . AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 13,898.20 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 13,898.20 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 1-860-277-3284 OR EMAIL RTORRES@TRAVELERS.COM