HomeMy WebLinkAbout322842 03/12/18 Q
CITY OF CARMEL, INDIANA VENDOR: 362876
CHECK AMOUNT: $"""'228.68`
ONE CIVIC SQUARE TRAVELERSCARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK NUMBER: 322842
CHICAGO IL 60693 CHECK DATE: 03/12/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT I DESCRIPTION
1205 4347500 000535023 166.28 GENERAL INSURANCE
1205 4347500 000535024 62. 0 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 362876 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
TRAVELERS IN SUM OF$ CITY OF CARMEL
13607 COLLECTIONS CENTER DRIVE An invoice or bill to be properly itemized must show:kind 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
$228.68
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
000535024 43-475.00 $62.40 1 hereby certify that the attached invoice(s),or 2/28/18 000535024 $62.40
1205 101 1205 101
000535023 43-475.00 $166.28 bill(s)is(are)true and correct and that the 2/28/18 000535023 $166.28
1205 101 1 materials or services itemized thereon for 1205 101
which charge is made were ordered and
received except
Monday, March 12,2018
CA-9-0 C�e4
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
/lftk
TRAVELERS J PAGE 1
POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER PAYMENT DUE TOTAL DUE'
14T62033—ZLP 5216X7087 02/28/2018 000535024 03/15/2018 62.40
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 62.40
CLAIM TOTAL 62.40
TOTAL CLAIMS) DUE $62.40
ACCOUNT SUMMARY
CURRENT CHARGES 62.40 INSURED NAME: CITY OFj CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 17-5000
TOTAL DUE 62.40
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 62.40
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED .TO YO�R POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE CONTACT YOUR ACCOUNTING SPECIALIST
ROSA TORRES AT 1-860-277-3284 OR EMAIL RTORRES@T AVELERS.COM
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TRAVELERS J PAGE 1
POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER PAYMENT DUE TOTAL DUE
3036P64A-810 521GX7087 02/28/2018 000535023 03/15/2018 166.28
CURRENT CHARGES
CLAIM#: ESM4777 DATE OF LOSS: 11/06/2017
DESCRIPTION: CARDONA, CHRIS VEHICLE WAS BACKED INTO BY INSURED
VEHICLE.
CLAIMANT: CHRIS CARDONA
LOSS 166.28
CLAIM TOTAL 166.28
TOTAL CLAIMS) DUE $166.28
ACCOUNT SUMMARY
CURRENT CHARGES 166.28 INSURED NAME: CITY 0 CARMEL,CARMEL CLAY
PAST DUE CHARGES 0.00 AGENT NAME: HYLANTGROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) :17-5000
TOTAL DUE 166.28
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 166.28
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YO�R POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE CONTACT YOUR ACCOUNTING SPECIALIST
ROSA TORRES AT 1-860-277-3284 OR EMAIL RTORRES@TRAVELERS.COM
MAR 0 7 2018 1