HomeMy WebLinkAbout184112 04/13/2010 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
ONE CIVIC SQUARE HYLANT GROUP
CARMEL, INDIANA 46032 P 0 BOX 40925 CHECK AMOUNT: $3,957.00
INDIANAPOLIS IN 46082 -4910 CHECK NUMBER: 184112
CHECK DATE: 4/1312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 720712 1,100.00 GENERAL INSURANCE
1 4347500 721581 2,857.00 GENERAL INSURANCE
HYLANT P.O. Box 40925
Indianapolis, IN 46280 -0925
GROUP Local: 317 817 -5000 INVOICE# 721 581
CARMEN 79 03/25/10
r W. Michael Wells
01/01/09
2,857.00
City of Carmel
Steve Engellung
One Civic Square
Carmel, IN 46032
INVOICE 721581
01/01/09 AUD PCKG GPO9313908 AUTO FINAL AUDIT Travelers Insurance Companies 2,857.00
FINAL AUDIT PERIOD 1/1/09 -10. PRENUUM ALLOCATION: STREI I
DEPT. $220 ADD'L. POLICE DEPT. $2,637.
STREET DEPT. 1 ADD L VEHICLE POLICE DEPT. 12 ADD'L
VEHICLES
Invoice Balance. S 2,857.00
D Q
APR 12 2010
HYLANT GROUP www.hylant.com
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Local: 317- 817 -5000 Fax: 317 -81.7 -5151
TRAVELERS J
DELIVERY .INVOICE
Company: audit
Policy Period Audited: 01/01/2009 TO 01/01/2010
Cl7 X off', 'C
N Agency Number: 130741 -2
S CARMEf [N 4603- Transaction Type: Final Auto Audit
U
R
E Processing Date: 03/01/10
D Policy Number. GP09313908
A TN.
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E %�rDtiapnixs trr a�2so
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Policy Description Amount Surtax/
Number Surcharge
GP09313908 COMMERCIAL AUTO COVERAGE $2,857.00
Account Due Premium Surtax/
Date Date Surcharge
03/01110 04/10/10 $2,857 $0.00
INSURED COPY TOTAL DUE: $2,857.00
NOTE:. THIS IS NOT A BILL, YOU WILL RECEIVE A SEPARATE BILLING INVOICE.
Entity Name: 6ftd RMEL ETG _Il�h
Policy Period: 00041 U09 O. t3 _10112D10 Policy Number: Number: 'OF Q9313908
Liability Coverages
New Count of Powered Units
Old Count count from any completed endorsements
375
Difference
6 5flI
Comprehensive Coverage
New Ph sical Damage Original Cost New
Old Physical Dama a values from an completed endorsements
Difference
Collision Coverage
New Physical Damage Original Cost New
Old Physical Damage values from any completed endorsements
F
Difference
PEN
Specified Perils
New Physical Damage Original Cost New
Old Physical Dama a values from an completed endorsements
:5
y1
Difference
old rates multiplied by exposures equals RIP or All'
Liability: 388, x
X
_t.
rte.:
X _t
Comprehensive M- D_17 x
Collision: E_.._,0 7t1a: x :.$182,98.: $235:
SP: -L r., x
Calculated Premium:
Total Additional Premium: TZ85T.00
HYLANT P.O. Box 40925
Indianapolis, IN 46280 -0925
d GROUP Local: 317- 817 -saoo INVOICE 720712 age
i�r CARME -9 79 03/14/10
1
r^,PR0D UCER.:
W. Michael Wells
6ALAi7CE' 1T lJEON£. ��"k.._.,`"
04/12/10
x IOU+IT :,u4 �$r .;a..�',k4 ,�n'.`G Al 0U1VT'6U�E �e c<.�;;„� ..a'<a_ 3 ar...,.4i
1,100.00
Carmel Farmers Market, Inc.
Ron Carter
12715 Stanwich Place
Carmel, TN 46033
d
13 s t" ,w ,y sh o y�xE:.%`� 8�§ B '�"'ni°�����,A r Y: s.{ a as' p. `�5� P` b�..: g ,...�.�4 F"'�a� i s.. d r. r u f� �;`,s
INVOICE 4 720713
04/12/09 REN D &O 104733360 D &O POLICY Travelers Insurance Companies 1,100.00
tnvoiceBatance: 1,100.00
D Q
APR 12 2010
By
HYLANT GROUP www.hylant.com
301 Pennsylvania Parkway Suite 201 PO- Box 40925 Indianapolis, IN 46280 -0925 Local. 317- 817 -5000 Fax: 317 -817 -5151
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hylant Group
IN SUM OF
301 Pennsylvania Parkway, Suite 201
Indianapolis, IN 46280 -0925
$3,957.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Administration
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1205 721581 43- 475.00 $2,857.00 1 hereby certify that the attached invoice(s), or
1205 720712 43- 475.00 $1,100.00 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
/1 Friday, April 09, 2010
Director, Administrati n
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No,
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
03/25/10 721581 $2,857.00
04/12/10 720712 $1,100.00
1 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
2a
Clerk- Treasurer