Loading...
166538 12/09/2008 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1 ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $634.00 P o BOX 1910 CARMEL, INDIANA 46032 CARMEL IN 46082 CHECK NUMBER: 166538 CHECK DATE: 12/9/2008 DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION _902 4460807 673913 148.00 ENERGY CENTER `902 4460807 673915 429.00 ENERGY CENTER 1205 4347500 674313 57.00 GENERAL INSURANCE i :14YLANT PO. Box 1910 Carmel, IN 46082 GR�UF Local: 317 -817 -5000 I N V O I C ]E 674313 CARME80 8Y 11/25/08 c W. Michael Wells 1 1/25108 57.00 City of Carmel Steve Engelking One Civic Square Carmel, IN 46032 Uw010E 674313 01101/08 MEM PCKG GPO9313908 Identity Theft Coverage Travelers Insurance Companies 57.00 Administration Dept. Invoice Balance: 57.00 HYLANT GR OUP wwmitylant.com 501 Congressional Blvd Suitc 300 P.O. Box 1910 Carmel, IN 46032 LocaI: 317 817 -5000 Fax: 317 -817 -5151 Pre3cribed by Slate Board of Accounts City Form No. 291 (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 Hylant Group Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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 Clerk- Treasurer VOUCHER Nj'-�8WARRANT NO. y ar ALLOWED t Group 20 IN SUM OF PO Box 1910 Carmel, IN 46082 $57.00 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1205 Administration Board Members DEPT. or INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or 1205 674313 475 $57. 0, 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 20 F. al� h Title Cost distribution ledger classification if claim paid motor vehicle highway fund �t?, a'.�' L��i .-,�'4 u it �G_�... Eff'Date Trrr T e =Palk Loan fA Descri bon p Q r g f' Amount, yp.. y 5 O�x. c i�`�•���k� `a 'X�.��'�x,� X s ,�..�T �.:._5 "e s+ c:'� �a�,,.•%s mar''` �C T. INVOICE 673915 10/22/07 +EN BR -I 06637524 Extend Cov. to 12/10108 Federal Insurance Company 429.00 Builders Risk Energy Center Invoice Balance: 429.00 HYLANT G ROUP www.hytant.com 501 Congressional Blvd Suite 300 PO. Box 1.910 Carmel, IN 46032 focal: 317 -817 -5000 Fax: 317- 817 -5151 cHUBe Hand arrne Insurance Premium Bill Policy Period OCTOBER 22, 2007 TO DECEMBER 10, 2008 Effective Date NOVEMBER 11, 2008 Policy Number 0663 -75 -24 IND Insured CARMEL REDLVELOPMENT COMMISSION AND CONTRACTORS INTERESTS Name of Company FEDERAL INSURANCE COMPANY Date Issued NOVEMBER 1.3, 2008 Portion of total premium attributable for terrorism and statutory standard fire where applicable is 0.00 PLEASE SEND PAYMENT TO AGENT OR BROKER. POLICY PERIOD EXTENDED Additional Date Payment Due Premium NOVEMBER 11, 2008 $429.00 TOTAL 429.00 WHEN SENDING PAYMENT, PLEASE- WI)ICA "I'E POLICY NUMBER ON YOUR CHECK, NOTE: PLEASE RETURN THIS BILL WITH PAYMENT AND INCLUDE ANY ADDITIONAL CHANGES. Producer: HYLANT GROUP INC 811 MADISON AV1 IJ17 TOLEDO, 01-143624-0000 last page �.w Form 04 -02 -0841 (Ed. 9 -95) Premium Bdl Page 1 cHUBe INLAND MARINE INSURANCE Schedule of Forms Policy Period OCTOBER 22, 2007 TO DECEMBER 10, 2008 Effective Date NOVEMBER 11, 2008 Policy Number 0663 -75 -24 IND Insured CARMLI_, REDEVELOPMENT COMMISSION AND CONTRACTORS INTERESTS Name of Company FEDERAL INSURANCE COMPANY Date Issued NOVEMBER 13, 2008 The following is a schedule of additional forms included with this policy: Form Number Form Name 04 -02 -0638 (Ed. 9 -95) PROPERTY DECLARATIONS 04 -02 -0859 (Ed. 6 -99) AMENDMENT OF POLICY PERIOD last page Form 80 -02 -1999 (Ed. 4 -94) Schedule of Forms Page 1 CHUBB Inland Marine Insurance Declarations Chubb Group of Insurance Companies 15 Mountain View Road Warren, NJ 07059 Named Insured and Mailing Address Policy Number 0663 -75 -24 IND CARMEI_ REDEVELOPMENT COMMISSION AND CONTRACTORS INTERESTS Effective Date NOVEMBER 11, 2008 ONE CIVIC SQUARE CARMEL, IN 46032 Issued by the stock insurance company indicated below, herein called the company. FEDERAL INSURANCE COMPANY Producer No. 0035144 Incorporated under the laws of INDIANA Producer HYLANT GROUP INC 811 MADISON AVENUE TOLEDO, 01-1 43624-0000 Policy Period From: OCTOBER 22, 2007 To: DI"ICE.MBER 10, 2005 12:01 A.M. standard time at the Named Insured's mailing address shown above. The Following displays the premises covered under this insurance. Premises Summary PREMISES 1 126TI -I RANGELINI RI) CITY Cl' ;N "I`LR DR. CARMEL, IN 46032 Buildinb Number: 1 Inland Marine Insurance Issue Date: NOVEMBER 13, 2008 continued Form 04-02-06,18 'Ed, 9 -95) Declarations Page i Premises Summary (continued) THIS PAGE INTENTIONALLY LEFT BLANK Inland Marine Insurance Issue Date. NOVEMBER 13, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 2 cHU�e Inland Marine Insuran Declarations Chubb Group of Insurance Companies 15 Mountain View Road Warren, NJ 07059 Named Insured and Mailing Address Policy Number 0663 -75 -24 IND CARMBL REDEVELOPMENT COMMISSION AND CONTRACTORS INTERESTS Effective Date NOVEMBER I1, 2008 ONE CIVIC SQUARE CARMEL, IN 46032 Issued by the stock insurance company indicated below, herein called the company. FEDERAL INSURANCE COMPANY Producer No. 0035144 Incorporated under the laws of INDIANA Producer HYLANT GROUP INC 811 MADISON AVENUE TOLT:DO, OH 43624 -0000 Policy Period From: OCTO11 R 22, 200)7 To: DECEMBER 10, 2008 12:01 A.M. standard time at the Named Insured's mailing address shown above. Deductible: S 10,000 The deductible shown above applies to all coverages, except Business Income and Extra Expense, contained within this policy unless a specific coverage deductible is shown below. The following displays the coverages provided by this policy. Coverages PREMISES 1 126TH RANGEI_INL RD., CII`Y CENTER DR, CARMEL, IN 46032 Building Number: I CONTRACT WORKS DESCRIPTION ENERGY CENTER LUAIT OF INSURANCE 6,500,000 DEDUCTIBLE 10,000 SOFT COSTS LIMIT OF INSURANCE'- 50,000 DEDUCTIBLE 168 HOURS Inland Marine Insurance Issue Date: NOVEMBER 13, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 3 �S Premises Coverages (continued) EFFECTS OF LAW LIMIT OF INSURANCE 1,000,000 LOSS PREVENTION EXPENSE LIMIT OF INSURANCE 25,000 ELECTRONIC DATA AND VALUABLE PAPERS LIMIT OF INSURANCE 50,000 FUNGUS CLEAN -UP OR REMOVAL LIMIT Oh INSURANCE S25,000 RENTAL INCOME Lfl\4lT OF INSURANCES 50,000 WAITING 1 12 HOURS Coverage at Unnamed Premises The following displays the coveragcs provided at other premises. PREMISES ANY OTHER PREMISES WITHIN THE COVERAGE TERRITORY CONTRACT WORKS AWAITING DELIVERY LIMIT OF INSURANCE 600,000 Coverages Away From Premises The following displays the coverages provided away from premises. CONTRACT WORKS IN TRANSIT LIMIT OF INSURANCE S200,000 Coverages at Named Premises, Unnamed Premises and Away From Premises The following displays the coverages provided at premises which are specil iically covered under this insurance, other premises and away from premises. DEBRIS REMOVAL 11MIT OF INSURANCES 150,000 Inland M arine Insurance Issue Date: NOVEMBER 13, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 4 cwuBe Inland Marine Insurance Declarations Effective Date NOVEMBER 11, 2008 Policy Number 0663 -75 -24 fND Premises Coverages (continued) POLLUTANT CLEAN UP OR REMOVAL LIMIT OF INSURANCE 50,000 EXPEDITING EXPENSES LIMIT OF INSURANCE 50,000 PREPARATION OF LOSS FEES LIMIT OF fNSUIZANC1 25,000 PUBLIC SAFETY SERVICE CHARGES LIMIT OF INSURANCE 25,000 Inland Marine Insurance Issue Date: NOVEMBER 13, 2008 last page Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 5 CHUE30 Inland Marine Insurance Endorsement Policy Period OCT013EK22.2007 TO DECEMBER \D.2008 Effective Date N0V0J8[K||.2000 Policy Number 0663'75'24QND Insured CAQMELKEDEV|-`L0YM ENT COMM lSS|8N AND CONTRACTORS INTERESTS Name ofCompany B INSURANCE COMPANY Date Issued N0V8&182R|9.2008 This Endomemon/oppUex/o the following formx: yROJBCTBU/iDEQ8'R|SK Common Poli Conditions 3CH|]}UD� This policy io issued for (he period 12:01 &M8undardTimc m the Named hsumd'nMailing Address. Policy Period: Pmm 10/22/2007l'o 12/1()/2008 CONDITIONS: Under Conditions, the following condition is added: AMBNDh4BN[UFPOOCYMBiOD The policy period of this poUoy, as dupoihod in the Insuring Agnccmen/. Premium 3unuoxry. Dcx|umdona and other documents that comprise /hixpnUcy is deleted and replaced wi/h the Policy period shown in the Schedule above. This endorsement does not modify, limit or enlarge any other policy pmvixinox, nor does it minmu\o any of' the Limits o[Insurance. All other |om^ and conditions remain uochonocd. Authorized Representative Inland Marine Insurance AMENDMENT OF POLICY PERIOD last page Form n*'u»nuxy(Eu6-o9) snm,momon, Page a`.? arsmr'7....-e� 3 "'�"e. .„x.. ro-n e x' MINE r Eff Date Trn T e bPolic a YR, Y Descnpt�onw 3, z INVOICE 673913 10122/07 BEN BR -I 06637524 Extend Cov. to I I/l/08 Federal Insurance Company 148.00 Builders Risk, Energy Center Invoice Balance: 148.00 HYLANT GROUP www.hylantxom 501 Congressional Blvd Suite 300 PO. Box 1910 Carmel, IN 46032 Local: 317 817 -5000 Fax: 31.7 817 -5151 OHUBe Inland arine Insurance Premium Bill Policy Period OC`FOBER 22, 2007 TO NOVEMBER 01, 2008 Effective Date OCTOBER 22, 2008 Policy Number 0663 -75 -24 WD Insured CAR.MEL REDEVELOPMENT COMMISSION AND CONTRACTORS INTERESTS Name of Company FEDERAL INSURANCE COMPANY Date Issued NOVEMBER 4, 2008 Portion of total premium attributable tier terrorism and statutory standard fire where applicable is 0.00 REISSUE: Initially issued under incorrect policy number. Policy Period Extended Date Payment Due Premium October 22, 2008 $148.00 TOTAL 148.00 Producer: HYLANT GROUP INC 811 MADISON AVE NU11 TOLEDO, OH 43624 -0000 last page Form 04 -02 -0841 (Ed. 9 -95) Premium Bill Page 1 cHUBB INLAND MARINE INSURANCE Schedule of Forms Policy Period OC OBE'R 22, 2007 "rO NOVEMBER 01, 2008 Effective Date OCTOBER 22, 2008 Policy Number 0663 -75 -24 IND Insured CAI MEL 12E1)I7VELOPMI NT COMMISSION AND CONTRACTORS INTERESTS Name of Company FEDERAL INSURANCIs COMPANY Date Issued NOVI MBER 4, 2008 The Following is a schedule or additional forms included with this Policy: Form Number Form Name 04 -02 -0638 (Id. 9 -95) PROPERTY I)ECLARATIONS 04 -02 -0859 (Ed. 6 -99) AMENDMENT OF POLICY PERIOD fast page Form 80 -02 -1999 (Ed. 4 -94) Schedule of Forms Page 1 criuBE3 Inland Marine Insurance Declarations Chubb Group of Insurance Companies 15 Mountain View Road Warren, NJ 07059 Named Insured and Mailing Address Policy Number 0663 -75 -24 IND CARMEL REDEVEL.OPMI NT COMMISSION AND CONTRACTORS MTERESTS Effective Date OCTOBER 22, 2008 ONE CIVIC SQUARE CARMEL, IN 46032 Issued by the stock insurance company indicated below, herein called the company. FEDERAL INSURANCE COMPANY Producer No. 0035144 Incorporated under the laws of INDIANA Producer IIYLANT GROUP INC 811 MADISON AVENUE TOLEDO, 01-1 43624 -0000 Policy Period From: OCT0131 R 22, 2007 To: NOVEMBER 01, 2008 12:01 A.M. standard time at the Named Insured's mailing address shown above. The following displays the premises covered under this insurance. Premises Summary PREMISES 1 126TI -I CITY CENTER DR CAIWEL, IN 46032 Building Number: 1 126'1'1-1 RANGELINE RD., CITY CENTEIZ DR. CARMEL, IN 46032 Buildinc Number: 1 Inland Marine Insurance Issue Date: NOVEMBER 4, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 1 ESL Premises Summary (continued) THIS PAGE INTENTIONALLY LEFT BLANK Inland Marine Insurance issue Date. NOVEMBER 4, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 2 0Hu13E3 Inland Marine Insurance Declarations Chubb Group of Insurance Companies 15 Mountain View Road Warren, NJ 07059 Named Insured and Mailing Address Policy Number 0663 -75 -24 IND CARMEL REDEVELOPMEN f COMMISSION AND CONTRACTORS INTERESTS Effective Date OCTOBER 22, 2008 ONE CIVIC SQUARE CARMEL, IN 46032 Issued by the stock insurance company indicated below, herein called the company. FEDERAL INSURANCE COMPANY Producer No. 0035144 Incorporated under the laws of INDIANA Producer 1-IYLANT GROUP INC RI 1 MADISON AVENUE l'OI- .1?D0, 01 143624 -0000 Policy Period From: 0C"I'0BFR 22, 2007 To: NOVEMBER O1, 2008 12:01 A.M, standard time at the Named Insured's mailing address shown above. Deductible: 10,000 The deductible shown above applies to all coverages, except Business Income and Extra Expense, contained within this policy unless a specific coverage deductible is shown below. The following displays the coverages provided by this policy. Coverages PREMISES 1 126T1 I CITY CENTER DR CARMEL, IN 46032 Building Number: 1 CONTRACT WORKS DESCRIPTION ENERGY CENTER LIMIT OF INSURANCE S6,000,000 DEDUCTIBLE S 10,000 SOFT COSTS LIMIT OF INSURANCE $50,000 DEDUCTIBLE 168 HOURS Inland Marine Insurance Issue Date: NOVEMBER 4, 2008 continued �,vr, Form 04 02 0638 (Ed. 9 -95) Declarations Page 3 Premises Coverages (continued) EFFECTS OF LAW LIMIT OF INSURANCE 1,000,000 LOSS PREVENTION EXPENSE LIMIT OF INSURANCE 25,000 ELECTRONIC DATA AND VALUABLE PAPERS LIMCP 01` INSURANCE S50,000 FUNGUS CLEAN -UP OR REMOVAL LIMIT OF INSURANCE 25,000 RENTAL INCOME LIMIT OIANSURANCE S50,000 WAITING PERI017 12 HOURS PREMISES r 126T1 -I CITY CENTER DR (continued) CARMEL,, IN 46032 Building Number: CONTRACT WORKS DESCRIPTION ENERGY CENTER LIMIT OF INSURANCE 6,500,000 DEDUCTIBLE 10,000 SOFT COSTS LIMIT OF INSURANCE 50,000 DI?DUCTIBLE 168 HOURS EFFECTS OF LAW LIMIT OF INSURANCE 1,000,000 LOSS PREVENTION EXPENSE LIMIT OF' INSURANCE 25,000 ELECTRONIC DATA AND VALUABLE PAPERS LIMIT OF INSURANCE 50,000 FUNGUS CLEAN -UP OR REMOVAL LIMIT Or INSURANCE 25,000 RENTAL INCOME LIMIT OF INSURANCE 50,000 WAPPING PER101) 12 HOURS Coverage at Unnamed Premises The following displays the coverages provided at other premises. Inland Marine Insurance Issue Date: NOVEMBER 4, 2008 continued Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 4 OHUBe Inland Marine Insurance Declarations Effective Date 0CT0131::R 22, 2008 Policy Number 0663 -75 -24 fND Premises Coverages (continued) PREMISES ANY OTHER PREMISES WITHIN THE COVERAGE TERRITORY CONTRACT WORKS AWAITING DELIVERY LIMIT OF INSURANCE S600,000 Coverages Away From Premises The following displays the coverages provided away from premiscs. CONTRACT WORKS IN TRANSIT LIMIT Oh INSURANCE 200,000 Coverages at Named Premises, Unnamed Premises and Away From Premises The following displays the coverages provided at premises which are specifically covered under this insurance, other premises and away from premises. DEBRIS REMOVAL LIMIT OF INSURANCE 150,000 POLLUTANT CLEAN UP OR REMOVAL LIMIT" OF INSURANCE 50,000 EXPEDITING EXPENSES LIMIT OF INSURANCE. 50,000 PREPARATION OF LOSS FEES LIMIT OI" INSURANCE 25,000 PUBLIC SAFETY SERVICE CHARGES LIMIT OF INSURANCE S25,000 Inland Marine Insurance Issue Date: NOVEMBER 4, 2008 194 page Form 04 -02 -0638 (Ed. 9 -95) Declarations Page 5 CHUBS Inland Marline Insurance Endorsement Policy Period OCTO13ER 22, 2007 TO NOVEWER O1, 2008 Effective Date OCTOBER 22, 2008 Policy Number 0663 -75 -24 IND Insured CARME'L REDI NT COMMISSION AND CONTRACTORS IN E,f�17S'rS Name of Company FEDERAL INSURANCE COMPANY Date Issued NOVEMBER 4, 2008 This Endorsement applies to the following forms: PROJECT 131111..DERS' RISK Common Policy Conditions SCI-II?DULE: This policy is issued for the period 12:01 AM Standard Time at the Named Insured's Mailing Address. Policy Period: From 10/22/2007 To 11/01/2008 CONDITIONS: Under Conditions, the following condition is added: AMENDMENT OF POLICY PERIOD The policy period of this policy, as described in the Insuring Agreement, Premium Summary, Declarations and other documents that comprise this policy is deleted and replaced with the Policy Period shown in the Schedule above. This endorsement does not modify, limit or enlarge any other policy provisions, nor does it reinstate any of the Isimits of Insurance. All other terms and conditions remain unchanged. Authorized Representative'" Inland Marine Insurance AMENDMENT OF POLICY PERIOD last page Form 04 -02 -0859 fEd. 6 -99) Endorsement Page 1 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 l G 11 lTr y Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note "attached invoice(s) or bill(s)) v/' cC"s La? 00 I 1 -zv q1 1 �l 8y vo Total 57'7. 'b a 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 cat IN SUM OF moo, 'B a l�ll0 '7- a ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 9a Z '73915 4(o080 I-12 ?aU bill(s) is (are) true and correct and that the gb Z 73 X13 L `j &oW materials or services itemized thereon for which charge is made were ordered and received except C 20 Cost distribution ledger classification if Titl claim paid motor vehicle highway fund