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