202441 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
ONE CIVIC SQUARE HYLANT GROUP
k l CHECK AMOUNT: $5,833.00
CARMEL, INDIANA 46032 Po BOX 4os2s
INDIANAPOLIS IN 46082-4910 CHECK NUMBER: 202441
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 771852 -46.00 CORR FIRE MAZ MAT
1205 4347500 771925 466.00 BLDG LIMITS
1205 4347500 771928 4,443.00 PARKING GARAGE
1205 4347500 772438 135.00 SCULPTURE ADDED
1205 4347500 772440 432.00 LIMIT ON PARKING GAR
1205 4347500 772460 403.00 STUDIO THEATHER 15M
INVOICE 772160
01/01/11 +EN PCKG 630581 M4076 ADD COV STUDIO THEA Travelers Insurance Companies 403.00
ADD BLDG COV $15,000,000 FOR STUDIO THEATRE AT 3 CENTER
GREEN, CARMEL. IN ALLOCATE: CRC
Invoice Balance: 403.00
OCT 10 2011
Sy -W--
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 678 -0361 Local: 317 817 -5000 Fax: 317- 817 -5151
4ol(k) Investments Benefits
z S Y$' 3 a$,.g i�.x ,,-a �s¢. d Y+ "g" �a T' s y^6FT.�` y
2 �s Eff DateTm Types Policy _Descript�ona'� 4mount'_
a INVOICE 771928
01/01/11 +EN PCKG 6305SIM4076 ADD PARKING GARAGE Travelers Insurance Companies 4,443.00
ADD PARCEL 7 PARKING GARAGE a 881 THIRD AVE, SW, CARMEL, IN
$10,000,000 LIMITS. ALLOCATE PREMIUM: CRC/CGDC
Invoice Balance: 4,443.00
OU 1 2011
By
�w
Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925
61 (Local: 317 -817 -5000 Fax: 317- 817 -5151
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INVOICE 771852
01 /01 /10 -EN PCKG GP09313908 CORREC'I'PREM Travelers Insurance Companies -46.00
ENDT ADDING HAZ MAT KITS INCORRECTLY CHGD FOR TWICE.
ALLOCATE TO FIRE DEPT.
Invoice Balance: -46.00
_a
OCT
10 1011
By
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -5151
41
MkWanagement
B enefits
INVOICE 771925
01/01/11 +EN PCKG 63058IM4076 INC BLDG LIMITS Travelers Insurance Companies 466.00
INC BLDG LIMITS AT ONE CIVIC SQUARE, TWO CIVIC SQUARE AND
THREE CIVIC SQUARE PER UPDATED APPRAISALS
ALLOCATE PREMIUM: ADM IN $130, I-IRE $117; POLICE $219
Invoice Balance: 466.00
7 W
D
OCT 1 1011
By
301 Pennsylvania Parkway Suite 201 P.O..Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 -678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -5151
40
ef it
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INVOICE t# 772438
01 /01 /11 +EN PCKG 63058IM4076 INC FINE ARTS SCH Travelers Insurance Companies 135.00
ADD COVERAGE FOR "AMBASSADOR OF THE STREET" SCULPTURE VALUED
AT $78,000. ALLOCATE TO CITY
Invoice Balance: 135.00
Gti 1�2011
By-
30 1 Pennsylvania Parkway Suite 201 P.Q. Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 -678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -5151
f its'
Risk Manager�16nt Insurance 4i B ene
Eff Date Frn T e Polic "Descri tion Amount M=
INVOICE 4 772440
01 /01 /11 +EN PCKG 6305SIM4076 INC PROP SCH rravelers Insurance Companies 43100
INCREASE LIMIT ON PARCEL 7 PARKING GARAGE TO INCLUDE CIVIC
SUPPORT BUILD OUT ALLOCATE CRC /CGDC
Invoice Balance: 432.09
n L EJ
U
0 CI T 1 7.011
By�_
301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925
Toll Free: 800 678 -0361 Local: 317 -81.7 -5000 Fax: 317 -817 -5151
-Risk Management Insurance 40
VOUCHER NO. WARRANT NO,
ALLOWED 20
Hylant Group
IN SUM OF
301 Pennsylvania Parkway, Suite 201
Indianapolis, IN 46280 -0925
$5,833.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO Dept, INVOICE NO. ACCT /TITLE AMOUNT Board Members
1205 771928 43- 475.00 $4,443.00 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 771925 43- 475.00 $420.00
materials or services itemized thereon for
1205 772438 43- 475.00 $135.00 which charge is made were ordered and
1205 772440 43- 475.00 $432.00 received except
1205 772460 43- 475.00 $403.00
Mon y, October 10, 2011
Director, Administratio
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))
09/23/11 771928 $4,443.00
09/23/11 771925 $420.00
09/30/11 772438 $135.00
09/30/11 772440 $432.00
09/30/11 772460 $403.00
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