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205382 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 2 0 ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $684,918.00 CARMEL, INDIANA 46032 P 0 BOX 40925 INDIANAPOLIS IN 46082-4910 CHECK NUMBER: 205382 CHECK DATE: 1/17/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 781734 22,293.50 OTHER EXPENSES 651 5023990 781734 22,293.50 OTHER EXPENSES 601 5023990 781738 18,491.50 OTHER EXPENSES 651 5023990 781738 18,491.50 OTHER EXPENSES 601 5023990 781740 20,206.00 OTHER EXPENSES 651 5023990 781740 20,206.00 OTHER EXPENSES 1205 4347500 781741 173,630.00 GENERAL INSURANCE 1205 4347500 781744 66,516.00 GENERAL INSURANCE 601 5023990 781745 9,640.00 OTHER EXPENSES 651 5023990 781745 9,640.00 OTHER EXPENSES 1120 4347500 781992 17,740.54 GENERAL INSURANCE 1205 R4347500 21671 781992 20,675.74 INSURANCE 1205 R4347500 26420 781992 24,154.72 INSURANCE CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 2 of 2 f ONE CIVIC SQUARE HYLANT GROUP CHECK AMOUNT: $684,418.00 CARMEL, INDIANA 46032 P o BOX 40925 INDIANAPOLIS IN 46082 -4919 CHECK NUMBER: 205382 CHECK DATE: 1/1712012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4347500 781993 72,259.46 GENERAL INSURANCE 1192 4347500 781993 7,700.00 GENERAL INSURANCE 1205 4347500 781993 151,079.54 GENERAL INSURANCE 1207 4347500 781993 9,900.00 GENERAL INSURANCE 7� HYLANT P.O. Box 40925 Indianapolis, IN 46280 -0925 b Local: 317 817 s000 INVOICE 781734 P�� °e ul a GROUP ,kccom NO CSR: v s.�L. ;�..._.,.M, v...:. CARME80 79 01/06/12 Package CoMine tal 630581 M4076 ._PRODUCFR 4 mob._..,...:: ��,.....::s_.,..._ W. Michael Wells x .�.:�ECECTIVE,...�� ,�.�E \P,iR,+.T10N_:A.� .:3.:ISAL?.NCE`DllE.ON__ ti City of Carmel 01/01/12 04/01/13 01 /01 /12 _AAtOUNTJP 1D .Nab AN'IOUNT DId.E Steve Engelking 44,587.00 One Civic Square Carmel, IN 46032 rEff�ateTrn g"pAmount INVOICE 9 781734 01/01/12 MEM PCKG 63058IM4076 PACKAGE Travelers InSnrance Companies 44,587.00 UTILITIES PROPERTY, INLAND MARINE CRIME: $44,587 Invoice Balance: 44,587.00 301 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 Risk"Managernent Insurance'- 40 W Investments Benefits HYLANT P.O. Bap i�it 46280 -0925 INVOICE 7$1738 Local: 317 -817 -5000 OZ G R OUP ._DrATP m ____w�.,�.,_.__ c s.. CARML80 79 01/06/12 Cen 'bility (1 "/97) f 14 N 99887 .PRODUCER,,,, .w.,�....�,.�..,.�.......,,r .e�..�� .�...�.a..? "..._,.,R.z W. Michael Wells ATION_�.,.... yd,. BALAICE�DUE01 \,..:..;..;.__.,�.�.�.x. City of Carmel 01/01/12 01101113 01 /01 /12 �_..1MOI NTY AID? ..m „,.,,,,„ter \nIOUNT_DUE .A,.�.__.w Steve Engelking 36,983.00 One Civic Square Carmel, IN 46032 "x„ sx a,�..� ��a s: �'"t� r �X w '__s•;�'r g�� x '�""�"y� --.•I F _.r. :...•.r..a.:ws �s».i,?«.. sp�� S �a�a, aS. t �a�. a. .8;�. °'`4 't ,...�..�...'.�.a.a�� ti:�,`�'.:.�Y- "rte _...y..uus..� INVOICE 781738 01/01/12 MEM GL -S 14N99887 GENL LIAB Travelers Insurance Companies 36,983.00 UfILITIES $36,983 Invoice Balance: 36,983.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Tall Free: 800 678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -5151 41 HYLANT Indianapo x409 [N 46280 -0925 x p Eiabe,w l 4 GROUP Local: 317- 817 -5000 INVOICE# 781740 ,<ccouN'r.NO CAIZME80 79 01/06112 r Automobile .$usutcss S1rup 8103036P64A W. Miebael Wells �Ef?rECT1VE` :..�,,..E \PIRi1T]ON..,i.� �sBALANCE'. DUE O\ ;,,39^";.,.r.�.,.,...,.:�.:,.M+ Ci of Carmel 01/01/12 01/01/13 01/01/12 =i r1110UNT_PAI11. L-1-2. x2 ...\R10UNT_DOE Steve Engelking S 40,412.00 One Civic Square Carmel, IN 46032 7 7 7 7 7 �Eff, Date rn TYpe: Policy# ,e1 DescnpEion� r 'r Amount x y i.;,�' f, a. a;. K... ys ...,.:.�.a.'*"a�.^� �P. ax v�., r �w�.: "`.�.a�;:..��'...::w. ="Y� i'� �L� s m�` ks�Ger a INVOICE 781740 01/01/12 MEM CA -S 8103036P64A AUTO Travelers Insurance Companies 40.412.00 UTILITIES $40,412 Invoice Balance: 40,412.00 30IPennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Toll Free: 800- 678 -0361 Local: 317 -817 -5000 Fax: 317 -817 -51.51 Insurance Risk AAAnageMent HYLANT Indiana IN s. p IN V O I CE 4 781745 GRO� Local: 317- 817 -5000 nCCUUVT N0 CSL Y u �TF CARME80 79 01/06/12 ��lImb►ell� C�o►n►n'I�S►mp yy a.�.�� ►�C� .....a� .�mr A.�.k..1 x., �i rte., :kk.S .2t_ .e.+ XC00000040 W. Michael Wells .EFFECTI� e'.'...�uN�. F,AP4RA1'lON Li CE:DUF,O� 4 $n,?,r ,,._....,...'4..., City of Carmel 01/01/12 01/01/13 01/01/12 'OUNT PAID w_ .w .r`A610UN'r:DtJE X Steve Engelking 19,280.00 One Civic Square Carmel, IN 46032 kt �Descri tion INVOICE 78174; 01/01/12 MEMUM -S XC00000040 UMBRELLA National Casualty Company 19,280.00 UTILITIES $19.280 Invoice Balance: S 19,280.00 301 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 W Investments Benefits Prescribed by State Board of Accounts Form No. 301 Rev` 1995) 4 ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount -1 rL: I hereby certify that the attached invoice(s), or 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 19 Signature Title 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. 19 Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. ACCT. nlo. CARMEL, INDIANA 6 Favor Of RZO (4p �N aP�A tiA d Iis �w yt,� o Total Amount of Voucher Deductions_ IR 7q O 6 0 1 0 7 7 56 C) Amount of Warrant s 7 0G3t i cc) Month of 19 VOUCHER RECORD Acct. No. Source of Su pply Water Treatment Transmission and Dist. Customer Accounts Administrative and General Operation Maintenance Utility Plant in Service Constr. Work in Progress Materials and Supplies Customers Deposits Total Allowed Board of Control Filed Official Title BOYCE FORMS SYSYEMS 1- 800. 382 8702 325 L A hidianapoliis9 MH Y 1N 46280 -0925 INVOICE# 781734 Local: 317 -817 -5000 Pub GROUP �ccoun r vo YcsH �,�Te ,r CARME80 79 01/06/12 fkhf';K Pacl �deSiCOnlnlCrCtal�.�a,'- `•y ,t. 3_..��`^ �'i`"'._� -.'.tr .Ci'r' 630581 M4076 ,siP,RODUCk.12 W. Michael Wells }EF.[CCTI \,E tk. \P.tRA1'ION �.t BaL�NCE;DUE,ON ?m.c City of Carmel 01/01/12 01101113 01/01/12 UNMP Is,.'AI1f0UP7k 0 0a Steve Engelking 44,587.00 One Civic Square Carmel, IN 46032 nt 'tiw y r r �5r`'.�j.� r ��:..�'kee .y. at, 5�i�.- �a�N 9 rd 4 §i�- ��a` kn 'Policy; .Amount{ EffDate °Trn T e �F INVOICE 781734 01 /01/12 MEM PCKG 63058IM4076 PACKAGE Travelers Insurance Companies 44,587.00 UTILITIES PROPERTY, INLAND MARINE CRIME: $44,587 Invoice Balance: 44,587.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, 1N 46280 -0925 Toll Free: 800 678 -0361 Local: 317 -817 -5000 Fax: 317 817 -5151 M H P.O. Box 40925 �h YI,ANT Indianapolis, IN 46280 -0925P e 1 INVOICE# 781738 �b GROUP Local: 317 -817 -5000 CARME80 79 01/06/12 W MT N �Geliel��l Ltabthty {1 97) 14N99887 S w P,ROD[7CER W. Michael Wells Ci ty of Carmel 01/01/12 01/01/13 01/01/12 "1NRT FAN ,Fp10UATdOUE Steve Engelking 36,983.00 One Civic Square Carmel, IN 46032 ry 1 �„Eff�Dateb. Trim Type:Po11cy� Descripf� x .1 INVOICE t{ 781738 01/01/12 MP-_M GL -S 14N99887 GENL LIAB Travelers Insurance Companies 36,983.00 UTILITIES $36,983 Invoice Ba €ante: 36,983.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Toll Free: 800- 678 -0361 Local: 3'17- 817 -5000 Fax: 317 -817 -5'151 HYLANT P .O Bap i09rN 46280 OUP INVOICE 4 781740 Page 1 ��`R 7l Local: 317- 817 -5000 t ?x �:"a� „NO. ,,a:`�;i�:®:,.�...,_,...rs... CARM ESO 79 01/06 /12 ��A�utomoblle Business S�mp�>�� 8103036P64A W. Michael Wells EFF. ECT11�Eti��. EYEUiA ON��''„.aa�_ '�'5'a� 01/01/12 O1 /01 /13 01/01/12 Ci of Carmel 'AtiLOUNT; ,,AID Steve Engelking S 40,412.00 One Civic Square Carmel, IN 46032 g g EffDate TrnarType Pol y y m w INVOICE 781740 01 /01/12 MEM CA -S 8103036P64A AUTO Travelers Insurance Companies 40,412.00 UTILITIES $40,412 Invoice Balance: 40,412.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Tndianapohs, IN 46280 -0925 Toll Free: 800 678 -0361 Local. 317 -817 -5000 Fax: 317 817 -5151 ME -MEM N 'HYLANT Indianapolis, P.O. 1N 46280 -0925 P�ae {1 Local: 317- 817 5000 I N V O ICE 781745 b d GRO ,CCOUN 1,0. CSIt s TM, i D. \TE CARMEN 79 01/06/12 a xUlllhl- Cllai� C.OI11n1 xj �KS'�a +ra a. L' �*u`.P.OLIC1sH �_.s.:`." .£e iy: ".�.'...�.r.>,.= i..'- s...._.= a:u:`G. r i ,mow XC00000040 W. Michael Wells EFON` 01/01/12 01/01/13 01/01/12 City of Carmel \ilfOU`J1uPi�LD A NT OUNTsDUE Steve Engelking 19,280.00 One Civic Square Carmel, IN 46032 n .fi fi}t 2� �r }'�a e,, a e` a .,r iii _t Eff Dated Trri Type Policy f Description p- K r F Amount•„ INVOICE 781745 01/01/12 MEM UM -S XC00000040 UMBRELLA National Casualty Company 19,280.00 UTILITIES $19.280 Invoice Balance: 19,280.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis IN 46280 -0925 Toll Free: 800 678 -0361 Local: 317 -817 -5000 Fax: 317-811-5151 Prescribed b State Board of Accounts ACCOUNTS PAYABLE VO UCHER TO ADDRESS Invoice Date Invoice '�ur4er Item Amount hereby certify that the attached invoioo(s), or bill(s), is (are) true and correct and that the mab*ha|a or services itemized thereon for which charge is made were ordered and received except 1 19 Signature Tide hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. 19 Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS SANITATION DEPARTMENT ACCT- CARMEL, INDIANA H y InN 1 /t4"%' Favor Of Total Amount of Voucher Deductions 79r7Y5 qb yo 715 1110 2,924b z N SV I iM I s 3 4 222. 0 Amount of Warrant Cg& 31 46 Month of 19 VOUCHER RECORD ANo. Collection System Operation Plant Commercial General Undistributed Construction Depreciation Reserve Stock Accounts Merchandise Total Allowed Board Members Filed BOYCE FOAMS SYSTEMS 1- 800-382 -8702 325 U HY L U anapol IN 46280 I NT Indi s0925 �Tj�� Tn Local: 317 817 -5000 .1 lv V 4 I C E 78].992 GROIJL \CCOEtN'1'ti0.. •C$N CAl2ME80 79 01/1 0/12 Package Commercial POLICY n 630581 M4076 W. Mich Wells EFFECTIVE 4 EXPERA'PION BALANCE'DUE ON City of Carmel 01/01/12 01/01/13 01/01/1 A \IDUNT�PAII}s• At10UNTDUE Steve Engelking S 62,571.00 One Civic Square Carmel, IN 46032 Eff Date 'Trn ,Type Policy., tJescrtp'tion` q .4 Arnount_ INVOICE 781992 01/01/12 MEM PCKG 630581M4076 PACKAGE, Travelers Insurance Companies S 62,571.00 CITY OF CARMEL PROPERTY, INLAND MARINE CRIME Invoice Balance: 5 62,571.00 D JAN 17 2W By 301 Pennsylvania Parkway Suite 201 P.U. Sox 40925 Indianapolis, IN 46280 -0925 'Poll Free: 800 -678 -0361 Local: 317- 817 -5000 Fax: 317- 817 -5151 MEN= I�YL,I�:NT P.O, 13o� 40925 P Indianap IN 46280 -0925 I N V O I C E# 781993 Page. I /ry Local: 317- 817 -5000 I r� o' f ACCOUNT NO. CSR DA'Z'E v CARME80 79 01 /1.0/12 General Liability (1/97) POLICY 14N99887 9'Nt]llUCER W. Michael Wells :XFFECr•.IVE, EXPIM71ON. BALANCE DUE ON City of Carmel 01 /01/12 01/01/13 01/01/12 ra�iru rl �,uii• :+iourr•uu►: Steve Engelking S 240,939.00 One Civic Square Carmel, IN 46032 Eff Date, Trn Type Policy.# o p •'Descrlpflon Amount INVOICE 0 781993 01 /01/12 MEM GL -S 14N99887 GENL LIA13 Travelers Insurance Companies S 240,939.00 CITY OF CA.RMEL $240,939 Invoice Balance: 240,939.00 Q JAN 17 2012 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 d b' VG AN T P.O, Box 40925 lIIdiannpoiis, IN 46280 -0925 INVOICE 781741 Local: 317-$17 -5000 UP CC OunT Nf? GSK; _�ISATF. CARMEN 79 01106112 rOLIC 'Autmm�bdc 1l3usu►c,� Slnik "3 ,f f 8103036P64A FROn1ICPR:.'.3r W. Michael Welts t r A Pnt. \TION "AA L A \GE UUE`t?N a City of Ca net 01 /01/12 01 /01/1.3 01/01/12 �AAtOLN 'x ..._.ro.:... F.�91GUhT,DU6ca.,: Z e Steve En;elking S 173,630.00 One Civic Square Carmel, IN .46032 .fit s. y d ._iA.. 4.t��y`jy�' i l n� `.T` {f b �,p�� ,a1 t. E .ti. .,f €irf F•. sEff; Dake Trn T ei Pollc t. r ,',l �1� r Descr {ption ft: �.'r, �a r t ,r•. �f�`�'ax 'r s l 1 Amount 1 b '44. `b Z i t rs p.rst yr�yfk'.�•r 1 e. �..w4,r tyt k �:r X �Ci 1 a �,t. w,.- +..E..• 1� a.. .i. .a....:� ._�.lt'.t :;s•:..�ii .r 4:' F}' r: fEv :'�ii,�... ...�z`^ .F INVOICEN 781741 01/01/12 MI M CA -S 8103016k4A Au• o Travelers Insurance Companies 173,6X00 CITY OF CARMErL $173,630 Invoice Balance: 173,630.00 D JAN 17 2012 i By 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 4'6250 -0925• Toll Free: 800.675 -0361 Local: 317 -SI7 -3000 Fax: 317-817-5151 HYLANT ndi aapoli IN 46280 -0925 INVOICE# 781 P age 'A GROUP Local: 317- .'WCOUNT,NQ CARME80 79 01/06/12 Urnk rclln Cormh!. �Sunh XC00000040 P ROD UCF R W. Michael W ells NCE:RUE 01/01/12 01/01/13 01/01/12 City of Carmel t Steve Engelking S 66,516.00 One Civic Square Carmel, IN 46032 INVOICE. If 781744 0!/01 /12 MEM UM -S XCO0000040 UMBRELLA National Casualty Company 66,516.00 CITY OF CARMEL $66,516 Invoice Balance: 66,516.00 as JAN 17 2012 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 Insurance Risk Management 40 VOUCHER NO. WARRANT NO. ALLOWED 20 Hylant Group IN SUM OF 301 Pennsylvania Parkway, Suite 201 Indianapolis, IN 46280 -0925 $543,656.00 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1205 781744 43- 475.00 $66,516.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1205 781741 43- 475.00 $173,630.00 materials or services itemized thereon for 1205 781993 I 43- 475.00 I $151,079.54 which charge is made were ordered and 781993 43- 475.00 $9,900.00 received except 09Z 781993 43- 475.00 $7,700.00 4q ao 781992 43- 475.00 $24,154.72 16 S71 781992 43- 475.00 $20,675.74 Friday, January 13, 2012 I I Z O 781992 43- 475.00 $17,740.54 781993 43- 475.00 $72,259.46 1 Director, Administration 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)) 01/06/12 781744 .$66,516.00 01/10/12 781741 $173,630.00 01/10/12 781993 $151,079.54 01/10/12 781993 $9,900.00 01/10/12 781993 $7,700.00 01/10/12 781992 $24,154.72 01/10/12 781992 $20,675.74 01/10/12 781992 $17,740.54 01/10/12 781993 $72,259.46 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 ,20 Clerk- Treasurer