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205880 01/31/2012 \,f CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1 0 ONE CIVIC SQUARE HYLANT GROUP CARMEL, INDIANA 46032 P 0 Box 40925 CHECK AMOUNT: $63,294.00 INDIANAPOLIS IN 460824910 CHECK NUMBER: 205880 CHECK DATE: 1/31/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4347500 781735 15.00 GENERAL INSURANCE 1091 4347500 781735 20,836.00 GENERAL INSURANCE 1125 4347500 781735 3,367.00 GENERAL INSURANCE 1091 4347500 781742 18,307.00 GENERAL INSURANCE 1125 4347500 781742 2,034.00 GENERAL INSURANCE 1125 4347500 781743 8,131.00 GENERAL INSURANCE 1091 4347500 781746 9,544.00 GENERAL INSURANCE 1125 4347500 781746 1,060.00 GENERAL INSURANCE <<^Yrcu t`ip' d n '%L a"..,"c„rc� Tp' Eff Date Trri Type Policy Descnption y 'Am ount LIM INVOICE 78173i 01/01/12 MEM PCKG 63058IM4076 PACKAGE Travelers Insurance Companies 24,218.00 PARKS PROPERTY, INLAND MARINE CRIME: $24,218 MONON $20,836, BEFORE SCHOOL $15, ALL OTHER $3,367 Invoice Balance: 24,218.00 Purchase JAN 13 2011 G scription I P CK QT- P.O. L11 `,zL- BY...... Line"Dt ��a1 -9�- Linebescr 4 3�75 pc Purchaser Date 1 Approval Dat 8.00 301 Pennsylvania Parkway Suite 201 P.O. Box 40925 Indianapolis, IN 46280 -0925 Toll Free: 800 678 -0361 Local: 317 817 -5000 Fax: 317- 817 -5151 Risk Management Insurance 401 Z HYLANT In P.O. Box 40925 dianapolis, IN 46280 -0925 Pa e l INVOICE# 781735 GROUP Local: 317- 817 -5000 i f4 \CC0UNT NO: CSR CARME80 79 01/06/12 Package 'Commercial 630581M4076 v A "P,RODUCER• W. Michael Wells E C09 0 Y EFFECTIVE±�S tK: E�PIRATION� �,�.'DALANCEDUEON� '.*a .a. a Ci of Carmel 01/01/12 01/01/13 01/01/12 'ATLIOUNT PZI at z.' G.l:..ar"_..uS PAD70UN'I' DUE_S.i,_..>. `1= Steve Engelking 24,218.00 One Civic Square Carmel, IN 46032 ;r' "'�".,4iTs-wi.^ '4...L�? C� T( .,;•:t fat r s .a;: 4 ,�iT �C�`' r'- ;•ss�``hJ�', r, s`, rat? v <s._'rY,i,"'"$ ,,�,�;^4., sue+ 1..i.> k s 'I r y s 5 w� EffDate V T�n ST e P,olic ;Descriptlonc+ w rt_ x?r ,Amount ,I �j �s Y•'. ::X1'1. 7•, 7+•t {YR Y zr #i G �,ai,L Y. t fix: "k: 4 lyt 1s .3' ::..rl b `��5.� S x .1.:7 :3�ti r✓L t .h xY" ._4 .s l: i r 5.a ry F YI T US s K,Y !l� kt 05" ,y `ri i {.'�Y j�. •s'� ..t 4.Z„ AL4C3LC '1_t_31k1- f�..�i1?wsis...�� t�s -.r INVOICE 781735 01/01/12 MEM PCKG 63058IM4076 PACKAGE Travelers Insurance Companies 24,218.00 PARKS PROPERTY, INLAND MARINE CRIME: $24,218 MONON $20,836, BEFORE SCHOOL $15, ALL OTHER $3,367 Invoice Balance: 24,218.00 0 C�� JAN 13 2Q12 (Imff 4t BY..................... -f 3 4- O, B3&. CC 1 081- 99- y 34750Q=. 1 oo a +n a l 218.00 301 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 LE4 unt INVOICE N 781742 01/01/12 MEM GL-S 14N99887 GENL LIAB Travelers Insurance Companies 20,34 1.00 PARKS: MONON $18,307, BEFORE SCH $0, ALL OTHER $2,034 Invoice Balance: 20341.00 J 151 1 Purchase De I-- MALI I ly I JAN 13 2012 1 P or F G. L. 10ql— T500 18,307,00 Budoet By Line Descr 2,0?)+,00 Purchaser ererni )naWcdr-r-f---2,, 4 Approval ate 1`1 Z �6" 7--r— 30IPennsylvania 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 Management lnsu�anqe 41 1 (k) "Investments Benefits 1 7HYLANT I pO Boo409 46280 -0925 INVOICE# 781 GROUP Local: 317- 817 -5000 y a, ''ACCOUNT•NO; 1. CSR�.,DATE r CARME80 79 01/06/12 General Liabilit 14N99887 ,il'RODUCERi W. Michael W ells ,rSEFFECTIVE:i E7C PIRA770 ElDUEON City of Carmel E c o py 01/01/12 01/01/13 01/01/12 J• u' qi his 5.. rtE}' k }Y` 5 'i:b ,,vr °.�z, AMOUNT.DUE ,h9b t.e tee, .,:AMOUNT:PAID,� ..a �i ..,...__.A_,.•., :ice. ..sE{ Steve Engelking 20,341.00 One Civic Square Carmel, IN 46032 -..a ri ,art, .::rte ,.y y Kk? n` jjt�. "�3#,.'- s��,.�3`"y"s ,�4.•;,��. }a'�`.;sL'9 �.+�e s. .ra�^,ry :rf, fi -�w�;r ,,t yee -�•E✓ •C r� y,..': f� s A A�. a 3 -'t. 'F� t hy" .S_ �'j`�, 4 k. Sfiv?'. 4 ,-w .3x` A£ p...� Y t F 1 v a x•�t :A h;.iN a �S.a.o �N�t�.) S r *'a a �x r _r ,ry•. ��..d i... Y, 1,3� a+� tt t� y ar'' A �x�• �:•tt3 �s"5'� v.0 f a. x'�,`� tf .:..��s,a <;t�� v; �t,�«.�r:�S`�.��'��5� v.� r �.v�.r....: �t� Zt�e.3* t$3_.'�u�i� ��5 >t _�.;.r� �.'3':t1..•:� �a'i'3�!s�. "�'t,�`. r, 7!2•s INVOICE 781742 01/01/12 MEM GL -S 14N99887 GENL LIAB Travelers Insurance Companies 20,341.00 PARKS: MONON $18,307, BEFORE SCH $0, ALL OTHER $2,034 Invoice Balance: 20,341.00 Kia ipnn JAN 13 2012 PnrF 5�Q 18 307.00 $Y: f !'Ctpt 2,0?+00 e a y'- 7jr r���c,c.� 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 1I.e..• u a a .i �1 o u- i e Eff Date Tm Ty Pe, Policy Y Descr p ion 7 a Amount INVOICE 781743 01/01/12 MEM CA -S 8103036P64A AUTO Travelers Insurance Companies 8,131.00 PARKS ALL OTHER $8,131 Invoice Balance: 8,131.00 O JAN 13 2011 BY:-* Purchase Description I .l i C) N�JIRAYI P.O.# -1 PorF G.L. l 1 aU Budget Line Descr�l TYl�llxc�l'l Purchaser Cute Approval r Date I 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 Management Insurance 401 B enefits HYLANT di napo109 46280 -0925 5 ,Pa e 1 Local: 317-817-5000 INVOICE 781743 gig: GROUP v h �CCOUNT.NO CARME80 79 01/06/12 Automobile"- Buslriess Simp 8103036P64A ����1!RODUCER'�,'� tY�._' <_...,.�s..r:!''KT �1,<+.._f�`' _e_._'i.+`r. ECOP W. Michael Wells `9 EFFECTIVE �At ni �.!F— xPIRATION BALAI�CEiDUE ON 01/01/12 01/01/13 01/01/12 City of Carmel htAINOUNT;P AID z I LN dB!W rta'sit 1, ,;'VNOUNTi6UE Steve Engelking 8,131.00 One Civic Square Carmel, IN 46032 -v a r v �v. -•5 .0 s a {F'c 7 1 ra^:. "t:t. �"'"�•P ..wa�?r`1'"`�'x`� sr s +.L c,,J�.:t�v,�!"�4"< "�pY��,'�7' t`�F �.j,�.r Y�'1�;,"',� e ,�•a s v�# ,'S.i` s �x.�,� K'�j i .s y. ,f x ""'S'xt' h•�FS;•=�.� 1. w F> -rr fi x S r:.L tJ4 ..7 tL 1 '�c' .t' a �'k 4.,-. r� C -s �i Y �t „�.,�a '+"'(..i31 v.'., '�fz.. .y�# 7�'� a s� f t z7i ..r.a»�....Et�:r�._'a't4a�t��e� u' ci: t., e..�.�s.��6E4cac+'t,.+s:�.s °e a* S�'.w �=r?,. 7 tL s x�.. c.-r1•4 +`yam- INVOICE 781743 01/01/12 MEM CA -S 8103036P64A AUTO Travelers Insurance Companies 8,131.00 PARKS ALL OTHER $8,131 Invoice Balance: 8,131.00 JAS[ 1 3 2012 By..... o w 1 a5_� =o -I Z� Lt �,00 Purch s, 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 �,�„�.A INVOICE 781746 01/01/12 MEM UM -S XC00000040 UMBRELLA National Casualty Company 10,604.00 PARKS: MONON $9,544 BEI`ORE SCH $0; ALL OTHER $10,604 Invoice Balance: 10.604.00 r r a RVS JAN 1 3 1011 By Purchase Description I NS Vt4Z�1Y1('E UYYLIe<<0.- P.O. ��P``or F G.l_.4 I �q� y W 47 0 i.I natrcxce q,5LI4-00 f ne Descr_ y 5gj50p Ge�'l. I r�Ltrc �(O ©,00 Purchaser Date, Approval ate_[�f J i (o G 4 o0 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 Management Insurance 401(k) Investments.- 'Benefits HYLANT P.O, Box 40925 Indianapolis, IN 46280 -0925 I 781746 Page CrRO UP Local: 317- 817 5000 VO E I e j •t •CSR, CARME80 79 01/06/12 Umbrella Comm't Slmp L E c F� XC00000040 %:PRODUCER, W. Michael Wells EFFECTIVE T.... ,.Tx1EXPIRA ALAIYCE:DUEO'V__..:' City of Carmel 01/01/12 01/01/13 01/01/12 AIOUNMPAID';E .`t::,tr.. .c__.:. x.�L r�AMOUNff Steve Engelking 10,604.00 One Civic Square Carmel, IN 46032 —f T any,. ;7 .a. ,'•-Sri 1 i.P` '1'T, vrf -,p.>� t4 r �.y S rsi„ c'^7 a Y w;,?' a q ..1. n�` w-t� >a.,,d Yt ihv?S' x.%- ,�,,.?"£;,v -r s" :fi'Y`e.� '�r. �l�., �''^B. i C`�St� r�^,`,. y tit rs;}'..;t� �'t���Ht'��Ea�. ax .S��.: x'S t.�s._. s.., vh..a� _::�'ta.�vd. <4.......?i'i�... 1..ax.w'_e.... 2t- :"r_;��:KS �si5F. _:a. .��i�.:4•A�ua4r��';mt>:✓:.t,.�. 4T �c:�.•_. a::._...e Ts?.u...�`t_�s __.>�a...rw:_.:��a�E INVOICE 781746 01/01/12 MEM UM -S XC00000040 UMBRELLA National Casualty Company 10,604.00 PARKS: MONON $9,544 BEFORE SCH $0; ALL OTHER $10,604 Invoice Balance: 10,604;00 JAN 13 2012 BY P.O. ForF l., 0 l- 4347500 Col, I n-- ci-c_e q ,5q 4.00 Pfg <t i..f'.;�? 1 r C.S ^,r_j W I �i11- 4 3'� 15W Gei'1. r1S(,U'c '1C OC ,O� 10, coG4.O� 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 a D E4 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 00352999 Hylant Group Terms P.O. Box 40925 Date Due Indianapolis, IN 46280 -0925 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 1/6/12 781735 Commercial package 3,367.00 1/6/12 781735 Commercial package 20,836.00 1/6/12 781735 Commercial package 15.00 1/6/12 781742 Liability insurance 18,307.00 1/6/12 781742 Liability insurance 2,034.00 1/6/12 781743 Auto insurance 8,131.00 1/6/12 781746 Insurance Umbrella 9,544.00 1/6/12 781746 Insurance Umbrella 1,060.00 Total 63,294.00 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 20_ Clerk- Treasurer Voucher No. Warrant No. 00352999 Hylant Group Allowed 20 P.O. Box 40925 Indianapolis, IN 46280 -0925 In Sum of 63,294.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund lob -ESE a, Id9 Mowai eEjQTF-F- PO# or INVOICE NO. CCT #[TITLI AMOUNT Board Members Dept 1125 781735 4347500 3,367.00 1 hereby certify that the attached invoice(s), or 1091 781735 4347500 20,836.00 bill(s) is (are) true and correct and that the 1081 -99 781735 4347500 15.00 materials or services itemized thereon for 1091 781742 4347500 18,307.00 which charge is made were ordered and 1125 781742 4347500 2,034.00 received except 1125 781743 4347500 8,131.00 1091 781746 4347500 9,544.00 1125 781746 4347500 1,060.00 26 -Jan 2012 Signature 63,294.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund